The Effect of Dental Flourosis on the Electric Pulp Tester Response and Probe Placement Site.

Abstract

Introduction:  The probe placement site for an electric pulp tester. (EPT) will have a significant outcome for the threshold readings. These relationships in previous studies have been documented. As dental flourosis is an endemic in regions of Pakistan the aim of this study was to compare and determine the appropriate EPT probe placement sites on fluorotic and non flourotic teeth. Methodology: In this cross-sectional clinical study equal number of flourotic and non flourotic maxillary central incisors(40 volunteers)  were selected from a known region of Pakistan for endemic of flourosis to measure threshold levels on EPT on four different parts of each tooth. (Incisal edge, incisal third, middle third and cervical third). Before the readings were taken flourotic teeth were also categorized on the bases of severity (Deans Index).The purpose was to assess if severity of dental flourosis had an impact on the EPT readings.  Once the mean values were taken the Dunn–Bonferroni post hoc tests was used to assess the statistical significance (p<0.05) between the four site in both groups. Results:  Mean values from the EPT presented that the threshold values increased from incisal to cervical in gender and both age groups i.e. 20-29 and 30-40. It was also found that the threshold values increased from incisal edge to the cervical third in flourotic and non flourotic teeth. Statical significance was found between the reading of flourotic and non flourotic groups across the four probe site readings taken (p value= 0.00).  Like previous literature the insical edge was considered the most ideal site for EPT assessment on anterior incisors. As this is where the lowest threshold response was recorded in our study .Dental flourosis does have a significant effect on the EPT threshold values. This is most likely due to structural changes because of dental flourosis. Recommendations: From the study conducted it can be recommended that clinicians need to be aware of the fact that fluorotic teeth response will vary from natural teeth on the EPT. Also further research needs to be done to assess if other vitality test methods will also alter in their response due to dental defects like flourosis.