Eod in chronic pulpitis of permanent teeth. Approximate cost of EDI. Application in pediatric dentistry

Dental industry medicine is developing quite actively, constantly appearing the latest technology for the treatment and diagnosis of certain pathologies. AT recent times EDI is gaining more and more popularity in dentistry. This technique allows you to accurately diagnose and prescribe effective treatment. Let's see what electroodontodiagnostics (EOD) is, in what cases its use is indicated and whether there are contraindications to the procedure.

The essence of the procedure

This technique has been known in dentistry for more than 60 years, but recently its popularity has been growing. The method is based on measuring the level of tissue resistance oral cavity electric current. The higher the indicators, the deeper the inflammatory process penetrated inside.

This method uses the property nervous tissue get excited under the influence electric current. During the procedure, the threshold excitation of the tooth receptors is determined. The current at the moment of passing through the pulp does not damage it, as it is strictly dosed. Therefore, to carry out it is necessary to have the necessary knowledge.

Normally, we can talk about such indicators:

• For teeth with formed roots, electrical excitability ranges from 2 to 6 μA.
• For milk teeth, the indicators lie in the same range.
• At the time of cutting permanent teeth and the formation of their roots, the electrical excitability is either greatly reduced or absent altogether, it can be 200-150 μA. When the root is fully formed, the indicator is in the region of 2-6 μA.

The values ​​of EDI in dentistry, compared with the norm, make it possible to judge the development pathological process. For example, with the development of caries, electrical excitability drops to 20-25 μA, when the pulp is affected, then the indicators are in the range of 7-60 μA. If the reaction is 61-100 µA, then we can say that the death of the coronal pulp is observed, and the inflammatory process passes to the root of the tooth.

For more accurate results the doctor usually first directs the patient to X-ray diagnostics in order to know approximately the area with pathological changes. But this study does not complete picture what is happening, so electroodontodiagnostics will be much more effective.

Rules for the use of EDI

Since the procedure is associated with the use of electric current, there are several rules for its application:

1. Only a doctor writes a referral for EDI and the whole procedure is carried out under his strict supervision and control.
2. The patient must strictly comply with all recommendations and requirements of the doctor. Before the first procedure, a thorough briefing must be carried out.
3. EOD in dentistry is not recommended immediately after a meal or on an empty stomach. The optimal time is 40-60 minutes after eating.
4. During the procedure, you can not get up, move and talk. Any movement can lead to errors in the results.
5. To avoid electric shock, do not touch the device, try to independently adjust the dose of current.
6. If during the procedure you feel strong pain, burning sensation, dizziness, then you must inform the nurse or doctor.
7. After the procedure is completed, the patient needs to rest for 40 minutes.

Purpose of electroodontodiagnostics

The doctor can refer to EDI, pursuing the following goals:

EDI indications in dentistry

The procedure is indicated in the presence or suspicion of the following pathologies:

It can be noted that almost all pathologies dental system require the use of EDI in dentistry for accurate diagnosis and effective treatment.

Contraindications for EDI

Any research and electrodontodiagnosis is no exception, they have their own contraindications for use. They can be divided into relative and absolute.

To absolute contraindications relate:

• The patient has a pacemaker.
• Mental disorders.
• Children's age up to 5 years.
• It is impossible to achieve complete dryness of the tooth.
• The patient does not tolerate electric current.

Pros and cons of the technique

EOD (electroodontodiagnostics of the tooth) has its advantages:

• Ease of use.
• Method availability.
• Excellent information content.
• The doctor has the opportunity to carry out the procedure directly in his office.

But there are also disadvantages:

• It is important to carry out the procedure correctly. Consider the patient's individual pain threshold.
• The procedure should be age-appropriate.
• It is necessary to take into account the characteristics of the device. Take into account the degree of formation of the roots.
• The technique requires both material and time costs.

EDI apparatus

Dentistry in its practice uses both domestic and foreign equipment. Among latest models The most popular brands are:

• Gentle Plus.
• digitaltest.
• Vitapulp.
• pulpster.

