The pulp of intact teeth reacts to the strength of the current. When is it used in dentistry? Contraindications for EDI

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 passing through it electric current. 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.

With 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 is an additional research method. The diagnosis is established by comparing all the information received during examination, X-ray, CT, laser diagnostics.

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 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 resorption of the roots of milk teeth. 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 for dynamics analysis inflammatory process and efficiency of medical procedures. It is used to check the condition of a patient with dental injuries, jaw fractures, tissue inflammation.

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 addition to eliminating caries and its complications, the device is used to diagnose other conditions. Specialists use EDI to detect diseases: neuritis and neuralgia trigeminal nerve, 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. For this, a healthy tooth (symmetrical) is diagnosed, taking the data as physiological norm for a specific person.

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.

Diagnostics in dentistry is carried out to detect pathological changes in tissues. 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:

trigeminal neuralgia;
osteomyelitis of the jaw;
neuritis of the facial nerve;
at a fracture mandible if the debris has shifted.

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. Sensitivity oral cavity returns to normal after about 60 minutes.

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.

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 using a cotton swab with an 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 should work in latex or rubber gloves.

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 electrode installation site, 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.

AT modern dentistry use more quantity additional methods research. Radiography and CT scan are prerequisite for staging correct diagnosis. Unfortunately, they cannot always give a complete picture of the disease.

In Soviet times, when such studies were not available, no less informative methods were used. One of these is electroodontometry (EOM).

Electroodontodiagnostics (EOD) is a research method that can be used to assess the viability of the dental pulp in case of traumatic injury, neoplasm, inflammation or any other disease of the teeth and jaws. As a result, the doctor gets the opportunity to choose the most rational methodology treatment and evaluate the results of the therapy.

The method of electroodontodiagnostics is based on the ability of living tissues to be excited under the influence of an irritant. The same fabric depending on its functional state at the time of the examination has a different excitability. Conclusions about the degree of excitability are made on the basis of the strength of irritation sufficient to obtain a response from the tissues. To do this, identify the minimum intensity of irritation.

In the case of a decrease in excitability, the response will occur only with an increase in the intensity of the acting stimulus. With an increase, on the contrary, less influence is needed to excite tissues.

EDI electrodes

Electric current is one of the most effective and accessible pathogens. The time of its exposure can be changed, and the irritation can be repeated several times without harm to the tissue.

The amount of water affects the electrical conductivity in the tissues of the tooth. The larger it is, the higher the number of ions capable of responding to the action of the current. The pulp of the tooth contains a larger volume of fluid than the enamel, therefore, during the study, special sensitive points were identified that correspond to the minimum distance to the pulp chamber.

The purpose of the study is to determine whether the tooth can be cured.

Electroodontometry in modern dentistry is used in the following cases:

differential diagnosis of the depth of carious lesions;
differential diagnosis of pulp lesions (diagnosis of pulpitis);
diagnosis of periodontitis;
detection of cysts on the roots of the tooth;
traumatic damage to the jaws and teeth;
inflammation of the sinus of the upper jaw;
osteomyelitis;
actinomycosis;
jaw tumors of various etiologies;
neuritis and neuralgia;
radiation damage;
treatment with orthodontic appliances.

Contraindications to the use of electroodontometry are divided into absolute and relative.

The study will be completely excluded when:

the patient has a pacemaker;
there are mental disorders;
effective drying of the investigated surface is impossible;
electric current is not transferred for one reason or another;
the patient is less than 5 years old.

Cases where there is a possibility of obtaining a false result, that is, relative contraindications:

nervousness of the patient during the reception;
the presence of a crown on the tooth;
presence of metal orthopedic structures in the oral cavity;
the presence of amalgam fillings;
root crack;
perforation of the root canal or cavity of the tooth;
malfunction in the equipment used for the study;
violation of the methodology.

The study involved both physicians and nurse.

First, the patient is explained what sensations may arise during the diagnostic process. The examined tooth may experience tingling, jolts, trembling, or a feeling of movement. The patient is warned that he must immediately report all new sensations. The most commonly used sound is "a".
Then the patient is given one of the electrodes, which is wrapped in wet gauze.
On the second electrode, the doctor winds a cotton wool turunda, which is also moistened.
An important step is the drying of the examination surface of the tooth. To do this, it is better to use cotton balls. The study area is also isolated using cotton and gauze rollers.
After drying, the electrode with turunda is placed on special points. In the frontal group of teeth, this place is the middle of the cutting edge. Small molars are best examined at the top of the buccal tubercle. In large molars, a special point is located in the middle of the medial buccal tubercle. In the carious cavity, the study is carried out along its bottom. To determine the excitability of the pulp, an electrode is placed at the mouth of each root canal.
The soft tissues of the oral cavity must be pulled back.
During the preparation of the patient, the nurse brings the equipment into working condition.
After completing all the preparatory activities, the sister turns the potentiometer clockwise by 1-1.5 mm, gradually increasing the applied voltage.
If the patient reports the appearance of uncharacteristic sensations, then the result obtained is fixed and the current strength is reduced.
This manipulation is repeated several times to reveal the exact values.

