Adjunctive ionizing and non-ionizing methods for endodontic diagnosis
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Adjunctive ionizing and non‑ionizing methods for endodontic diagnosis Josanne O’Dell1 · Petra Wilder‑Smith2 Received: 31 July 2020 / Accepted: 27 August 2020 © Springer Nature Switzerland AG 2020
Abstract Endodontics is concerned with the prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. It is critical that an accurate diagnosis is made prior to any treatment. Each clinician will use their knowledge, experience as well as results of diagnostic tests to formulate an individual treatment plan for the patient. On occasion, it is not possible to elicit test results that pinpoint a definitive diagnosis. At best it may only be possible for the clinician to provide a list of possible differential diagnoses. More advanced technology may help the clinician gain additional information on which to base treatment decisions. This article will review the materials and instruments required to perform diagnostic tests for establishing a baseline. In addition, more advanced diagnostic tests will be reviewed. Keywords Endodontics · Adjunctive endodontic diagnostic methods · Ionizing endodontic methods · Non-ionizing endodontic methods
Quick reference/description Adjunctive diagnostic techniques are required for an accurate endodontic diagnosis when teeth do not respond to the common diagnostic tests performed by the clinician. These additional methods can provide valuable information about the pulp status, and the periapical and periodontal conditions of teeth. Therefore, following a proper sequence of steps including a clinical examination, performing prevalent diagnostic tests and adjunctive diagnostic methods aid in making a precise endodontic diagnosis and establishing a comprehensive treatment plan.
* Josanne O’Dell [email protected] 1
Department of Endodontics, University of Tennessee Health Science Center, 875 Union Avenue, Memphis, TN 38163, USA
2
School of Medicine, Beckman Laser Institute, University of California, 1002 Health Sciences Road, Irvine, CA 92612, USA
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Clinical Dentistry Reviewed
(2020) 4:21
Overview
Imaging modalities
Indications
Non-ionizing methods Pulse oximetry
– Determination of pulp vitality – Determination of pulp status after traumatic injury
Optical coherence tomography (OCT)
– Imaging of teeth, periodontal structures and restorative margins – Identification of vertical root fractures – To avoid inadvertent pulp exposure during tooth preparation – Monitoring of dentin bridge formation for information on outcome of pulp capping
Laser Doppler flowmetry (LDF)
– Measurement of pulpal blood flow to determine pulp vitality – Determination of pulp status after traumatic injury
Ultrasound imaging
– Evaluation of hard and soft tissues – Measurement of pulpal blood flow to determine pulp vitality – Aid in the accurate diagnosis of apical lesions – Monitor healing of lesions of endodontic origin
Magnetic resonance imaging (MRI)
– Detection of odontogenic cysts and tumors – Longitudinal eva
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