There are demanded among Russian models:

• EOM-3.
• EOM-1.
• IVN-01.
• OD-2.

The first of the presented Russian models is not so often used, since an assistant is required to carry out the procedure, and not all doctors have their own nurse.

Preparing the device for the procedure

Before the procedure begins, it is necessary to prepare the device for work. This stage includes the following manipulations:

1. First of all, the active and passive electrodes are connected to the corresponding keys.
2. Carry out grounding.
3. Connect the device to the network.
4. Press the “On” key, when the device starts working, the signal lamp will light up.

Preparing the patient for the procedure

After preparing the device, it is necessary to deal with the patient:

Tooth preparation is as follows:

• Dry the tooth using a cotton swab. For these purposes, alcohol or ether should not be used.
• If there are deposits on the teeth, they should be removed.
• In the presence of caries in the teeth, it is necessary to remove the soft dentin and dry the cavity.
• If there is an amalgam filling, then it must be removed, since this material is a good current conductor.
• Position the electrodes in the desired location.
• The passive electrode is fixed on the back of the hand and fixed.
• The active electrode is fixed on sensitive points.

EDI in dentistry - procedure procedure

After the device and the patient are ready for EDI, the procedure begins. The current is applied, the force gradually increases until the patient feels pain, tingling or burning. The nurse or doctor registers the threshold current and turns off the device. Quite informative EDI in dentistry. Indicators allow you to accurately determine the pathology.

To check the reliability of the results, a healthy tooth is also checked.

It must be taken into account during the procedure that there must be a closed circuit between the device, the patient and the doctor, otherwise, not entirely reliable results can be obtained. The specialist should not wear gloves during the procedure.

For getting reliable results measurements are taken several times and the average value is taken. If the patient's reaction changes slightly, then the results are reliable, but with large deviations, a false positive or false negative reaction can be suspected.

Reasons for getting incorrect results

When EDI is used in dentistry, the readings may not always be correct. False positive reactions are possible if:

• There is contact between the electrode and a metal part, such as a bridge or a filling.
• If the patient is not explained in detail what to expect and how to proceed, then he may raise his hand prematurely.
• Poorly treated pulp necrosis.
• Not well isolated from saliva.

In some cases, it is possible to obtain false negative results:

• The patient used before the procedure alcoholic drinks, sedatives drank painkillers.
• During preparation, the nurse made poor contact between the electrode and tooth enamel.
• The patient has recently suffered a trauma to the tooth.
• The device is not plugged in or the batteries are dead.
• The tooth erupted recently, and the apex is not quite formed.
• Incomplete necrosis of the pulp.
• The electrical circuit breaks because the doctor is wearing rubber gloves.

EDI in some diseases

EDI in dentistry is quite informative for various dental pathologies. According to the obtained values, the doctor puts accurate diagnosis and prescribe appropriate treatment. Consider indicators for some diseases:

1. The values ​​of electrical excitability in caries change, depending on the degree of its development:

2. EDI with pulpitis gives the following results:

• The acute and focal form gives values ​​of 20-25 μA, in this case, the inflammation has not yet affected the root of the tooth.
• With diffuse and acute pulpitis indicators in the range of 20-50 μA.
• Chronic fibrous pulpitis- 20-40 uA.
• The gangrenous form is characterized by indicators from 60 to 100 μA.

It must be taken into account if the tooth is covered with metal or ceramic-metal crown, then it will not be possible to determine the electrical excitability.

3. With periodontitis, the readings, as a rule, already go beyond 100 and can reach 150, and in some cases even 300 μA.

4. permanent teeth during the formation period, they show from 50 to 200 μA.

5. Electrical excitability on milk teeth during the period of root resorption reaches 200.

A competent specialist should take into account the pain threshold during the procedure, which each person has his own. That is why you should not rely on the average values ​​for a particular pathology. To obtain a reliable result, it is necessary to measure the electrical excitability intact teeth, adjacent and antagonistic teeth. It is imperative that the teeth are in same conditions, that is, the degree of formation of the roots, the location on the jaw, and in reality this is almost impossible to achieve.

