Restor Dent Endod.  2014 Feb;39(1):68-73.

Use of ultrasound Doppler to determine tooth vitality in a discolored tooth after traumatic injury: its prospects and limitations

• Cho YW
• Park SH

Abstract

When a tooth shows discoloration and does not respond to the cold test or electric pulp test (EPT) after a traumatic injury, its diagnosis can be even more difficult due to the lack of proper diagnostic methods to evaluate its vitality. In these case reports, we hope to demonstrate that ultrasound Doppler might be successfully used to evaluate the vitality of the tooth after trauma, and help reduce unnecessary endodontic treatments. In all three of the present cases, the teeth were discolored after traumatic injuries and showed negative responses to the cold test and EPT. However, they showed distinctive vital reactions in the ultrasound Doppler test during the whole observation period. In the first case, the tooth color returned to normal, and the tooth showed a positive response to the cold test and EPT at 10 wk after the injury. In the second case, the tooth color had returned to its normal shade at 10 wk after the traumatic injury but remained insensitive to the cold test and EPT. In the third case, the discoloration was successfully treated with vital tooth bleaching.

Keyword

Tooth discoloration; Tooth vitality; Traumatic injury; Ultrasound Doppler

MeSH Terms

Diagnosis
Hope
Methods
Tooth Bleaching
Tooth Discoloration
Tooth*
Ultrasonography*

Figure

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  Figure 1 (a) In case 1, discoloration of tooth #12 was observed at 2 weeks after the injury; (b) The result of an ultrasound Doppler test at 6 weeks after the injury. It shows a typical pulsated image, which represents normal vital pulp; (c) At 10 weeks after the injury, the tooth had returned to a normal shade.

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  Figure 2 (a) In case 2, tooth #21 was splinted at a local clinic after a subluxation injury that had occurred 2 weeks before the patient visited our clinic. It showed a negative response to the thermal test and EPT, and a positive response to the percussion test; (b) Tooth #21 showed pinkish discoloration; (c) In the ultrasound Doppler test, tooth #21 showed a normal pulsated response like that of the other teeth; (d) At 10 weeks after the injury, the shade of tooth #21 had returned to normal.

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  Figure 3 (a) In case 3, tooth #11 showed yellowish brown discoloration; (b) The coronal pulp space was obliterated, whereas the pulp space was present in the root area. There was no radiolucency in the periapical area, but the root apex was slightly shortened; (c) In the ultrasound Doppler test, tooth #11 showed an image typical of a vital tooth; (d) The patient was satisfied with the shade of tooth #11 after vital bleaching treatment.

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