EOD is performed using the following devices:

OD-2M;
EOM-3;
IVN-1;
OSM-50;
Pupptest 2000;
EOM-1.

During electrodontometry, it is important to remember that the tooth can react differently to the current. Be sure to take into account the age of the patient and the presence of systemic diseases. Also, the sensitivity of the tissues of the tooth is changed by the pathology of the jaw bones and perimaxillary soft tissues.

In addition, external interference can also influence. UHF and microwave devices have a negative effect on devices for electroodontometry and lead to false results.

The most important thing is to fully comply with the research methodology. It must exactly match the instructions for the device. Only in this case can reliable results be obtained.

EDI indicators that dentists are guided by when evaluating diagnostic results:

Normal values vary within 2-6 μA.
In children during the period of changing teeth, the reaction may be completely absent. During teething indicators are constantly changing. At the initial stages, excitability can reach up to 150-200 μA. Then it rises to 30-60 µA. Normal values appear only after the full formation of the root.
At primary and secondary caries EDI values correspond to normal, and when deep characterized by a decrease in performance to 18-20 μA. These values indicate initial changes in the dental pulp.
Values of 20-5 µA indicate reversible changes in the pulp, or focal pulpitis. With the development of necrosis in the coronal pulp, the indicators are 50-60 μA. Values greater than 60 μA indicate the spread of the process to the root canals.
At periodontitis excitability will be 100-200 μA, such EDI values indicate the complete death of the pulp. React only receptors located in the periodontium.
At periodontitis indicators will be 35-40 μA. The data obtained indicate the presence inflammatory changes in bone tissue around the tooth. Its resorption occurs, the root of the tooth is exposed. As a result, the pulp chamber begins to decrease in size in order to avoid an increased reaction to external stimuli.
At periodontal disease values can vary from normal to low. Results up to 30-40 uA are possible. The mechanism of change in excitability is the same as in periodontitis.
At neuralgia values will be correct.
At Do not lie electrical excitability decreases. Perhaps its complete absence.
At dental injuries indicators will correspond to the degree of damage to the pulp.
If present neoplasms in the tissues of the jaws, there will be a gradual decrease in indicators in the affected area.

The price of this type of diagnostics varies from 150 to 400 rubles per tooth.

Electroodontodiagnostics is affordable and informative method examination of dental tissues. But it cannot be used on its own. Due to the complexity and a large number Contraindications Electroodontometry can only act as an additional examination.

In combination with other research methods, the doctor will receive full information about the changes that have arisen in the dental tissues and make the correct diagnosis.

The dental industry 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.

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 resistance of oral tissues to electric current. The higher the indicators, the deeper the inflammatory process penetrated inside.

AT this method property is used nervous tissue excited by an 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 of the 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.

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

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

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

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.

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.

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 individual pain threshold in patients.
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.

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.

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

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

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.

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 you can get not entirely reliable results. The specialist should not wear gloves during the procedure.

To obtain 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.

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 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:

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 μA.
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 of intact teeth, adjacent and antagonist 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.

Most patients, having only heard that the method is based on the use of electric current, immediately begin to panic and are afraid to go for the procedure. But EDI in dentistry (reviews of many patients confirm this) does not pose a danger to the body, and during the procedure there is no severe pain, but only a slight tingling and tremors that must be immediately responded to. But on the other hand, the technique makes it possible to determine the pathology with great accuracy, the degree of its development, in order to choose the tactics of therapy.

Despite the fact that in modern clinics, electroodontodiagnostics competes with diagnostics with light or with the help of laser equipment, dentistry cannot do without this method. EOD of a tooth is an informative procedure and is not so problematic for a patient's wallet.

In conclusion, it can be noted that it is not at all important in what ways the doctor diagnoses the pathology, the main thing is that it be timely and accurate. The effectiveness of treatment depends on the correct diagnosis.

