cold testing through full-coverage restorations.pdfVIP

JOURNAL OF ENDODONTICS Printed in U.S.A. Copyright © 2004 by The American Association of Endodontists VOL. 30, NO. 10, OCTOBER 2004 Cold Testing Through Full-Coverage Restorations Stuart O. Miller, DDS, MS, James D. Johnson, DDS, MS, John D. Allemang, DDS, and James M. Strother, DDS, MS Endodontic diagnosis often requires thermal test- causing stronger and faster wave movement of the fluid within the ing through porcelain fused-to-metal (PFM) and dentinal tubules, stimulating receptors, and exciting pulpal A-delta all-ceramic restorations. The purpose of this study fibers. Gradual temperature changes do not produce a rapid re- was to measure and compare the temperature sponse but will eventually produce a response by stimulating pain change during thermal testing by three commonly receptor activity in the pulpal C-fibers (3, 4). CO2 snow can be as cold as 78° C, but, as it is used clinically, CO2 snow can only used methods occurring at the pulp-dentin junc- produce a temperature of 56°C (5). CO2 snow has been deter- tion (PDJ) of nonrestored teeth and teeth restored mined to be safe for vitality testing (5). Application of CO2 snow with full coverage restorations made of PFM, all- for as long as 2 minutes does not damage the enamel surface (5, 6), porcelain, or gold. The methods used to produce a and no infla