The usefulness of standard endodontic diagnostic tests in establishing pulpal status

The purpose of the present study was to evaluate the efficiency of cold and electric pulp tests in combination with other standard endodontic diagnostic methods used to assess pulpal status. Methods selected for evaluation were history of pain, tenderness to lateral and vertical percussion, sensitivity to probing, cold test, electric pulp test, tooth sensitivity on caries removal without anaesthesia and radiographical examination (caries pulp exposure, width of periodontal ligament space and loss of lamina dura periapically). Forty-nine intact teeth and 93 teeth which needed endodontic treatment were tested. The sensitivity was 0.93 for the cold test and 0.83 for the electrical test. The specificity was 0.98 for the cold and 0.96 for the electrical test. The positive predictive value was 0.97 for the cold test and 0.94 for the electrical test. The negative predictive value was 0.94 for the cold test and 0.87 for the electrical test. The accuracy rate was 0.95 for the cold test and 0.90 for the electrical test. The sensitivities and specificities were 1 for the caries removal test and for the loss of lamina dura. Percussion sensitivity was the least effective method in evaluating the pulpal status.