Comparison of the efficacy of a custom-made pulse oximeter probe with digital electric pulp tester, cold spray, and rubber cup for assessing pulp vitality

Abstract

Introduction: The ideal technique for the evaluation of pulp vitality should be noninvasive, painless, objective, reliable, and reproducible. To achieve this, the most routine tests are sensitivity tests. However, a major shortcoming with these tests is that they indirectly indicate pulp vitality by measuring a neural response. Pulse oximetry is a well-established oxygen saturation monitoring technique broadly used in medicine. However, its efficacy as the pulp vitality test should be evaluated. The aim of this study was to design and build a custom-made pulse oximeter dental probe and to evaluate its efficacy in comparison with electric pulp tester, cold spray, and a rubber cup in pulp vitality testing.

Methods: Twenty-four single-canal mandibular premolars needing endodontic treatment were selected. The patients did not have systemic disease and did not consume drugs. Also, they had no clinically relevant signs of necrosis. The selected teeth were pulpally tested with 4 kinds of tests including pulse oximetry, the electric test, cold spray, and the rubber cup. After endodontic treatment of these teeth, which revealed the actual status of the pulp, the results were analyzed by the kappa test to show the efficacy of these tests.

Results: When comparing electric, cold, heat, and pulse oximeter tests with the gold standard, the kappa agreement coefficient was 18%, 18%, 14%, and 91%, respectively. The sensitivity of pulse oximetry, a rubber cup, electric test, and cold spray was 0.93, 0.60, 0.60, and 0.53, respectively. The specificity of these tests was 1.00, 0.55, 0.22, and 0.66, respectively.

Conclusions: Pulp testing by using pulse oximetry is more reliable than the electric test, rubber cup, and cold spray. The custom-made pulse oximeter dental probe is an effective and objective method for pulp vitality assessment.