Accuracy of the American Association of Endodontists diagnostic criteria for assessing pulp health in primary teeth
Author | Dhillon, Ishreen Kaur |
Author | Hong, Catherine Hsu-Ling |
Author | Hu, Shijia |
Author | Sim, Yu Fan |
Author | Goh, Benny Kwee Chien |
Author | Duggal, Mandeep Singh |
Author | Sriram, Gopu |
Available date | 2023-11-19T05:45:36Z |
Publication Date | 2023 |
Publication Name | Clinical Oral Investigations |
Resource | Scopus |
ISSN | 14326981 |
Abstract | Objectives There is a lack of studies evaluating the accuracy of the 2009 American Association of Endodontists (AAE) diagnostic criteria for diagnosing pulpal health in primary teeth. This study aimed to estimate and correlate the diagnostic accuracy of clinical diagnosis of reversible and irreversible pulpitis using the 2009 AAE criteria with histological findings in primary teeth. Methods Eighty primary teeth that were clinically diagnosed with normal pulp (n = 10), reversible pulpitis (n = 30), irreversible pulpitis (n = 30) and pulp necrosis (n = 10) were collected. The teeth were histo-processed, and pulp tissues were diagnosed histologically as uninflamed pulp, reversible or irreversibly inflamed and necrosis based on previously proposed criteria. Results The clinical diagnosis of pulp necrosis (sensitivity 70%, specificity 96%) and normal pulp (sensitivity 91%, specificity 100%) matched the histological diagnosis of necrosis and uninflamed pulp in 70% and 100%, respectively. The clinical diagnosis of irreversible pulpitis (sensitivity 64%, specificity 72%) matched the histological diagnosis of irreversible pulp inflammation for 47% of teeth evaluated. For the clinical diagnosis of reversible pulpitis (sensitivity: 65%, specificity: 86%), 80% matched the histological diagnosis of reversible pulp inflammation. Teeth with histologically diagnosed irreversible pulp inflammation were more likely to have lingering (OR 5.08; 95% CI 1.48–17.46, P = 0.010) and nocturnal tooth pain (OR 15.86; 95% CI 1.57–160.47, P = 0.019) when compared to teeth with reversible pulp inflammation. Using the classification and regression tree model, the presence of widened periodontal ligament space and nocturnal tooth pain were useful predictors of irreversible pulp inflammation with an accuracy of 78%. Conclusion The 2009 AAE criteria was acceptable for primary teeth with pulp necrosis and normal pulp but poor for reversible pulpitis and irreversible pulpitis. |
Sponsor | This study was supported by a post-graduate grant from the Faculty of Dentistry, National University of Singapore, and partially supported by Singapore Ministry of Education Academic Research Fund Tier 1 (A-8000071-00-00). |
Language | en |
Publisher | Springer Science and Business Media Deutschland GmbH |
Subject | Dental pulp diseases Diagnosis Histology Sensitivity and specificity Tooth, deciduous |
Type | Article |
Pagination | 6043-6053 |
Issue Number | 10 |
Volume Number | 27 |
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Dental Medicine Research [285 items ]