This diagnostic method is based on an assessment of the sensitivity of the nerve of the tooth to an electric current. With the help of such manipulations, the dentist can choose best option treatment and most rationally distribute the load on the damaged tooth.

The technique itself originated and has been used for more than half a century ago. However, its popularity began to gain only in the last decade. The method of treatment and diagnosis with current is considered the safest and most effective. The method is based on the principle of excitability of tooth tissues to electric current. The norm of resistance is considered to be indicators from 2 to 6 μA (microamperes). If the indicators exceed this threshold, then this indicates the presence of pathologies or infections in the pulp.

How it works?

The method of electroodontodiagnostics is based on the current that penetrates into the tissues of the tooth, or rather into the pulp. Tissues have the ability to conduct electricity and respond to current. Therefore, it is possible to assess how irritated the pulp is. The electrical conductivity of tissues depends on the amount of fluid they contain. Therefore, in order to achieve the most realistic performance, before the procedure, the patient is removed all possible moisture with cotton swabs. However, water cannot be removed from the tooth itself. Most a large number of moisture is in the pulp. During scientific research special points were identified, with the help of which the diagnostic result is revealed.

The purpose of the technique of electroodontodiagnostics is to determine the possibility of curing a tooth.

Indications for EDI in dentistry

• Pulpitis (inflammation of the internal soft tissues of the tooth, which are located inside the dental canal)
• (damage to hard tissues of the tooth)
• (inflammation caused by bone infection)
• Tumors of the jaws
• Actinomycosis (infectious chronic tissue-producing disease)
• Periodontitis ( inflammatory disease, often occurs as a complication of caries, generates connective tissue between tooth and socket)
• (chronic inflammatory process in the periodontium)
• Trauma to the teeth or jaw
• radiation damage
• Sinusitis

EDI indicators in dentistry

Each dental disease has its own indicators of the device. A healthy tooth, when exposed to an electric current, gives a reaction of 2-6 μA. The more inflammation, the worse the tissue reacts to the current. When an inflammatory process takes place in the tissues, the performance of the electrical appliance increases. So, 20-40 µA indicates the presence of pathologies or infections in the initial stages. When the current strength increases to 60 µA, this indicates necrosis of the coronal pulp, above 60 µA, the presence of gangrenous infections in the pulp. If the indicators of the drug go off scale for 100 μA, then infectious process takes place in ligamentous apparatus. However, the opinion: “the higher the indicators, the higher the degree of tissue damage” is erroneous. The reaction to the electric current is checked in several parts of the tooth. For healthy tissues, the indicators will be the same and within the normal range at each point. Depending on the difference in the reaction in the areas of the tooth, specialists assess the degree of tissue damage and the possibility of their treatment.

The above indicators are typical for teeth of permanent occlusion, since in teeth with reduced functionality, the sensitivity of the pulp is reduced.

EDI table in dentistry

Four types of devices are used for electroodontodiagnostics in dentistry:

• IVN-1
• EOM-1
• EOM-3
• OD-2 (an improved version of the device, used for odontodiagnostics, can work not only on AC, but also on DC). The norms of indicators of devices operating from direct current are different from devices with alternating current.

Pulp tester - device for electroodontodiagnostics

Before the procedure of electroodontodiagnostics, it is necessary to prepare the device for use and the patient.

The patient is comfortably seated in a chair and counseled about the sensations that may arise during the diagnostic process. It can be: tingling, vibrations or jolts. It is important for the patient to report how he feels to the doctor in a timely manner. A rubber mat is placed on the floor for insulation. The EDI apparatus is grounded.

Before the diagnosis, the patient is removed all possible liquid from the oral cavity. The tooth that will be exposed to the current is dried with cotton balls in the direction from the cutting edge to the middle. If there is a filling on the tooth, then it is removed to achieve more realistic diagnostic indicators. If the tooth is susceptible to caries, then it is necessary to remove the softened dentin and dry it.

