China: A prospective observational study involving 51 avulsed and replanted immature permanent teeth showed a pulse oximeter test as an effective tool to evaluate the pulp status.
"An oxygen saturation test is a reliable diagnostic method to evaluate pulp status of avulsed teeth as early as 2 weeks after replantation," the researchers wrote in the Journal of Endodontics. This non-invasive technique monitors O2 saturation levels, facilitating early diagnosis of revascularization success or failure.
Replantation of avulsed immature permanent teeth is a delicate procedure in dental practice, often necessitating meticulous post-operative care to ensure successful outcomes. Avulsion, the complete displacement of a tooth from its socket, particularly affects immature permanent teeth which are still undergoing root development. Successful replantation of these teeth is contingent upon various factors, including maintaining proper blood supply to the periodontal tissues and preventing ischemic injury.
Evaluating pulp status is crucial for avulsed immature permanent teeth following replantation. Oxygen saturation tests may offer valuable assistance in addition to commonly used radiographic and clinical examinations providing clinical evidence. Considering this, Jinghui Yang, Wuhan University, Wuhan, China, and colleagues aimed to analyze the pulse oximeter efficacy in evaluating pulp status in avulsed and replanted immature permanent teeth.
For this purpose, the researchers performed a prospective observational study including 51 avulsed and replanted immature permanent teeth. Routine radiographic and clinical examinations were performed and used as a basis for pulp status diagnosis during the 1-year follow-up period. Meanwhile, the researchers recorded oxygen saturation values of these teeth using a modified pulse oximeter at each visit.
Following were the study’s key findings:
· Seven teeth completed pulp revascularization (success group), whereas 44 teeth failed to revascularize (failure group).
· Abnormal clinical and/or radiographic manifestations in the failure group were observed at an average period of 42.7 days, which was too late because a high incidence of inflammatory root resorption (43.18%) had occurred.
· For oxygen saturation tests, teeth in the success group showed an immediate post-replantation oxygen value of 70.71 ± 3.35, then an upward trend starting from the 2-week post-replantation visit, and a significantly increased final value of 81.86 ± 2.34 at the 1-year visit.
· No increase trend was found for teeth in the failure group as abnormal clinical and/or radiographic manifestations emerged.
In conclusion, an oxygen saturation test is a reliable diagnostic method for evaluating the pulp status of avulsed teeth as early as 2 weeks after replantation.
"The application of oxygen saturation testing after the replantation of avulsed immature permanent teeth represents a valuable advancement in dental care," the researchers wrote.
Reference:
Yang J, Liu Z, Chen Z, Yang G, Yuan G. Application of oxygen saturation test after replantation of avulsed immature permanent teeth: A prospective observational study. J Endod. 2024 Apr 9:S0099-2399(24)00229-2. doi: 10.1016/j.joen.2024.04.003. Epub ahead of print. PMID: 38604473.