The use of pulse oximetry in evaluation of pulp vitality in immature permanent teeth

Background and aim: The current methods of pulp vitality assessment, either electric or thermal, are of limited use in children. Recently, traumatized and immature teeth may not respond to such methods and because such methods require subjective responses, it may not provide accurate results particularly in children. Pulse oximetry, an atraumatic approach, is used to measure oxygen saturation in vascular system. The aim of this study was to investigate the use of pulse oximetry to evaluate pulp vitality status in immature permanent teeth. Methods and materials: The study was conducted on 329 maxillary central and lateral incisors in children. The negative control group consisted of 10 root filled teeth. Systemic oxygen saturation was first measured on the thumb of the individual using a custom-made sensor. Oxygen saturation values of the teeth were then evaluated. The correlation between oxygen saturation measurement obtained from finger and tooth, and the correlation between oxygen saturation values and stage of root development were analyzed. A further comparison was made between the teeth with open and closed apex. Results: Mean oxygen values recorded in the patient's finger were 97.17, and mean oxygen values in the maxillary central and lateral incisors were 86.77 and 83/92, respectively. There was no significant correlation between blood oxygen levels in the finger and in the teeth. (P > 0.05) There was a significant negative correlation between the stage of root development and the blood oxygen levels in the patients' teeth. (P < 0.05) Mean oxygen values in the teeth with open apex were significantly higher than the teeth with closed apex. (P < 0.001). Conclusion: Vital teeth provided consistent oxygen saturation readings, and non-vital teeth recorded no oxygen saturation values. During tooth development, the oxygen saturation values decreased. These findings confirm that the pulse oximetry is capable of detecting the pulpal blood flow and oxygen saturation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd