Reliability of Electric Pulp Test, Cold Pulp Test or Tooth Transillumination to Assess Pulpal Health in Permanent Dog Teeth

The aim of this study was to evaluate the reliability of electric pulp test (EPT), cold pulp test (CPT) and tooth transillumination (TTI) in the assessment of pulpal health in dog teeth. Forty-five client-owned dogs requiring tooth extraction or pulpectomy were included. For each patient, one affected and two control healthy teeth were evaluated with EPT, followed by CPT and TTI. Direct pulp inspection was used as a gold standard. The real pulpal health (vital or necrotic) was determined by the presence or absence of bleeding after creating access to the pulp chamber. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of EPT, CPT and TTI were obtained for each pulp test using the binomial Clopper-Pearson exact method to establish confidence intervals. Forty-five affected teeth were tested. Forty-three were tested with EPT, CPT, and TTI, and two were tested solely with EPT and CPT. All dogs tested with EPT and TTI were included in the study whereas 21 out of 45 (47%) dogs tested with CPT were excluded. The sensitivity, specificity, PPV, NPV and accuracy were respectively 0.96, 1.00, 1.00, 0.96 and 0.98 for EPT; 1.00, 0.89, 0.92, 1.00 and 0.95 for CPT; and 0.59, 0.95, 0.94, 0.67 and 0.76 for TTI. This study concluded that EPT is a highly reliable diagnostic test to evaluate pulpal health in dogs. The high accuracy of CPT is conditional on the patient's responsiveness to stimulation applied to its control healthy teeth. TTI was the least reliable test in the study.

Vibrotactile evaluation: osseointegrated versus socket-suspended transfemoral prostheses

This study investigated detection thresholds of vibrometric stimuli in patients with transfemoral amputation supplied with osseointegrated (OI) and socket-suspended prostheses. It included 17 patients tested preoperatively with socket-suspended prostheses and after 2 yr with OI prostheses and a control group (n = 17) using socket-suspended prostheses, evaluated once. Assessments on the prosthetic and intact feet were conducted at six frequencies (8, 16, 32, 64, 125, and 250 Hz). Furthermore, measurements were conducted to investigate how vibrometric signals are transmitted through a test prosthesis. The results showed that the OI group had improved ability to detect vibrations through the prosthesis at 125 Hz (p = 0.01) at follow-up compared with the preoperative measurement. Compared with the control group, the OI group at follow-up had better ability to detect high frequency vibrations through the prosthesis (125 Hz, p = 0.02; 250 Hz, p = 0.03). The vibrometric signal transmitted through the test prosthesis was reduced at 8, 125, and 250 Hz but was amplified at 16, 32, and 64 Hz. Differences between the OI and the control groups were found in the highest frequencies in which the test prosthesis showed reduction of the vibrometric signal. The study provides insight into the mechanisms of vibration transmission between the exterior and bone-anchored as well as socket-suspended amputation prostheses.