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, neuritis of the facial or trigeminal nerve, with injuries of the teeth, 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 indicators of the response of nerve endings 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 devices. 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 dental branch of medicine is developing quite actively, the latest technologies for the treatment and diagnosis of certain pathologies are constantly appearing. In recent years, EDI has become increasingly popular 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 method uses the property of the nervous tissue to be excited under the influence of an 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 eruption of permanent teeth and the formation of their roots, electrical excitability is either greatly reduced or absent at all, it can be 200-150 μA. When the root is fully formed, the indicator is in the region of 2-6 μA.

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 give a complete picture of 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:

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

Absolute contraindications include:

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 device

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

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:

First of all, the active and passive electrodes are connected to the corresponding keys.
Carry out grounding.
Connect the device to the network.
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

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

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 before the procedure consumed alcoholic beverages, 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 values obtained, the doctor makes an accurate diagnosis and prescribes the appropriate treatment. Consider indicators for some diseases:

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, the indicators are 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 that if the tooth is covered with a 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 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 of intact teeth, adjacent and antagonist teeth. It is imperative that the teeth be in the same conditions, that is, the degree of formation of the roots, the location on the jaw, and this is almost impossible to achieve in reality.

Electroodontodiagnostics(electroodontometry) allows you to get a complete picture of the state of the pulp and tissues surrounding the tooth. The application of electric current is based on the well-known fact that any living tissue characterized by excitability, i.e. the ability to come into a state of excitation under the influence of a stimulus.

The minimum force of irritation, excitatory, is called the threshold. It has been established that in the presence of a pathological process in the pulp, its excitability changes.

The use of electric current for the purpose of diagnostics has become most widespread, since its strength and duration of exposure are easily dosed, and this current can be used repeatedly without fear of causing damage. To determine the electrical excitability of a tooth, the OD-2M, IVN-1, EOM-1, EOM-3, OSM-50 devices are used, which make it possible to accurately determine the threshold current strength.

In the study electrical excitability of the pulp using the OD-2M apparatus, a doctor and a nurse take part. When working with the OSM-50 apparatus, in contrast to the OD-2M, the current increase from zero to the threshold value is carried out by a smooth increase in voltage. The study of the electrical excitability of the pulp with the devices EOM-1 and IVN-1 is carried out by a doctor.

Research methodology. A passive electrode in the form of a lead plate 10x10 cm in size, connected with a wire to the terminal of the device, marked with a "+" sign (positive pole), is placed on the patient's hand and fixed with a bandage. A wet pad of several layers of flannel is placed between the electrode and the skin, the area of which should be slightly larger than the area of the electrode. The surfaces of the examined tooth are thoroughly dried. cotton swab, cover with cotton rolls and proceed to the determination of excitability. The end of the active electrode connected to the terminal marked "-" ( negative pole), wrap thin layer cotton wool, moistened with water and applied to the sensitive point of the tooth. In incisors and canines, sensitive points are located in the middle of the cutting edge, in premolars - at the top of the buccal tubercle, in molars - at the top of the anterior buccal tubercle. In the teeth with a big carious cavity sensitivity can be determined at the bottom of the cavity cleared of decay. It should be remembered that non-compliance with the research methodology can lead to significant errors.

When conducting this study, it is usually not limited to one threshold irritation. Having received a positive answer, reduce the current strength and check the excitability threshold again. To avoid errors associated with current leakage, the doctor should work with rubber gloves, and use a plastic spatula instead of a mirror.

Indicators of threshold excitation of the pulp in the norm and at pathological conditions. Healthy teeth respond to a current of 2-6 μA. The sensitivity of the tooth does not change. With moderate caries, and especially with deep caries, the excitability of the pulp may decrease, which indicates morphological changes in it. A decrease in electrical excitability to 20-40 μA indicates the presence of an inflammatory process in the pulp. It should be remembered that the indicator of electrical excitability does not characterize the degree of prevalence of the process. The limitation of the inflammatory process can be said if the excitability from one tubercle is reduced, and from the rest it is not changed. If the process captures the entire coronal pulp, then the excitability will be reduced from all tubercles of the crown.

The reaction of the pulp to a current of 60 μA indicates necrosis of the coronal pulp. With necrosis of the root pulp, the tooth reacts to a current of 100 μA or more. Normal periodontium is sensitive to a current of 100-200 μA. With pronounced morphological changes in the periodontium, the tooth responds to currents with a power of more than 200 μA.

It has been established that the sensitivity of the pulp can decrease in the teeth, the function of which is reduced, not standing outside the arch, with petrification of the pulp, etc.

