Adult pulpal diagnosis. I. Evaluation of the positive and negative responses to cold and electrical pulp tests.

This study investigated the positive and negative responses of 1488 teeth in 60 patients to two electric pulp testers and a cold thermal pulp test. Three subgroups of known pulpless or pulpally diseased teeth (teeth receiving root canal therapy, teeth with root canal fillings, or teeth with confirmed associated apical radiolucencies) were identified and their responses evaluated separately. Testing was performed on two tooth surfaces, the facio-occlusal and faciocervical, and on all restorations. The gingival tissue of each patient also was tested using both electrical tests. The primary findings were: (a) teeth not responding to cold and either not responding or responding at readings greater than the tissue response to electrical had a high probability of being in the known pulpless or pulpally diseased subgroups; (b) the only false positive responses to cold in the three subgroups were in multirooted teeth with probable vital tissue remaining in at least one canal; and (c) in the three subgroups, if the false positive responses to electrical that responded at levels higher than the patient's tissue response were considered to be negative responses, the difference in false positives between cold and electrical became not statistically significant (p = 0.07).