歯髄電気診断による歯髄疾患の臨床病理学的研究
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概要
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The purpose of this study was to assess the availability of the electric pulp tester (EPT) on the pulp disease. 149 teeth were tested with "Dentotest" (Swiss, Malk co. Ltd.). Specimens were investigated by histopathology. The correlation among clinical, EPT and pathologic diagnosis was evaluated utilizing the student-t test and chi-square test. The results and conclusions are as follows : 1) There is no significant difference in accordance rate between clinical (33.6%) and EPT (40.3%) diagnosis on the pulp disease, but the latter has an inclination to gain higher accordance rate. 2) As a poor correlation exists between threshold values of pulpal sensitivity to the EPT and the state of the pulp, thus pulp disease can not be diagnosed by EPT. 3) A significant difference in threshold values of pulpal sensitivity to the EPT between pathological vital (6.4±2.8) and non-vital (9.5±1.2) pulp is obtained (p<0.01). On the other hand, there is no significant difference in accordance rate between vital (85.7%) and non-vital (66.7%) pulp for clinical diagnosis, whereas a significant difference is observed for EPT diagnosis (vital : 94.3%, non-vital : 46.5%)(p<0.01). 4) There is no significant effect on the threshold values of pulpal sensitivity to the EPT in terms of sex, age, different teeth, number of roots, caries, fillings and periodontal status, whereas EPT may promote an increase of accordance rate. 5) It is observed that the fine nerve fibers accumulate and argyrophilic fibers increase at the inflammatory lesions in pulp hyperemia, acute serous pulpitis, localized acute suppurative pulpitis, chronic ulcerative pulpitis and ascending pulpitis, that is the reason why the threshold values of the EPT decreased. However, the threshold values of the EPT increase in generalized acute suppurative pulpitis, chronic closed pulpitis, acute gangrenous pulpitis and pulp necrosis (gangrene), because nerve fibers are degenerated, diminished and finally disappeared. From the mention above, we conclude that although the EPT can not diagnose the true state of the pulp, but it may play a important role in determing the vitality of a pulp. By the progress of immunohistochemistry, it is noted that the number of neuropeptide containing nerve fibers is increasing on the pulpal inflammation, but the function of neuropeptides in pulpitis is unknown, the further study is needed.
- 九州歯科学会の論文
- 1998-10-25
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