The apparatus itself consists of two electrodes, with the help of which the reaction of the pulp is detected. The electrodes are carefully wrapped in gauze or cotton wool and moistened.

The operation of the device is preliminarily checked on healthy teeth. If the indicators are normal, then proceed to the diagnosis of diseased tissue areas. In some cases, the response of tissues to an electric current may be distorted:

• if the conductor touched in the oral cavity metal constructions(piercing);
• if the patient has taken painkillers before the procedure;
• if the electrode touched the cheek.

To avoid distortion of indicators, the oral cavity is continuously dried during the procedure.

All indicators of tissue reactions to current are checked twice. After the procedure, the doctor displays the arithmetic mean of the two available values, and this result is considered the most correct.

When conducting a study, it is necessary to strictly follow the instructions for use of the drug and always listen to the opinion of the doctor.

EDI device

Electroodontodiagnosis of a tooth is considered the most budgetary and high-quality research option. The price for the procedure ranges from 150 to 400 rubles. To this cost should be added the cleaning of the teeth, the removal of soft dentin and the unsealing of the teeth, if necessary. It is significantly cheaper than other survey options. These price quotes are average. The cost of EDI diagnostics in dentistry depends on the clinic where the procedure is performed, the region and location.

Many patients have already used the method of electroodontodiagnostics and were extremely satisfied. This method of research allows the doctor to correctly recognize the foci of infection or pathologies in the tissues of the oral cavity and prescribe the optimal treatment plan.

For patients who have contraindications to the use of electroodontodiagnostics ( chronic diseases), this method cannot be considered the only correct one. For achievement maximum effect in such cases, several research methods are used.

EOD of a tooth or electrodiagnostics is one of the the latest ways determination of the current state of the dental pulp. Through the use of weak electrical impulses, the doctor can determine the state of the nerve endings, what is the susceptibility of the receptors. This method, unlike X-ray diagnostics, is absolutely harmless, and at the same time, it is very representative. Indications for EDI in dentistry are carious lesions teeth. Serve as important reasons for the appointment of EDI - pulpitis, periodontitis and osteomyelitis. Electrodiagnostics is carried out in the presence of sinusitis, facial neuritis or trigeminal nerve, with dental injuries, various tumors when orthodontic intervention is required. This method does not damage the pulp, since the EOD device delivers electric current in fixed small doses.

Impressive results are demonstrated by EDI in periodontitis. The electrical excitability of the tooth in the presence of fibrous periodontitis demonstrates indicators exceeding 100 μA. This is direct evidence of damage and death of the dental pulp. Control measurements are carried out until the response indicators nerve endings will not return to normal.

• Studies of EDI in the course of treatment are carried out several times - they allow you to trace the dynamics of the disease, determine how effective the prescribed treatment is and what is the progress in restoring the vital activity of the pulp.
• According to generally accepted recommendations, EDI is carried out 40-60 minutes after a meal. During the procedure, the patient should not move, sleep, read or speak. Mandatory after completion of the procedure rest for 30-40 minutes.
• EDI is characterized by high accuracy of results and can often completely replace X-ray examination.

Already throughout years we sell professional equipment for EDI in dentistry. The price of the device depends on the class of the chosen model and availability. additional features, but we guarantee the high quality of any presented models - from the most affordable to luxury appliances. Our consultants are always ready to give comprehensive answers to customers on all models of EDI devices presented on the pages of the catalog.

The values ​​of the electrical excitability of the dental pulp in normal and pathological conditions
Electroodontodiagnostics (EDD) is a method based on the patient's subjective response. Wherein different patients have different specific resistances, are in different physiological state, have different nervous system, sensitivity and reaction speed.

Therefore, when researching, you should always reckon with the following rules:

1. EDI serves to clarify the pre-supposed diagnosis. That is why only the attending dentist can conduct proper research and correctly interpret the results.
2. Since the patient's reaction largely depends on his individual features, it is recommended to carry out diagnostics in the following sequence:

The first measurement is made on any vital tooth so that the patient can get a sense of irritation;
- after that, a control measurement is made on a symmetrical vital tooth (or a tooth of the same group) to determine normal reaction the patient;
- only after that, electroodontodiagnostics of the tooth of interest to us is performed.

