The commonly accepted clinical research methods pulp include inspection, sensing and determination of the reaction on the temperature and electrical irritations.
Inspection is an objective method of determining the status of the pulp. However, to judge on the basis of the extent of the pathological process, its character at depth not possible, not to mention the fact that almost at the clinic they can be used only in extremely rare cases.
Small and role sensing. With it, at best you can only get a rough idea of whether to keep the cavity of the tooth or passable channel live pulp or she is completely destroyed. To judge on the basis of this method on the nature of the pathological process, its length is impossible. Sounding calls are equally intense pain and at absolutely normal pulp and inflammation her, and in the case of a partial necrosis. To all this we must add to that associated with the sounding sharp pain have extremely limit the application of this research method in the clinic.
Widely used for diagnostic purposes, the reaction of the tooth on the temperature of irritation. The value of this research method pulp no doubt. No doubt also that it is often overestimated, which leads to annoying diagnostic errors. For example, it is widely believed that on the basis of the reactions pulp temperature irritation easy to differentiate serous form of pulpitis from festering. This view is profoundly mistaken, that firmly established clinical-morphological research of both domestic and foreign authors. The reaction of the pulp temperature stimuli cannot be judged not only on the nature of the exudate, but also about the extent and severity of the inflammatory process. The same thermal irritant may cause exactly the same reaction in the diffuse inflammation and limited focus, with completely preserved the pulp and remaining extremely small cult in one of the root canals.
Regarding the reaction of pulp on electric irritation, that until recently was accepted to consider (and some dentists adhere to this point of view, and currently)that electroodontodiagnosis is secondary, "helper" method, in the best case, allowing only determine whether to keep the tooth alive pulp or she is completely destroyed.
Needless to say that when the imperfect clinical research methods pulp doctor is not able to have a more or less clear picture of the nature of the pathological process in it. It deprive him of the opportunity in each case, identify the correct treatment plan to save the entire pulp, or, amputirovali crown part, to save the root, or to resort to polipektomii.
Recent years have published a lot of works, devoted to the so-called biological methods of treatment of pulpitis. However, so far none of them has received wide practice. And we never know exactly what the cause of these failures: the imperfection of these methods, or in our limited diagnostic capabilities, not allowing us to develop appropriate for these methods readings.
The absence of sufficiently reliable clinical research methods pulp leads to the fact that clinicians fix their attention only on those pathological processes in it, which are accompanied by pain, i.e. mainly in acute and subacute pulpit. It is common knowledge that for a number of diseases of hard tissues of teeth, periodontal tissue (increased erosion, periodontal disease, and other)and some diseases of blood, cardiovascular system, etc. in the pulp are observed more or less marked changes inflammatory and degenerative forms of proceeding without pain. These diseases pulp in routine clinical practice are not diagnosed. Do they need any therapeutic intervention, complicate whether they are for caries, periodontal disease are the issues that await response.
Improvement of existing clinical research methods pulp is one of the topical problems of modern stomatology. We conducted over the past 26 years, research in the field of physical methods of diagnostics in dentistry has shown that this task is largely feasible.