Assessment of pulps vitality for children and adolescents.

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Noy AF, Fuks A. Assessment of pulps vitality for children and adolescents. Refuat Hapeh Vehashinayim 2010 27;13-6.73	Gopikrishna V, Pradeep G, Venkateshbabu N. Assessment of pulp vitality: a review. Int J Paediartr Dent 2009;19:3-15.
Accurate assessment of pulp status is one of the greatest diagnostic challenges in clinical practice. This may be further complicated in children and adolescent where the practitioner is faced with different situations such as: primary teeth, developing permanent dentition, traumatized teeth, patients undergoing orthodontic treatment. In addition, the dentist is frequently faced with young children who have limited ability to recall a pain history or cooperate with the test itself. A variety of pulp testing approaches exist, and there may be a confusion as to their validity in different clinical situations. Sensitivity tests include thermal testing and Electric Pulp Test. Their limitation is the possibility to get false positive or false negative results. Their primary limitation lies in the fact that they test the sensory response of the tooth, which can be temporarily lost after dental trauma. A more accurate assessment of pulp vitality would be made by determining the presence of a functioning blood supply with the use of Laser Doppler Flowmetry or Pulse Oximetry. This paper provides the clinician with a comprehensive review of current pulp testing methods and allow greater insight into the interpretation of pulp testing results, especially in young patients.	One of the greatest diagnostic challenges in clinical practice is the accurate assessment of pulp status. This may be further complicated in paediatric dentistry where the practitioner is faced with a developing dentition, traumatized teeth, or young children who have a limited ability to recall a pain history for the tooth in question. A variety of pulp testing approaches exist, and there may be confusion as to their validity or appropriateness in different clinical situations. Aim.The aim of this paper is to provide the clinician with a comprehensive review of current pulp testing methods. A key objective is to highlight the difference between sensitivity testing and vitality testing. A biological basis for pulp testing is also provided to allow greater insight into the inter- pretation of pulp testing results. The rationale for, and methods of, assessing pulpal blood flow are described.