Restor Dent Endod.  2020 Nov;45(4):e48. 10.5395/rde.2020.45.e48.

Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis

• Lambert P
• Miguens Jr SAQ
• Solda C
• Sganzerla JT
• Reichert LA
• Estrela C
• Barletta FB

• KMID: 2512039
• DOI: http://doi.org/10.5395/rde.2020.45.e48

Abstract

Objectives
This systematic review aimed to identify mean oxygen saturation values (SpO₂ ) using pulse oximetry in permanent maxillary anterior teeth.
Materials and Methods
The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of “oximetry” AND “dental pulp test” were used as search terms. Studies reporting means and standard deviations of SpO₂ values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I² statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale.
Results
Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO₂ values were 84.94% (95% confidence interval [CI], 84.85%–85.04%) for the central incisors, 89.29% (95% CI, 89.22%– 89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%–89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment.
Conclusions
Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

Keyword

Dental pulp test; Diagnostic techniques and procedures; Endodontics; Oximetry; Systematic review

Figure

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  Figure 1 Flow diagram of study identification, selection, and inclusion [14].

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  Figure 2 Results of the meta-analysis of individual and combined effect measures of mean oxygen saturation levels in the dental pulp of the maxillary central incisors in the included studies.TE, treatment effect (mean oxygen saturation); seTE, standard error of the treatment effect (mean oxygen saturation); CI, confidence interval.

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  Figure 3 Results of meta-analysis of individual and combined effect measures of mean oxygen saturation levels in the dental pulp of the maxillary lateral incisors in the included studies.TE, mean treatment effect (oxygen saturation); seTE, standard error of the mean treatment effect (oxygen saturation); CI, confidence interval.

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  Figure 4 Results of meta-analysis of individual and combined effect measures of mean oxygen saturation levels in the dental pulp of the maxillary canines in the included studies.TE, mean treatment effect (oxygen saturation); seTE, standard error of the mean treatment effect (oxygen saturation); CI, confidence interval.

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