The results of the study are compared with the results of a symmetrical intact tooth. The interpretation of the results correlates with the values ​​for various diseases described below.

ELECTRICAL EXCITABILITY OF PULPS WITH INTACT TEETH
Normal pulp with intact teeth healthy people at sensitive points most often reacts at 2-20A. The lowest values ​​of the current that caused irritation are observed in the study of single-rooted teeth. With multi-rooted teeth, most likely due to the possibility of distributing current along more channels, these values ​​can be several times higher. Usually the teeth upper jaw respond to even higher current values ​​compared to the values ​​for mandible. The electrical excitability of wisdom teeth, primarily for the upper jaw, as a rule, has underestimated values ​​(the patient reacts at high values ​​of the flowing current). The worse developed tuberculosis, the lower the electrical conductivity.

In the study of electrical excitability and comparison of data morphological features It has been established that electroodontodiagnostics reflects the state of the pulp, in particular its inervation system. Often, with intact teeth, a reaction is noted when increased values current strength, which is usually the result of degenerative changes in nerve fibers, hemorrhages, cystic formations, atrophy. The magnitude of the decrease in electrical excitability depends on the severity of these changes.

The excitability of intact teeth is reduced (higher values ​​​​of the strength of the irritating current are noted):
- in adult patients, due to deposits of secondary dentin and senile atrophy of the pulp;
- in children whose teeth have not completed their development;
- with severe common diseases and intoxication of the body;
- with wisdom teeth, especially the upper ones, due to the peculiarities of their development, mineralization and innervation;
- with teeth exposed to orthodontic appliances;
- with teeth in traumatic occlusion;

Electrical excitability in caries
At caries in the macular stage and superficial caries, electrical excitability usually remains normal. With moderate to deep caries, the patient may respond to more high value current strength in comparison with a symmetrical intact tooth, depending on the changes that have occurred in the pulp.
A regular relationship between the values ​​of EOD and the proximity of caries to the pulp has not been established. More significant is the nature of the process. With chronic caries, sclerotic and reparative dentin is deposited, changes in the pulp occur, and electrical excitability decreases.
It is generally accepted that the higher the set threshold of irritability, the more significant the changes in the pulp. In cases of electrical excitability exceeding 30μA, it is recommended to carry out two caries treatment sessions with appropriate medication.

Electrical excitability in pulpitis

The method allows diagnosing individual stages of pulp inflammation. In severe forms of inflammation of the pulp, electric shock causes its reaction with more low values current flow strength compared to normal pulp. In cases of pulpal hyperemia, the threshold remains without deviations from the norm or is slightly underestimated.
In acute pulpitis, a decrease in electrical excitability (a higher value of the strength of the irritating current) was established, depending on the progressive development of the pathological process. It is generally accepted that biological treatment can be undertaken with electrical excitability up to 35 A. At chronic pulpitis electrical excitability is underestimated due to degenerative processes in the pulp. With exacerbated pulpitis of multi-rooted teeth, it is even more underestimated in comparison with chronic pulpitis and reaches 80-90 A. This has great importance at differential diagnosis acute and exacerbated chronic pulpitis.

There is no satisfactory evidence that with pulp hyperemia and acute (acute) pulpitis, the irritation threshold is lower, and with chronic pulpitis it is higher. Both in acute and chronic pulpitis, electrical excitability varies widely (from normal to a significant decrease). A reduced or significantly reduced response indicates a localized pathological process, while a pronounced decreased response at all points of the study indicates the presence of diffuse pulpitis.
The study of electrical excitability itself cannot be a criterion for acute or chronic inflammatory process, and also does not provide an opportunity to determine the type of inflammatory process, since there is no correlation between pain threshold and histopathological picture.
Electroodontodiagnostics for pulpitis is helper method. It contributes to the differential diagnosis in relation to the localization of the process, acute or exacerbated pulpitis and facilitates the choice of treatment method - biological treatment, amputation or extirpation.

