Application of transmitted laser light for the assessment of human pulp vitality

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The purpose of this study was to determine if use of transmitted laser light might enable a better assessment of human pulpal vitality than does back-scattered light (LDF : laser Doppler flowmetry). The experiments were carried out on 10 upper central incisors in 6 subjects aged 23-28 years ; 5 of the teeth were vital with no restoration, and 5 were non-vital. For use with transmitted laser light, the fibers within the probe of a conventional LDF apparatus were used, one for transmitting light onto the buccal surface, the other for receiving it at the palatal surface of the same tooth. For LDF,the probe was fixed at the buccal surface. Blood flow (BF) was measured at three different locations on each experimental tooth : the incisal third, the center and the cervical third of the tooth crown. In non-vital teeth, (1) output signals with transmitted laser light all registered zero, and no oscillation could be seen in recordings from any location on the tooth, but (2) LDF signals were above zero, there were regular oscillations related to heart rate, and passive increases in BF (corresponding to BP increases) were recorded from both the center and cervical third of the tooth, indicating that LDF registered blood flow of non-pulpal origin. In vital teeth, LDF signals were significantly higher than in non-vital teeth at each location on the tooth. At the central site on vital teeth, the output signals for transmitted laser light were about twice those seen with LDF,and passive BF changes corresponding to BP increases were more clearly observed. These results indicate that transmitted laser light would be useful for the assessment of tooth pulp vitality both because the blood flow signals do not include flow of non-pulpal origin, and because its output signals and response to BF changes are larger and so can be more easily monitored.