2. Two type
1. Cold test 2. Heat test
Cold test
When cold is applied , the fluid in the
dentinal tubules contracts and a net outward
flow of the fluid occurs.
There is fall in intrapulpal pressure when
the cold is applied. It is stimulate the A δ
nerve fiber.
3. Cold drinks , ice stick , Ethyl chloride , Solid
Co2, dry ice.
The tooth should be isolated and soft tissue
should be protected with 2” * 2” gauze.
It is started from the most posterior teeth.
Co2 stick is applied on the facial aspect of the
tooth.
Due to low temp soft tissue burn can occur. (-
56 °C to -96 °C)
Other method : refrigerant spray (1,1,1,2-
tetrafluroethane)
Temp is -26.2 °C
Applied on the tooth with the cotton pellet
4.
5. Interpretation
1) Similar response that of contra lateral
tooth :- normal pulp
2) Lingering quality of pain :- Irreversible
pulpitis
3) Pain is subside immediately :-Reversible
pulpitis
4) No response :- non vital pulp
6. Heat test
Heat cause vasodilation and subsequence
increase in the intrapulpal pressure.
It stimulate the slower conducting c fibers
and results in dull pain for longer duration.
Hot water , heated gutta percha , hot
burnisher , hot compound is use.
It usually applied on the junction of cervical
and middle third area .
Temp greater then 65.6 °C is sufficient to
elicit response.
8. Electric pulp tester is an instrument that
uses gradations of electric current to
excite a response from susceptible
elements of the pulp tissue.
Principally the A δ fibres that are
stimulated by controlled electric current
and the patient feels a “tingling” or
“warming” sensation.
Instrument such as dentometer and
digitest are use.
9.
10. Steps
1. Describe the test to the patient.
2. Isolate the area.
3. Apply an tooth paste (electrolyte) on
tooth (occlusobuccal or incisolabial) do
not contact it with the restoration.
4. Retract the patient cheek and away from
the tooth, and electrode circuit is
completed by either asking the patient to
touch the metal handle or using lip clip.
5. Turn on the rheostat slowly and then
increase the current slowly.
6. When patient feel tingling sensation
record that results according to the scale
on the pulp tester.
11. Incisal 3rd of anterior teeth
and mid 3rd of posterior
teeth are the area where
the pulp tester should be
place. (high nerve density)
12. The level of response is affected by
factors like:
• enamel thickness
• probe placement
• dentin calcification
• interfering restorative materials
• patient’s level of anxiety
13. Interpretation
1. Normal response :- a positive response
which similar to that of control tooth.
2. Negative response :- non vital tooth
3. Early response :- diseased state of pulp
when the tooth responds to a threshold
which less than control tooth.
4. Delayed response :- :- diseased state of
pulp when the tooth responds to a higher
threshold level than control tooth.
5. False positive response :- gangrenous
necrotic pulp and multirooted teeth in
which the pulp is partially necrotic and
some fibers are still vital.
14. 6. False negative response :-
• Extensive calcification in the pulp tissue.
• Increased reparative dentin formation and a
diminished pulp cavity.
• Fibrotic pulp
• Teeth with excessive restoration.
• Recently traumatized teeth.
• Recently erupted teeth with incomplete root
formation.
• sedative medication taken by patient.
