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Validity of preoper...
Validity of preoperative clinical findings to identify dental pulp status : A National Dental Practice-Based Research Network Study
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- Pigg, Maria (author)
- Malmö högskola,Odontologiska fakulteten (OD)
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- Nixdorf, Donald R. (author)
- Division of TMD and Orofacial Pain, University of Minnesota, Minneapolis, MN, United States; Department of Neurology, Medical School, University of Minnesota, Minneapolis, MN, United States; HealthPartners Institute for Education and Research, Bloomington, MN, United States
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- Nguyen, Ruby H.N. (author)
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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- Law, Alan S. (author)
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, MN, United States; Private Practice, Dental Specialists, Lake Elmo, MN, United States
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(creator_code:org_t)
- Elsevier, 2016
- 2016
- English.
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In: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 42:6, s. 935-942
- Related links:
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https://europepmc.or...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- INTRODUCTION: Endodontic diagnostic tests are often used clinically to assess pulp status as a basis for the diagnosis and determination of whether root canal treatment (RCT) is indicated. Response to cold and pain on percussion are 2 common tests, yet their validity in identifying nonvital pulp in regular dental practice has not been reported. METHODS: We assessed the validity of cold and percussion tests to identify nonvital pulp in teeth requiring RCT in a dental practice setting performed by 46 general dentists and 16 endodontists in the National Dental Practice-Based Research Network. The influence of patient-, tooth-, and dentist-related characteristics was investigated. Observed bleeding from the pulp chamber was the clinical reference. Sensitivity (SN), specificity (SP), overall test accuracy (TA), positive (PPV) and negative (NPV) predictive values, and likelihood and diagnostic odds ratios (LR+, LR-, dORs) were calculated for each single test and the combined cold and percussion tests. RESULTS: Seven hundred eight patient teeth were included. Cold test showed high validity to identify a nonvital pulp status (SN = 89%, SP = 80%, TA = 84%, PPV = 81%, NPV = 88%, LR+ = 4.35, LR- = 0.14, dOR = 31.4), whereas pain on percussion had lower validity (SN = 72%, SP = 41%, TA = 56%, PPV = 54%, NPV = 60%, LR+ = 1.22, LR- = 0.69, dOR = 1.78). Combining the 2 tests did not increase validity, whereas preoperative pain, medication intake, patient age and sex, and dentist training level affected test validity significantly. CONCLUSIONS: In regular dental practice, the cold test exhibits higher validity to discriminate between vital and nonvital pulp than the tooth percussion test.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Odontologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Dentistry (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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