The use of electrodermal activity in pulpal diagnosis and dental pain assessment.
The use of electrodermal activity in pulpal diagnosis and dental pain assessment.
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DOI：
10.1111/iej.13868
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发表时间：
2023-03
影响因子：
5
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中科院分区：
文献类型：
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探讨皮电活动（EDA）是否可以作为牙髓诊断的辅助工具（目的1）和评估局部麻醉前后牙痛的客观指标（目的2）。Aim 1和Aim 2分别招募53名受试者（189颗牙齿）和14名受试者（14颗牙齿）。我们使用市售设备，PowerLab和电皮肤反应（GSR）放大器，结合冷和电浆测试（EPT）记录EDA。每次测试后，参与者用0-10的视觉模拟量表（VAS）对他们的感觉水平进行评分。我们记录了因牙髓炎疼痛而需要根管治疗（RCT）的参与者在局部麻醉前后ept刺激的EDA活动。将原始数据转换为时变交感神经活动指数（TVSymp），这是EDA的一个敏感而特异的参数。使用Python 3.6及其Scikit-post hoc库进行统计分析。正常牙髓在冷刺激和EPT刺激下，EDA活性上调。与坏死髓相比，低温试验和EPT均显著增加了鲜活髓的TVSymp信号。对寒冷表现出强烈敏感性的牙齿，与对寒冷有轻微感觉的牙齿相比，有无持续疼痛的牙齿的TVSymp峰值数量增加。记录疼痛性牙髓炎患者麻醉前和麻醉后的EDA活动和VAS评分。麻醉后的EDA信号明显低于麻醉前的水平。大约71%的患者（14名患者中有10名）在治疗期间没有疼痛，VAS评分为0或1。大多数患者（10 / 14）在麻醉后显示TVSymp减少。三分之二的患者在根管治疗期间疼痛增加（治疗后VAS >治疗前VAS），麻醉后TVSymp增加。我们的数据显示了在牙髓诊断和牙痛评估中使用EDA的良好结果。虽然我们的测试仅限于有足够沟通能力的受试者，但我们未来的目标是能够使用这项技术来帮助沟通能力有限的患者进行牙髓诊断。
To explore whether electrodermal activity (EDA) can serve as a complementary tool for pulpal diagnosis (Aim 1) and an objective metric to assess dental pain before and after local anaesthesia (Aim 2). A total of 53 subjects (189 teeth) and 14 subjects (14 teeth) were recruited for Aim 1 and Aim 2, respectively. We recorded EDA using commercially available devices, PowerLab and Galvanic Skin Response (GSR) Amplifier, in conjunction with cold and electric pulp testing (EPT). Participants rated their level of sensation on a 0–10 visual analogue scale (VAS) after each test. We recorded EPT-stimulated EDA activity before and after the administration of local anaesthesia for participants who required root canal treatment (RCT) due to painful pulpitis. The raw data were converted to the time-varying index of sympathetic activity (TVSymp), a sensitive and specific parameter of EDA. Statistical analysis was performed using Python 3.6 and its Scikit-post hoc library. EDA activity was upregulated by the stimuli of cold and EPT testing in normal pulp. TVSymp signals were significantly increased in vital pulp compared to necrotic pulp by both, cold test and EPT. Teeth that exhibited intensive sensitivity to cold with or without lingering pain had increased peak numbers of TVSymp than teeth with mild sensation to cold. Pre- and post-anaesthesia EDA activity and VAS scores were recorded in patients with painful pulpitis. Post-anaesthesia EDA signals were significantly lower compared to pre-anaesthesia levels. Approximately 71 % of patients (10 out of 14 patients) experienced no pain during treatment and reported VAS score zero or 1. Majority of patients (10 out of 14) showed the reduction of TVSymp after the administration of anaesthesia. Two out of three patients who experienced increased pain during root canal treatment (post-treatment VAS > pre-treatment VAS) exhibited increased post-anaesthesia TVSymp. Our data show promising results for using EDA in pulpal diagnosis and for assessing dental pain. While our testing was limited to subjects who had adequate communication skills, our future goal is to be able to use this technology to aid in the endodontic diagnosis of patients who have limited communication ability.
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