EUROMEDICA  Hanover 23-24  Mai 2011	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover

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Introduction

It is known that in various systemic diseases there may be changes in dental pulp that reduces the threshold of its electroexcitability and can be viewed as pathology, although teeth are clinically healthy. Such diversity between the clinic and indices of the pulp electroexcitability threshold may mislead a doctor in the choice of treatment even in superficial lesions of hard tissues, where the reaction of the pulp decreases instead of keeping within the normal range.

The aim of our research was to study the pulp electroexcitability threshold of sound (intact) teeth in patients with systemic somatic pathology.

Materials and methods

Against (the background of ) the systemic pathology the diseases with possible involvement of various structures of the pulp (blood vessels, nerves, stroma) were chosen to determine the threshold of the pulp electroexcitability in sound teeth.

943 measurements of the threshold of the pulp electroexcitability in sound teeth were carried out among 159 persons at the age of 20-60 years. 101 patients had the pathology of the internal organs and 58 - were somatically healthy. The patients with a somatic pathology were divided into 4 groups depending on their underlying diseases. The first group included 24 patients at the age of 41-60 years with the diseases of the cardiovascular system (hypertension, coronary heart disease (CHD), heart defects), where 118 teeth were examined; The second group included 23 patients at the age of 20-30 years with neurological disorders (disseminated sclerosis, transverse myelitis, craniocerebral injury), where 78 teeth were examined; and the third group numbered 23 patients at the aged of 41-60 years with connective tissue diseases (systemic lupus erythematosus, gouty arthritis, spondylarthritis, rheumatoid arthritis, ankylosing spondylitis, polyarthritis), where pulp electroexcitability threshold was estimated in 92 teeth, and the fourth group included 31 patients with insulin-independent diabetes of the second type, where 135 teeth were examined.

As the examined groups of patients were of different ages (20-30 years and 41-60 years) they were compared according to their age periods.

Pulp electroexcitability threshold was measured in the main sensitive points with elektroodontotester CAP 2.0 Aveyron (2006 release, Russia) by Rubin’s technique (1976).

Statistical processing was conducted with the programme Statsoft Statistica ver.6.0

Findings

It was established that in patients with no somatic pathology the threshold of the pulp electroexcitability was on average 9.3 mA (p <0,001), in patients with cardiovascular diseases it was 6.6 mA (p <0,001), in patients with neurological disorders the threshold averaged 11.12 mA (p <0,001). But in the patients with connective tissue diseases this index was – 4.3 mA (p <0,001). And in patients with diabetes the threshold of the pulp electroexcitability significantly decreased and averaged 18.4 mA (p <0,001).

Conclusion

Thus, in patients with systemic disorders it is necessary to take into account the changed reactivity of the pulp and not to expand the scope of surgical interventions.