DefinePK

Abstract

Objective: To determine the diagnostic accuracy of cold test and electric Pulp testing for testing pulp vitality in single rooted teeth with irreversible pulpitis
Materials & Methods: This cross-sectional study validation study was carried out in the Operative dentistry department at Rehman College of Dentistry Peshawar, from January 2019 to June 2019. Non-probability consecutive sampling technique was used. Expected sensitivity was 0.94 and expected specificity was 0.92, keeping β-error (precision) 6% and α-error (confidence interval) 95%, sample size was calculated. A total of 120 participants with the history of irreversible pulpitis were included in the study. Teeth were cleaned and ionic medium (toothpaste) was applied to the diseased tooth. An electric pulp tester (EPT) and refrigerant spray (cold test) was used to apply at the mid of facial surface of teeth. Positive response to the electrical stimulus was recorded as ‘vital’ while absence of response showed that tooth is ‘non-vital. The sensitivity, specificity, positive predictive value negative predictive value and the overall accuracy for both cold test and EPT was calculated.
Results:  On clinical observation 81(45%) teeth were non-vital and 99(55%) were vital. The Sensitivity and specificity of EPT was 94.95% and 92.59% respectively and diagnostic accuracy of EPT was 93.89%. The diagnostic values of cold test were lesser than EPT.  The Sensitivity and specificity of cold test was 77.78% and 75.31% respectively. And diagnostic accuracy of cold test was 76.67%.
Conclusion: The electric pulp test is more reliable than cold test in diagnosing pulp vitality. The cold test sensitivity was higher in males, but specificity was higher in females. Age has no association with the accuracy of EPT and cold test in diagnosis of pulp vitality.