Authors: Hill CM.
Title: The efficacy of transillumination in vitality tests.
Journal: Int Endod J
Date: Jul 1986
Citation: 19(4):198-201
Category: Diagnosis and Case Selection
Evidence-based Ranking: 4
Purpose/ Objectives: Two small studies designed to assess the usefulness of transillumination for testing tooth vitality.

Materials & Methods: Two experiments were performed with a flexible 5-inch battery-powered optic fiber light. First part of the experiment, 31 observers were issued a standard set of instruction to examine the upper left quadrant of the authorÂ’s mouth. Second experiment, single observer trial on 100 patients who were waiting for a tooth to be extracted. The results of transillumination were recorded. The results of ethyl chloride were also recorded to compare the relative efficacy. The extracted teeth were examined histologically and categorized into: normal, partial pulpitis, partial pulpitis with necrosis, complete pulpitis with necrosis, and complete necrosis. The results of the histological examination were compared with the clinical tests.

Results: As seen on Table I, there were 4 possibilities: 1. vital tooth with positive transillumination. 2. vital tooth with negative transillumination. 3. non-vital tooth with positive transillumination. 4. non-vital tooth with negative transillumination. 1 and 4 both support the effectiveness of transilluminatin. In table II, results of histological examination are shown. The results of ethyl chloride testing are shown in Table III.

Discussion: The author suggests that the transillumination could be a useful adjuvant to conventional methods of pulp testing. With the limitation of large amalgam restorations that effect the translucency and the frequently false diagnonsis of the tooth that is non-vital

Validity of Conclusion: questionable

ReviewerÂ’s Comments: Poorly designed study, not reproducible. The transilluminate interpretation can be a very subjective. Also, why was ethyl chloride used instead of carbon dioxide snow or dichlorodifluromethan.