There are devices for determining the electrical excitability of the pulp with direct current. These devices have an electrode that is in contact with the tooth being examined, and a scale with divisions from 1 to 10. Using this device, you can determine the presence of the pulp and its condition (normal or inflamed). Normal pulp responds to a current corresponding to a deviation of the arrow by 1-2 divisions, with inflammation - by 4-5, and if the pulp is absent or necrotic, then the tooth does not respond to the applied current. Such devices do not allow to accurately determine the state of the pulp, but they are simpler.

It should be noted that the given indicators of the state of the pulp refer to permanent occlusion teeth with a fully formed root tip.

Electroodontodiagnostics - a method from 60 summer practice, which helps to reveal the depth of the pathological process inside the tooth. The main indications for electrodontometry are suspicions of the development deep caries, pulpitis or periodontitis. The method allows you to determine not only the localization of the pathological process, but also its nature.

The interpretation of the results of the procedure is carried out by the doctor on the basis of the threshold current strength indicators registered by the nurse. Although the procedure is considered safe, there are a number of contraindications to it. The price for the diagnosis of one tooth does not exceed 400-500 rubles in the capital's dental clinics.

The essence of the method of electroodontodiagnostics

Electroodontodiagnostics is a method for studying serious dental pathologies, used as an additional diagnostic measure along with radiography and laser research. Due to the fact that nerve endings tend to conduct current - one of the most effective pathogens, the technique allows you to determine the reaction of tooth tissues to electrical stimulation. The electric current does not injure the pulp in any way.

In modern dentistry, EDI is used after radiography or laser diagnostics. Both latest method do not always provide detailed information about the nature of the inflammatory process, they only allow you to visualize it.

When is it used in dentistry?

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Electroodontodiagnostics is a research method that is used in case of suspicion of certain dental diseases. These include:

caries and pulpitis varying degrees development;
periodontitis and periodontitis;
injuries of the dentoalveolar apparatus;
neoplasms;
the formation of pus on the jaw bones;
sinusitis;
neuritis;
radiation damage to the enamel;
fungal infection localized in the dentition.

Not always the dentist sends the patient to the EDI in order to establish or confirm the diagnosis. This diagnostic method is extremely informative for the doctor, since it makes it possible to determine the localization and nature of the inflammatory process.

Ownership reliable information allows the dentist to choose the most optimal and effective treatment strategy.

Devices used

The field of dentistry is developing very rapidly. All used technical equipment is also modernized and improved. In our country, the use of imported and domestic devices is practiced, including:

Gentle Plus, Digitest, Vitapulp. These are the latest foreign models of EDI devices.
EOM-1, EOM-3 is considered an obsolete model. An assistant is required to operate the machine.
OD-2, OD-2M. The second option is a modernized model, which uses alternating and direct current.

EDI technique

Before carrying out the EDI procedure, the dentist needs to prepare the device - turn it on and check the operation of the signal light. If at this stage the doctor does not have any difficulties, he proceeds to prepare the patient. He needs to be seated in a chair and put a rubber mat at his feet. Next, the dentist begins the diagnosis.

Conducting an EDI includes the following steps:

During the study, the doctor must ensure that the active electrode does not touch the gums and oral mucosa, and also dry the enamel from time to time so that it does not become wet. The electrical excitability of one tooth is checked twice, at the end the dentist makes a conclusion based on the average.

Contraindications

Electroodontodiagnostics is not indicated for all patients. There are several categories of people for whom EDI is contraindicated: the dentist prescribes them alternative methods study of pathological processes in the tooth. Among them:

Decoding for caries, pulpitis and other diseases

Taking readings during the procedure is carried out by a nurse. It registers the threshold values of the electric current strength. The index of tissue resistance determines the depth of the inflammatory process. Normally, it should be 2-6 µA. An increased response of 20-25 µA indicates the development carious process, 7-60 μA - about pulpitis or deep caries (see also:). An indicator above 60 μA in the deviation table is defined as a sign of complete destruction of the pulp and the development of periodontitis. Reduced result observed in patients with underdeveloped roots.

In children during the period of changing teeth, the norm indicators may vary. On the initial stage excitability value can reach 150-200 μA. Further, this indicator becomes 30-60 μA. Normal numbers as a result can be seen only after the roots are fully formed.

Prices

Despite the high information content of the method, its cost is quite budgetary. In metropolitan clinics average cost electroodontometry is 300 rubles per tooth. In other megacities of the country, the price of the procedure will be slightly lower - 200-250 rubles, and in provincial cities the price range varies between 150 and 200 rubles. Electroodontometry costs patients much cheaper than other methods for diagnosing pulpitis, deep caries and periodontitis.