Electrical excitability in chronic generalized periodontitis (parchr.gen.)

On the initial stage parchr.gen. electrical excitability is normal or even slightly increased. The anterior teeth respond when the current is below 2 A. Increased excitability in large numbers cases precede others clinical symptoms and can be used as a test for early diagnosis.
With an increase in periodontal damage, electrical excitability decreases, the values ​​obtained during measurements can significantly exceed the values ​​with intact teeth.
Comparing data on the electrical excitability of teeth with the morphological state of nerve fibers in the pulp in varying degrees diseases, it was found that there is a certain correspondence - with the development of the process and a decrease in electrical excitability, morphological changes in nerve fibers also deepen. Changes in the pulp are secondary.

Electrical excitability in trauma and other surgical diseases.

Of particular interest for the clinic and diagnostics is the study of electrical excitability in dental injuries and crown or root fractures. At the beginning, due to the appearance of a hematoma in the pulp and periapex, electrical excitability may decrease. In such cases, a follow-up study should be carried out within a few weeks (3-4) after hematoma resorption, in order to take into account the real state of the pulp. With a root fracture, one can expect the consolidation of fragments with preserved, albeit reduced, electrical excitability. With neuritis n.mandibularis, there is a decrease or even absence of electrical excitability of all teeth of the corresponding side. It gradually normalizes with the subsidence of inflammation. Controlling electrical excitability allows you to track the effect of treatment.

In cases of a large cyst of the jaw, covering on x-ray the roots of several teeth, the importance of electrical excitability for determining the causative tooth is emphasized. electrical excitability neighboring teeth may be lowered due to cyst pressure. If, after 10-20 days after the operation, the electrical excitability is not restored, but even decreases, we can assume that we are talking about pulp necrosis due to trauma. With injuries in the facial-maxillary region, in 60% of cases, a decrease in the electrical excitability of the affected teeth is observed. In all likelihood, this is a consequence of damage to the neurovascular plexus. The behavior of the dentist in such cases should not differ from his behavior in case of a tooth injury.

After traumatic extraction of wisdom teeth, the electrical excitability of neighboring teeth decreases and normalizes after 3-5 days. During this period, patients have side numbness. With injuries of the n.mandibularis, with the resulting hyperapathy in the damaged area, the electrical excitability of the molars increases. Hyperpathy persists for 2-5 months, and electrical excitability returns to normal after 6 months.

With maxillary sinusitis, there is a decrease in the electrical excitability of the corresponding molars and premolars, and to a lesser extent even opposite side. With a radical operation, the electrical excitability of the teeth on the diseased side can also decrease or even disappear. After treatment, she gradually recovered. Through periodic checks, it is possible to trace the dynamics of the pathological process and the effectiveness of treatment.
With osteomyelitis, often, there is no electrical excitability of the teeth, especially with concomitant neuritis. If the treatment restores the sensitivity of the mucous membrane and skin, but the electrical excitability of the teeth is not restored, we can assume that necrosis of the pulp has occurred, which should be treated. In other cases, one should patiently wait for the recovery of osteomyelitis and the subsidence of neuritis for the corresponding restoration of electrical excitability.

With difficult for X-ray diagnostics fractures alveolar processes sigomitic bone, etc., decreased or increased electrical excitability of the teeth of the corresponding side, together with impaired sensitivity of the skin and mucous membrane, have a large diagnostic value for practice. With neoplasms in the facial-maxillary region without external symptoms, early symptoms are odontalgia and paresthesia in the respective area. Reduced electrical excitability of the group of teeth on this side is also an early diagnostic sign.
A decrease or absence of electrical excitability of the teeth near corpus mandibulare fractures was established. With treatment, electrical excitability slowly improves and even normalizes. Fate healthy teeth fractures in the gap are solved by periodic control of electrical excitability until they are restored.

