Article Data

  • Views 787
  • Dowloads 155

Original Research

Open Access

Blood Gas Tension and Acidity Level of Caries Exposed Vital Pulps in Primary Molars

  • Aviv Shmueli1,*,
  • Marcio Guelmann2
  • Nili Tickotsky3
  • Rinat Ninio-Harush1
  • Avia Fux Noy1
  • Moti Moskovitz1

1Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel

2University of Florida College of Dentistry, Gainesville, USA

3Weizmann Institute of Science, Rehovot, Israel

DOI: 10.17796/1053-4625-44.6.5 Vol.44,Issue 6,November 2020 pp.418-422

Published: 01 November 2020

*Corresponding Author(s): Aviv Shmueli E-mail: aviv.dentist@gmail.com

Abstract

Objective: The purpose of this study was to determine if gas tension and acidity levels could serve as biomarkers of pulp inflammatory status in primary dentition. Study design: The present study evaluated acidity level and blood partial pressures of O2 and CO2 collected from vital pulp chambers of 84 primary molars with deep carious lesions encroaching the pulp. Teeth were treated with pulpotomy or pulpectomy based on clinical judgement. Pulpectomy was performed when symptoms of spontaneous pain, difficulty in obtaining hemostasis and/or dark purple blood were present. Using a glass capillary, pulp chamber bleeding was collected and within ten minutes a neonate Astrup test was performed to determine blood gas module pH, pCO2, and pO2. Results: Eighty-four children with one affected tooth participated in the study (37 girls and 47 boys). Age ranged between 3.5 to 9-years (average: 5.3 years). Seventy-one (84%) were treated with the aid of inhalation analgesia, conscious sedation or general anesthesia. Pulpotomy was performed on 58 teeth (69%). Teeth undergoing pulpectomy revealed significant higher level of CO2 partial pressure (P= 0.002). Acidity level values (pH) were also lower but none significantly in teeth with pulpectomy (P= 0.137). Conclusions: Higher pCO2 levels was found in pulps needing pulpectomy.


Keywords

Blood gas monitoring; Acidity levels; Biomarkers; Primary dentition

Cite and Share

Aviv Shmueli,Marcio Guelmann,Nili Tickotsky,Rinat Ninio-Harush,Avia Fux Noy,Moti Moskovitz. Blood Gas Tension and Acidity Level of Caries Exposed Vital Pulps in Primary Molars. Journal of Clinical Pediatric Dentistry. 2020. 44(6);418-422.

References

1. Smaïl-Faugeron V, Courson F, Durieux P, Muller-Bolla M, Glenny AM, Fron Chabouis H. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst Rev. 6(8):CD003220, 2014.

2. Heyeraas KJ, Berggreen E. Interstitial fluid pressure in normal and inflamed pulp. Crit Rev Oral Biol Med. 10(3):328-36, 1999.

3. Ricucci D, Loghin S, Siqueira JF Jr. Correlation between clinical and histologic pulp diagnoses. J Endod. 40(12):1932-9, 2014.

4. Kearney M, Cooper PR, Smith AJ, Duncan HF. Epigenetic Approaches to the Treatment of Dental Pulp Inflammation and Repair: Opportunities and Obstacles. Front Genet. 7; 9:311, 2018.

5. Smaïl-Faugeron V, Glenny AM, Courson F, Durieux P, Muller-Bolla M, Fron Chabouis H. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst Rev. 31;5:CD003220, 2018.

6. Dhar V, Marghalani AA, Crystal YO, Kumar A, Ritwik P, Tulunoglu O, Graham L. Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions. Pediatr Dent. 39(5):146-59, 2017.

7. Waterhouse PJ, Nunn JH, Whitworth JM, Soames JV. Primary molar pulp therapy-histological evaluation of failure. Int J Paediatr Dent. 10(4):313- 21, 2000.

8. Pulp Therapy for Primary and Immature Permanent Teeth. Pediatr Dent Reference Manual V40/NO6 18/19 343-351, 2018.

9. Hyman JJ, Cohen ME. The predictive value of endodontic diagnostic tests. Oral Surg Oral Med Oral Pathol. 58(3):343-6, 1984.

10. Maltos KL, Menezes GB, Caliari MV, Rocha OA, Santos JM, Alves DL, Duarte ID, Francischi JN. Vascular and cellular responses to pro-inflammatory stimuli in rat dental pulp. Arch Oral Biol. 49(6):443-50, 2004.

11. Martin FE. Carious pulpitis: microbiological and histopathological considerations. Aust Endod J. 29(3):134-7, 2003.

12. Eltzschig HK, Carmeliet P. Hypoxia and inflammation. N Engl J Med. 364(7):656-65, 2011.

13. da Rosa WLO, Piva E, da Silva AF. Disclosing the physiology of pulp tissue for vital pulp therapy. Int Endod J. 51(8):829-46, 2018.

14. Mente J, Petrovic J, Gehrig H, Rampf S, Michel A, Schürz A, Pfefferle T, Saure D, Erber R. A Prospective Clinical Pilot Study on the Level of Matrix Metalloproteinase-9 in Dental Pulpal Blood as a Marker for the State of Inflammation in the Pulp Tissue. J Endod. 42(2):190-7, 2016.

15. Piattelli A, Rubini C, Fioroni M, Tripodi D, Strocchi R. Transforming growth factor-beta 1 (TGF-beta 1) expression in normal healthy pulps and in those with irreversible pulpitis. Int Endod J. 37(2):114-9, 2004.

