Prognostication & the Exclusion !!

[endodontist]

What are the AAE rationale by Excluding the Pulp Vitality from the prognostication of Tx-outcome ??
any Clues ??

Although it has been stated in Dec. issue 2009 JOE by the AAE which stated
Co2 test is accurate upto 90% according to petersson study
which is merely close to the "gold standard" !! However,It is more logic for not accepting the R.G as a tool where its PPV and/or NPV never reached 60 - 70 % " far far away from gold standard " !! this sounds quite strange !!
Beside that, abscence of PEARL which include " vital / non-vital+non-infected / non-vital+infected+wo PEARL ) are being given a prognostication range of 11% !! dont you think this could be confounded ??

Any Answers !!

[Khaled Balto]

That is a good question and detailed analysis.....from the top of my head....vitality of dental pulps can not be measured directly. All the clinical tests used up to date are just estimation of vitality and non of them measure it.

If you noticed the term "vitality tests" have been excluded from almost all the new text books. The term viability has been used instead and others have been advocating sensibility.

The current pulp tester just give an indication of the vaiblity of nerve endings but not the blood supply....what do you think?

[Wajih]

AS far as I know, pulse doppler is the only mean to findout vitality of tissue within the pulp chamber. The rest of tests are better called as sensitivity tests, as above mentioned. Doppler scans are at the moment not feasable at chairside scale.