Heat testing methodology comparison.

Abstract

Pre-operative pulpal and periapical diagnosis is critical for effective and appropriate endodontic treatment. Occasionally patients present with a chief complaint involving hypersensitivity to heat – a hallmark sign of irreversible pulpitis. In an attempt to replicate this chief complaint, a variety of clinical methods have been developed to deliver a heat stimulus to a tooth. Friction from a burlew wheel, heated gutta-percha, a heated instrument, and hot water have all been used to warm teeth. Recently, an instrument has been developed which is heated electronically and placed directly against a tooth. The aim of this study was to determine which of these methods produces the most consistent temperature rise within the pulp of a tooth. The value of this consistency is that it allows clinical differentiation between a normal pulp and a pulp demonstrating irreversible pulpitis. The present study used extracted maxillary teeth with thermocouples mounted within the pulp chamber. Four operators applied the following methods to the teeth: heated gutta-percha, heated ball burnisher, hot water, and an electronic probe attached first to a System B™ and then to an Elements™ unit. Each test was performed for 60 seconds, and the temperature recorded every half-second. Analysis of the data revealed the most consistent warming of the pulp was accomplished with the electronic probe attached to the Elements™ unit. The lowest level of consistency was found with hot water. The electronic probe also yielded temperature changes which were more consistent between operators compared to the other three methods.