(PO103) Diagnostic Accuracy of Dental Pulp Tests in Traumatized Teeth: A Systematic Review and Meta-Analysis

Abstract: The accuracy of pulp testing methods in traumatized teeth has not been thoroughly evaluated. This systematic review aimed to investigate the diagnostic accuracy of cold pulp testing (CPT), heat pulp testing (HPT), electric pulp testing (EPT), laser Doppler flowmetry (LDF), and pulse oximetry (PO) in traumatized teeth. Four electronic databases were searched from January 1964 to May 2023. For the quantitative analysis, a diagnostic accuracy value was calculated based on true-positive, false-positive, true-negative, and false-negative values extracted from each study. A random-effects model was used to calculate the pooled estimates of the diagnostic accuracy value for each test. For the qualitative analysis, the primary findings of each study were analyzed and consolidated. A total of 248 articles were identified, and 15 were included in the final review. Among the studies included, the most frequently investigated traumatic injury was luxation. The pooled estimates of sensitivity for CPT, EPT, HPT, and LDF were 0.850, 0.500, 0.900, and 0.981, respectively. There was a significant difference between EPT and LDF in sensitivity (p < .05). The studies included were of low quality according to the modified Quality Assessment of Diagnostic Accuracy Studies criteria. LDF was the most accurate diagnostic test in detecting nonvital teeth in the early stages of trauma, while EPT was the least accurate. According to qualitative analysis, PO and LDF showed more accurate and earlier detection of vitality in traumatized teeth compared to CPT and EPT. The specificity of EPT in traumatized teeth was not as high as that in non-traumatized teeth.