Evaluation of Pulpal Blood Flow Changes in Primary Molars with Physiological Root Resorption by Laser Doppler Flowmetry and Pulse Oximetry

Aim: The aim of this study was to undertake a comprehensive quantitative investigation of pulpal blood flow (PBF) changes in human non-carious primary molar teeth with variable degrees of root resorption by Laser Doppler Flowmetry (LDF) and Pulse Oximetry (PO) methods. Materials and Methods: Data was collected from clinically and radiographically healthy 86 mandibular primary molars which have different physiological root resorption levels (PRRLs). PRRLs for each of the teeth were assessed using periapical radiographs and teeth were subdivided into three groups. Results: The LDF values demonstrated a significant difference (p = 0.0001) between all groups although PO did not demonstrate any difference (p = 0.109). Statistical analysis of LDF values demonstrated significant differences between Groups A and C (p = 0.0001) and Groups B and C (p = 0.008). Furthermore, positive correlations were determined between LDF values and PRRL groups (p = 0.0001) and patients' ages (p = 0.0001). Conclusions: In our study, it was observed that the PBF values of human primary molars measured by LDF tended to increase with the progress of physiological root resorption and age. LDF was found to be a more effective method than PO to assess the pulpal vascularity changes of human primary molars.

Laser Doppler Flowmetry, Pulse Oximetry, Pulpal Blood Flow, Primary Molars, Physiological Root Resorption

1. Mason  C.  Endodontics  in  children.  In:  Pitt  Ford  TR  (editor).Harty’s Endodontics  in  Clinical  Practice.  (5th  ed.)  London,  Butterworth-Heinemann, 183–193, 2004.

2. Simsek S, Durutürk L. A Flow cytometric analysis of the biodefensive response of deciduous tooth pulp to carious stimuli during physiologi-cal root resorption. Arch Oral Biol, 50 (5): 461–468, 2005.

3. Rowe AHR, Pitt Ford TR. The assessment of pulp vitality. Int Endod J, 23: 77–83, 1990.

4. Bhaskar SN, Rappaport HM. Dental vitality tests and pulp status. J Am Dent Assoc, 86: 409–411, 1973.

5. Goho C. Pulse oximetry evaluation of vitality in primary and immature permanent teeth. Pediatr Dent, 21: 125–127, 1999.

6. Samraj  RV,  Indira  R,  Srinivasan  MR,  Kumar A.  Recent  advances  in pulp vitality testing. Endodontology, 15: 14–19, 2003.

7. Jafarzadeh H, Rosenberg PA. Pulse oximetry: Review of a potential aid in endodontic diagnosis. J Endod, 35(3): 329–333, 2009.

8. Jafarzadeh H. Laser Doppler flowmetry in endodontics: a review. Int Endod J, 42(6): 476–490, 2009.

9. Wilder-Smith PE. A new method for the non-invasive measurement of pulpal blood flow. Int Endod J, 21 (5); 307–312, 1988.

10. Ramsay  DS, Artun  J,  Martinen  SS.  Reliability  of  pulpal  blood  flow measurements utilizing laser Doppler flowmetry; J Dent Res, 70(11): 1427–1430, 1991.

11. Gazelius  B,  Olgart  L,  Edwall  B.  Restored  vitality  in  luxated  teeth assessed  by  laser  Doppler  flowmeter.  Endod  Dent  Traumatol,  4(6): 265–268, 1988.

12. Evans D, Reid J, Strang R, Stirrups D. A comparison of laser Doppler flowmetry with other methods of assessing the vitality of traumatized anterior teeth. Endod Dent Traumatol, 15(6): 284–290, 1999.

13. Ingớlfsson  ER,  Tronstad  L,  Hersh  EV,  Riva  CE.  Efficacy  of  laser Doppler flowmetry in determining pulp vitality of human teeth. Endod Dent Traumatol, 10(2): 83–87, 1994.

14. Ingớlfsson  ER,  Tronstad  L,  Riva  CE.  Reliability  of  laser  Doppler flowmetry in testing vitality of human teeth. Endod Dent Traumatol, 10(4): 185–187, 1994.

15. Kramer WS, Ireland RL. Measurements of the primary teeth. J Dent Child, 26: 252–261, 1959.

16. Suda  H,  Ikeda  H.  The  Circulation  of  the  pulp.  In:  Hargreaves  KM, Goodis H. (editors) (Rev. ed. of 3rd ed.) Seltzer and Bender’s Dental Pulp. Chicago, Quintessence Publishing Co Inc, 123–150, 2002.

17. Sari S, Aras S, Gunhan O. The effect of physiological root resorption on repair potential of primary tooth pulp. J Clin Pediatr Dent, 23(3): 227–233, 1999.

18. Sari S, Aras S, Gunhan O. The effect of physiological root resorption on the histological structure of primary tooth pulp. J Clin Pediatr Dent, 23(3): 221–225, 1999.

19. Alexander SA. Collagenolitic activity from human deciduous pulps. J Endod, 7(9): 418–420, 1981.

20. Kopel HM. Consideration for the direct pulp capping procedure in pri-mary teeth: A review of the literature. J Dent Child, 59: 141–149, 1992.

21. Rood GD, Boissonade FM. Vascular status of human primary and per-manent teeth in health and disease. Eur J Oral Sci, 113: 128–134, 2005.

22. Rapp  R.  Vascular  pathways  within  pulpal  tissue  of  human  primary teeth. J Clin Pediatr Dent, 16: 183–201, 1992.

23. Bolan M, Rocha MJ. Histopathologic study of physiological and patho-logical resorptions in human primary teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 104(5): 680–685, 2007.

24. Monteiro  J,  Day  P,  Duggal  M,  Morgan  C,  Rodd  H.  Pulpal  status  of human primary teeth with physiological root resorption. Int J Paediatr Dent, 19(1): 16–25, 2009.

25. Komatsu  H,  Ikawa  M,  Mayanagi  H.  Age  related  changes  of  pulpal blood flow in primary teeth measured by laser Doppler blood flowme-try. Pediatr Dent J, 17(1): 27–31, 2007.

26. Chambers IG. The role and methods of pulp testing in oral diagnosis. Int Endod J; 15(1): 1–15, 1982.

27. Polat  S,  Er  K, Akpınar  KE,  Polat  NT. The  sources  of  laser  Doppler blood-flow  signals  recorded  from  vital  and  root  canal  treated  teeth. Arch Oral Biol, 49(1): 53–57, 2004.

28. Leahy  MC,  de  Mul  FFM,  Nilsson  GE,  Maniewski  R.  Principles  and practice of the laser-Doppler perfussion tecnique. Technol Health Care, 7(2–3): 143–162, 1999.