16. Di Nardo Di Maio F, Lohinai Z, D’Arcangelo C, De Fazio PE, Speranza L, De Lutiis MA, Patruno A, Grilli A, Felaco M. Nitric oxide synthase in healthy and inflamed human dental pulp. J Dent Res. 83(4):312-6, 2004.

17. Bruno KF, Silva JA, Silva TA, Batista AC, Alencar AH, Estrela C. Characterization of inflammatory cell infiltrate in human dental pulpitis. Int Endod J. 43(11):1013-21, 2010.

18. Rechenberg DK, Galicia JC, Peters OA. Biological Markers for Pulpal Inflammation: A Systematic Review. PLoS One. 11(11): e0167289, 2016.

19. Stella JP, Barletta FB, Giovanella LB, Grazziotin-Soares R, Tovo MF, Felippe WT, Estrela C. Oxygen Saturation in Dental Pulp of Permanent Teeth: Difference between Children/Adolescents and Adults. J Endod. 41(9):1445-9, 2015.

20. Aaminabadi NA, Parto M, Emamverdizadeh P, Jamali Z, Shirazi S. Pulp bleeding color is an indicator of clinical and histohematologic status of primary teeth. Clin Oral Investig. 21(5):1831-41, 2017.

21. Mutluay M, Arıkan V, Sarı S, Kısa Ü. Does Achievement of Hemostasis After Pulp Exposure Provide an Accurate Assessment of Pulp Inflammation? Pediatr Dent. 40(1):37-42, 2018.

22. Lejri W, Douki N, Kallel I. Evaluation of a new means of pulpal diagnosis through a prospective study of 133 cases. Endodontology 31:21-4 2019.

23. Biesterfeld RC, Taintor JF, Marsh CL. The significance of alterations of pulpal respiration. A review of literature. J Oral Pathol. 8(3):129-39, 1979.

24. . Katherine AJ, Acidosis. Comprehensive Pediatric Hospital Medicine 1st Edition, Ed. Zaoutis L, Chiang, V. Mosby; 125-32. 2007. https:// www.elsevier.com/books/comprehensive-pediatric-hospital-medicine/9780323030045/. Accessed October 23, 2019.

25. Alfaro V, Ródenas J, Palaclos L, Mitjavila MT, Carbonell T. Blood acidbase changes during acute experimental inflammation in rats. Can J Physiol Pharmacol. 74(3):313-9, 1996.

26. Becker DE, Reed KL. Local anesthetics: review of pharmacological considerations. Anesth Prog. 59(2):90-101, 2012.

27. Hirose Y, Yamaguchi M, Kawabata S, Murakami M, Nakashima M, Gotoh M, Yamamoto T. Effects of Extracellular pH on Dental Pulp Cells In Vitro. J Endod. 42(5):735-41, 2016.

28. Anusha B, Madhusudhana K, Chinni SK, Paramesh Y. Assessment of Pulp Oxygen Saturation Levels by Pulse Oximetry for Pulpal Diseases -A Diagnostic Study. J Clin Diagn Res. 11(9):ZC36-ZC39, 2017.

29. Shahi P, Sood PB, Sharma A, Madan M, Shahi N, Gandhi G. Comparative Study of Pulp Vitality in Primary and Young Permanent Molars in Human Children with Pulse Oximeter and Electric Pulp Tester. Int J Clin Pediatr Dent. 8(2):94-8, 2015.

30. Moskovitz M. and Tickotsky N. Pulpectomy and root canal Treatment in Primary Teeth: Techniques and Material, In Pediatric Endodontics Current Concepts in Pulp Therapy for Primary and Young Permanent Teeth. Ed. Fuks AB.& Peretz B., Springer International Publishing Switzerland 2016. 72-97

31. Baer D. M, Acid base disorders the clinical use of the astrup method of determining pH, pCO2 and base Excess. California Medicine 101(6):439- 44, 1964.

32. ASTRUP P. A new approach to acid-base metabolism. Clin Chem. 7:1-15 1961.

33. Chen GS, Lee SP, Huang SF, Chao SC, Chang CY, Wu GJ, Li CH, Loh SH. Functional and molecular characterization of transmembrane intracellular pH regulators in human dental pulp stem cells. Arch Oral Biol. 90:19-26, 2018.

34. Okabe T, Sakamoto M, Takeuchi H, Matsushima K. Effects of pH on mineralization ability of human dental pulp cells. J Endod. 32(3):198- 201, 2006.

35. Donaldson LF. Understanding pulpitis. J Physiol. 573(Pt 1):2-3, 2006.

36. Matthews B, Andrew D. Microvascular architecture and exchange in teeth. Microcirculation. 2(4):305-13, 1995.

37. Freckmann G, Schmid C, Baumstark A, Pleus S, Link M, Haug C. Partial pressure of oxygen in capillary blood samples from the fingertip. J Diabetes Sci Technol. 7(6):1648-9, 2013.

38. Setzer FC, Kataoka SH, Natrielli F, Gondim-Junior E, Caldeira CL. Clinical diagnosis of pulp inflammation based on pulp oxygenation rates measured by pulse oximetry. J Endod. 38(7):880-3, 2012.

39. Weiner M. Concepts of “tissue pO2” in relation to O2 delivery. Artif Cells Blood Substit Immobil Biotechnol. 22(3):763-8, 1994.

40. Saito T, Ogawa M, Hata Y, Bessho K. Acceleration effect of human recombinant bone morphogenetic protein-2 on differentiation of human pulp cells into odontoblasts. J Endod. 30(4):205-8, 2004.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time

Conferences

Top