Evaluation of Dental Pulp Vitality in Reversible Pulpitis Using Laser Doppler Flowmetry and Electric Pulp Testing

Abstract

Introduction: Accurate assessment of pulp vitality is a critical component in the diagnosis and formulation of treatment plans in endodontic practice. Electric Pulp Testing (EPT) is routinely used by dental practitioners to evaluate neural response; however, its ability to reflect the true histological status of the pulp—particularly in cases of reversible pulpitis—remains limited. In contrast, Laser Doppler Flowmetry (LDF), a non-invasive technique that measures pulpal blood flow, offers a more direct physiological assessment and may serve as a reliable alternative to conventional methods in determining pulp vitality.

Materials and Methods: This diagnostic study was conducted over a 12-month period from March 2022 up until March 2023 at the Dental Section of Punjab Medical College, Faisalabad. A total of 93 patients clinically diagnosed with reversible pulpitis were enrolled. Each participant underwent pulp vitality evaluation using both EPT and LDF. The diagnostic accuracy of each method was assessed by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Comparative analysis between the two modalities was performed using the paired t-test and chi-square test, with a significance level set at p < 0.05.

Results: Of the 93 participants, 46 (49.5%) were male and 47 (50.5%) were female, with a mean age of 28.84 ± 6.47 years. EPT indicated pulp vitality in 76 patients (81.7%), while LDF detected vitality in 81 patients (87.1%). The diagnostic performance of EPT demonstrated a sensitivity of 80.2%, specificity of 8.3%, PPV of 85.5%, and NPV of 5.8%. Statistical analysis using the paired t-test revealed a significant difference between EPT and LDF readings (t = 4.12, p = 0.0001). However, the association between the two diagnostic approaches was not statistically significant based on the chi-square test (χ² = 0.31, p = 0.5789).

Conclusion: Laser Doppler Flowmetry offers a more physiologically accurate and diagnostically reliable method for assessing pulp vitality in cases of reversible pulpitis compared to Electric Pulp Testing. Incorporating LDF into routine endodontic diagnostics may enhance treatment precision and clinical outcomes. Further research with larger sample sizes and long-term follow-up is recommended to validate these findings.