With severe pain syndromes in the facial and maxillary region (trigeminus neuralgia, neuritis, maxillary sinusitis, acute total pulpitis, acute and chronic pulpitis, etc.), it is only by examining the electrical excitability of the teeth in the corresponding area that it is possible to determine whether we are talking about pain of odontogenic origin or not, after which the patient should be referred to the appropriate specialist.

Electrical excitability during anesthesia

A number of authors conduct a study of electrical excitability before and after the use of methods of anesthesia and premedication as a test for the effectiveness of the method. Exploring the electrical excitability, the effect for electrophoresis with anesthetics is monitored. With wired and infiltration anesthesia It was found that when electrical excitability is below 100 A, pain occurs during extirpation and amputation of the pulp.

EDI method in dental practice was introduced by Lev Rubin in 1949, and due to its effectiveness, the study became widespread outside the USSR. Special device allows you to determine the threshold of excitation of the receptors of the pulp of the tooth with the help of an electric current passing through it.Electroodontometry helps to get an idea of ​​the state of the tissues of the teeth, to identify the functionality and sensitivity of the nervous apparatus.

During inflammatory processes and changes in the pulp, not only the structure of the tissue changes, but also dystrophy of nerve receptors occurs, which affects their electrical excitability. A special apparatus helps to identify the presence of the disease and determine the methods of treatment. EDI - additional method research. The diagnosis is established by comparing all the information received during examination, X-ray, CT, laser diagnostics.

What is the method of electroodontodiagnostics?

Nerve endings located in the tissue of the tooth are capable of conducting current. Depending on the state of the neurovascular endings, the response to exposure may change - this is the basis of the research method. The higher the current strength to which the nerves are able to respond, the deeper and stronger the spread of pathological processes.

The affected pulp has less electrical excitability than healthy teeth. A weak reaction to the current is observed with periodontitis, pulpitis, deep caries, jaw tumors, during the resorption of the roots of milk teeth (we recommend reading:). Complete absence or too weak a reaction is manifested in teeth that are just erupting and have insufficiently developed roots. Depending on the indicators of response to irritation, the specialist draws a conclusion about the state of the tissues. Electroodontodiagnostics is carried out for:

• assessment of the state of nerve endings in the tooth;
• calculating the length of the root canal;
• determination of the quality of tooth enamel mineralization;
• tone measurements blood vessels tooth.

The device has a high diagnostic value to analyze the dynamics of the inflammatory process and the effectiveness of medical manipulations. It is used to check the condition of a patient with dental injuries, jaw fractures, tissue inflammation.

Taking readings and EDI tables

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During the practice, dentists have established a correspondence between the disease, the presence of which is assumed in the patient, and the numbers appearing on the device. Normally, sensitivity occurs at a current of 2-6 microamperes, if the indicator changes, the tissue is damaged and requires treatment.

In the presence of caries, the values ​​on the device change depending on the degree of damage to the area. It is convenient to check the information with the table.

In addition to eliminating caries and its complications, the device is used to diagnose other conditions. Specialists use EDI to detect diseases: neuritis and trigeminal neuralgia, cysts (contacting teeth are checked).

The sensitivity of patients fluctuates significantly under the action of an electric current, so the doctor focuses on relative numbers. To do this, diagnose healthy tooth(symmetrical), taking the data as physiological norm for a specific person.

EDI equipment

Electroodontometry is a popular and informative method for obtaining information about the state of the soft tissues of the teeth. The doctor evaluates the current strength at which the tooth responds to the procedure. The research uses modern foreign and domestic devices that allow high-precision diagnostics. Of the imported devices, Vitapulp, Gentle Plus, Pulptester are often used, but it should be borne in mind that on the models the scale is presented not in the value of μA, but in conventional units.

From domestic devices, models are used: EOM-1 and 3, OD-2, IVN-01, Analytic. OD-2M is a modernized device that makes it possible to use both alternating and direct current. It is inconvenient for a doctor to work with EOM-3 on his own, so the help of an assistant is required.

