Authors: Fuss Z, Trowbridge H, Bender IB, Rickoff B, Sorin S.
Title: Assessment of reliability of electrical and thermal pulp testing agents.
Journal: J Endod
Date: Jul 1986
Citation: 12(7):301-5
Category: Diagnosis and Case Selection
Evidence-based Ranking: 1
Purpose/Objective: To determine in vivo the accuracy of carbon dioxide snow and dichlorodifluoromethane in comparison to ethyl chloride (Endo-Ice), ice and EPT and to assess in vitro the degree of temperature change occurring in the pulpodentinal border zone following application of cold testing agents. DDM: prohibited use (1996) – 21.6 degrees F CO2 Snow: -77.7 degrees C or –108 degrees F

Materials and methods: 24 subjects with ages 9-34 were included in the study. Electric and thermal vitality tests were conducted on 96 clinically sound premolars (2 maxillary and 2 mandibular). EPT, ice, ethyl chloride, CO2 Snow, DDM were tested. Each subject was instructed to indicate if they experienced reaction to the tests. A negative response was evoked after 2 successive 15s application of the agent. 10 endodontically treated teeth served as control.

Results: The EPT, CO2 Snow, and DDM were found to be statistically more effective in eliciting a positive response than ice or ethyl chloride. The EPT was significantly less effective than CO2 Snow and DDM when used in a younger age group.

Conclusion: The results indicate that DDM, CO2 Snow and EPT are equally reliable in adult patients. However, DDM and CO2 Snow are more reliable than EPT in young patients. CO2 Snow is the most efficient cold testing method. DDM and CO2 Snow produced a considerably greater decrease in temperature than did ice and ethyl chloride.

Reviewer’s comments: Good article showing the probable indications of using specific cold tests and EPT as it applies to old and young patients.