Intraoral Somatosensory Alterations Impact Pulp Sensibility Testing in Patients with Symptomatic Irreversible Pulpitis

Author(s)

Costa, Yuri M. ^[1] ; de Souza, Paulo Roberto J. ^[2] ; Marques, Vanessa A. S. ^[2] ; Conti, Paulo Cesar R. ^[3] ; Vivan, Rodrigo R. ^[2] ; Duarte, Marco Antonio H. ^[2] ; Bonjardim, Leonardo R. ^[4]

Affiliation

^[1] Univ Estadual Campinas, Piracicaba Dent Sch, Dept Biosci, Av Limeira 901, BR-13414903 Piracicaba, SP - Brazil

^[2] Univ Sao Paulo, Bauru Sch Dent, Dept Dent Endodont & Dent Mat, Bauru, SP - Brazil

^[3] Univ Sao Paulo, Bauru Sch Dent, Dept Prosthodont, Bauru, SP - Brazil

^[4] Univ Sao Paulo, Bauru Sch Dent, Dept Biol Sci, Sect Head & Face Physiol, Bauru, SP - Brazil

• Document type: Journal article
• Source: JOURNAL OF ENDODONTICS; v. 46, n. 6, p. 786-793, JUN 2020.
• Web of Science Citations: 1

Abstract

Introduction: This case-control study aimed to compare trigeminal somatosensory sensitivity between patients with a clinical diagnosis of symptomatic irreversible pulpitis (n = 33) and healthy participants (n = 33) and to evaluate the impact of somatosensory stratification of symptomatic irreversible pulpitis on pulp sensibility testing. Methods: A standardized battery of qualitative sensory assessment measured intra- and extraoral sensitivity to touch, cold, and pinprick stimuli. Dental pain intensity (0-100, numeric rating scale) and duration (seconds) evoked by cold stimuli (refrigerant spray) were applied to, respectively, the nonaffected and affected tooth (cases) and the upper right and left premolars (controls); z score transformation, analysis of variance (ANOVA), and chi-square tests were applied to the data (P <.050). Results: Patients with irreversible pulpitis reported intraoral hypersensitivity more frequently than healthy participants (58% and 33%, respectively; P<.05). In addition, patients with irreversible pulpitis reported higher z scores of pain intensity (ANOVA main effects, F = 37.10, P<.05, partial eta(2) = 0.37) and duration (ANOVA main effects F = 23.3, P<.05, partial eta(2) = 0.27) after the pulp sensibility test compared with healthy participants. Nevertheless, subgroup analysis taking into account the presence of intraoral hypersensitivity indicated that the pain lingered most for patients with symptomatic irreversible pulpitis who also presented intraoral hypersensitivity (Tukey test, P<.05) but with no differences between patients with irreversible pulpitis without intraoral hypersensitivity and healthy participants (Tukey test, P<.05). Conclusions: QualST is able to detect intraoral alterations in patients with symptomatic irreversible pulpitis that seem useful to stratify the patients into distinct subgroups. Therefore, somatosensory assessment of the adjacent tissues may provide diagnostic fine-tuning of dental pulp diseases. (AU)

• FAPESP's process: 19/06035-7 - Effect of transcutaneous electrostimulation on the analgesic efficacy of anesthetic blockade of the inferior alveolar nerve in irreversible pulpitis: A placebo-controlled randomized clinical trial.
• Grantee: Leonardo Rigoldi Bonjardim
• Support Opportunities: Regular Research Grants
• FAPESP's process: 15/09913-4 - The effect of cutaneous afferents in the mechanical somatosensory profile of masticatory myofascial pain.
• Grantee: Yuri Martins Costa
• Support Opportunities: Scholarships in Brazil - Post-Doctoral