Stages of the procedure

Diagnostics in dentistry is carried out to identify pathological changes fabrics. It competes with radiography and checking the condition of the teeth with a laser, but the first method does not always have the desired effect, and transillumination is applicable only on the front teeth. Both methods help to detect the problem, and electroodontodiagnostics provides information about its nature.

To obtain the results, the patient first takes a picture - this helps the doctor to suggest which areas need to be examined. The diagnosis of EDI is uninformative in the following cases:

During one study, it is undesirable to check more than 3-4 teeth in a row affected by pulpitis, deep caries. The body adapts to the action of the current, and inhibitory processes develop in medulla oblongata. The sensitivity of the oral cavity returns to normal after about 60 minutes.

Equipment preparation

To avoid cross-infection, the mouthpiece and active electrode are sterilized and disinfected before each patient is taken. Other surfaces require regular disinfection, but sterilization is not required. Charge the battery in the device or connect it to the mains. The doctor selects the angle of attachment of the active electrode and inserts it into the desired slot on the control unit, then the device is turned on and adjusted. It is advisable not to twist the wires of the device.

Before starting the procedure, the current slew rate for diagnostics is set. Some devices have a function sound signal and illumination of the working area to facilitate the work of a specialist and convenient readings.

Patient preparation

To obtain reliable data, it is desirable to pre-clean the studied areas from plaque and tartar. In this case, you should not use devices that intensively act on tissues: ultrasound, kinetic processing. Before the examination, the specialist explains to the patient the stages of the procedure, its safety and benefits for prescribing treatment. He is seated in a comfortable position and the studied part of the oral cavity is prepared:

• isolate the tooth from contact with metals (prosthesis parts, fillings);
• clean teeth from soft touch by using cotton swab with antiseptic (3% peroxide);
• dry the cavity from saliva with cotton balls.

The patient holds the passive wire with his hand (in modern models appliances it hangs on lower lip with a hook). During the procedure, hold the electrode firmly to ensure good contact. The patient must respond to the stimulus by pressing a button. The sterile electrode is inserted by a specialist into the EDI attachment, after which the STOP button is pressed - everything is ready for work. To prevent current leakage, the specialist must work in latex or rubber gloves.

EDI procedure

For the procedure, the research tip is placed on sensitive areas. It is pre-treated with a conductive gel-based preparation. The tip is pressed lightly against the tooth, and the device begins to generate impulses. At the first unpleasant feeling the patient presses the button, and the device records the readings. This will be the current strength to which the problem area reacted.

The check is carried out at points where the reaction occurs at minimum values: incisors in the middle of the cutting edge, premolars on the buccal tubercle, molars on the anterior buccal tubercle - they have the greatest resistance. When examining, there are sensations of burning, pain, pushing or tingling.

To control the correctness of the procedure for setting up the EDI device, they are checked on healthy tissue. If the numbers are within the normal range, then the information is reliable. When the values ​​go beyond 2-6 µA, the procedure must be repeated after setting up the device. The doctor may get inaccurate results:

• if the conductor has touched metal elements in the mouth;
• the electrode touched the cheek;
• the patient took an anesthetic or sedative before the procedure.

During the procedure, it is important that the active electrode does not touch the gums, and the enamel is regularly dried to prevent the appearance of moisture. The electrical excitability of the affected area is checked twice, after which the average is calculated.

Contraindications for the procedure

Electroodontodiagnostics - convenient and fast way detection of pathology in the patient. However, there are a number of contraindications for the procedure, in which the study cannot be carried out, or it will not give reliable results:

• nerve damage that causes excessive sensitivity of the oral cavity;
• inability to completely dry the place from saliva;
• fibrous pulpitis in a chronic form;
• temporary loss of sensation under the action of jaw anesthesia;
• hypertonic disease;
• the presence of a pacemaker;
• not carried out in areas with installed seals amalgam and artificial crowns.

The specialist must carefully monitor the place of installation of the electrode, the presence of liquid in the mouth, the contact of the seals - an incorrectly performed diagnosis gives a false positive result. The mood of the patient is important: if he is very nervous, he can signal the sensations that have appeared when the device has not yet applied voltage.