Peculiarities of changes in electroodontodiagnostic indicators of pulp of intact teeth and teeth with non-carious lesions in the age aspect

Abstract

Actuality. When planning the application of medical and prosthetic measures, choosing the method of protection of the prepared tooth surfaces, the method of manufacturing temporary and permanent structures and cement for fixation, both the degree of destruction of the tooth crown and the state of the pulp are important. It is known that the degree of mineralization of enamel and dentin changes with age, obliteration of root canals occurs, which should be taken into account when choosing methods of prosthetic restoration of tooth crowns. Each orthopedic construction has certain clinical requirements regarding the volume of preparation of hard tissues of the teeth, and when planning methods and materials for the protection of the surface of the prepared teeth, age characteristics should be taken into account, which formed the basis for our research.

Aim. Electroodontometric examination of the state of the pulp of affected vital teeth, compared to the norm in the age aspect for the prevention of complications of orthopedic treatment.
Materials and methods. We observed 68 people aged 18 to 59, who were divided into two groups. The first group (control) consisted of 30 people whose teeth were examined without clinically diagnosed signs of hard tissue lesions and who did not have orthopedic structures in the oral cavity. The second clinical group included 38 patients with non-carious lesions of tooth crowns and clinical indications for permanent prosthetics. The specified contingent of persons was also divided into three age groups: 18 29, 30–44, and 45–59 years. In all patients, the state of the dental pulp was assessed by the method of electroodontometry (EOD), using the Endoest-3D device. Before the beginning of the measurement, professional hygiene of the oral cavity was performed. To prevent the loss of electric current, the teeth under study were isolated from saliva and the surface of the tooth was dried. The tip of the probe of the device was lubricated with conductive gel and sensitive points were touched with minimal current.

The results. When analyzing the obtained results, it was established that there is a strong correlation between the patient’s age and EOD indicators at the corresponding measurement points: in the areas of the cutting edge (r = 0.74), in the cervical areas, vestibular (r = 0.79) in the points of the vestibular surface in the area of the equator (r = 0.70), with (р < 0.05) with a general tendency to a significant decrease in the indicators of electrical excitability of the pulp of the vital teeth in the age aspect. Orthopedic treatment of patients of the second group with lesions of the hard tissues of the teeth of various genesis was carried out using both modern technologies and traditional aesthetic designs. Veneers, vestibular half-crowns, metal-ceramic and metal-free crowns with the use of desensitizers and temporary structures were made for the patients of these groups. Clinical results confirm the absence of complaints about postoperative sensitivity, which indicates the effectiveness of means of preventing complications.

Conclusions. Electrodental diagnostics of the vital teeth should be carried out before orthopedic treatment to assess the state of the pulp and prevent prosthetic complications. Indicators of electrical excitability of the pulp of vital teeth tend to decrease significantly with age. Reliable differences of EOD indicators in the cervical area of the vestibular surface of the affected teeth were established in relation to the indicators of the vestibular surface at the level of the equator and measurement points of the cutting edge or the top of the buccal tubercle. There are significant differences between the EOD indicators of intact and affected teeth, which proves the need for the use of medical and prosthetic measures to prevent complications from the pulp.

Keywords: electroodontology, teeth, dental pulp, non-carious lesions of teeth, orthopedic structures.