In modern dentistry, more additional research methods are used. and are a prerequisite for making a correct diagnosis. Unfortunately, they cannot always give a complete picture of the disease.
In Soviet times, when such studies were unavailable, no less informative methods were used. One of these is electroodontometry (EOM).
Electroodontodiagnosis (EDD) is a research method that can be used to assess the vitality 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 treatment method and evaluate the results of the therapy.
How it works?
The method of electroodontodiagnosis is based on the ability of living tissues to be excited under the influence of an irritant. The same tissue, depending on its functional state at the time of examination, has 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, the minimum intensity of irritation is determined.
In the case of a decrease in excitability, a response will occur only when the intensity of the current stimulus increases. When it increases, it’s the other way around—less influence is needed to excite tissues.
Electric current is one of the most effective and accessible pathogens. The time of its exposure can be changed, and irritation can be repeated several times without harm to the tissue.
The electrical conductivity in tooth tissue is influenced by the amount of water. The greater it is, the higher the number of ions capable of responding to the influence of current. The dental pulp contains a larger volume of fluid than the enamel, so the study identified special sensitive points that correspond to the minimum distance to the pulp chamber.
The purpose of the study is to determine whether the tooth can be cured.
Indications for EDI
Electroodontometry in modern dentistry is used in the following cases:
- differential diagnostics of depth;
- differential diagnosis of pulp damage ();
- diagnostics ;
- identification;
- traumatic damage to the jaws and teeth;
- inflammation of the maxillary sinus;
- tumors of the jaws of various etiologies;
- neuritis and neuralgia;
- radiation injury;
- treatment with .
Restrictions on the use of this technique
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 surface under study is impossible;
- electric current is not transferred for one reason or another;
- the patient is less than 5 years old.
Cases when there is a possibility of obtaining a false result, that is, relative contraindications:
- patient's nervousness during the appointment;
- presence on the tooth;
- the presence of metal orthopedic structures in the oral cavity;
- the presence of amalgam fillings;
- root crack;
- root canal or tooth cavity;
- malfunction in the equipment used to conduct the study;
- violation of the methodology.
Diagnostic technique
Both a doctor and a nurse take part in the study.
Equipment used
EDI is performed using the following devices:
- OD-2M;
- EOM-3;
- IVN-1;
- OSM-50;
- Puptest 2000;
- EOM-1.
Difficulties during the study
When performing electroodontometry, it is important to remember that the tooth can react differently to the current. It is imperative to take into account the patient’s age and the presence of systemic diseases. Also, the sensitivity of tooth tissues is affected by pathologies of the jaw bones and perimaxillary soft tissues.
In addition, external interference can also have an impact. UHF and microwave devices negatively affect electroodontometry devices and lead to false results.
The most important thing is to fully comply with the research methodology. It must correspond exactly to the instructions for the device. Only in this case can reliable results be obtained.
Decoding indicators
EDI indicators that dentists focus on when assessing diagnostic results:
Cost of the study
The price of this type of diagnosis varies from 150 to 400 rubles per tooth.
Electroodontodiagnostics is an accessible and informative method for studying dental tissues. But it cannot be used independently. Due to the complexity and large number of contraindications, electroodontometry can only act as an additional examination.
In combination with other research methods, the doctor will receive complete information about the changes that have occurred in the dental tissues and make the correct diagnosis.
EDI (Electroodontodiagnosis) in dentistry is the determination of the state of the nerve elements of the dental pulp using electric current.
Physical and physiological effects
The property of nervous tissue to become excited when stimulated by an electric current is used. The threshold excitation of pain and actile receptors of the dental pulp is determined. The electric current passing through the tooth tissue does not damage the pulp and is precisely dosed.
EDI of intact teeth with formed roots.
The electrical excitability of such teeth is 2-6 μA. A response to a current of up to 2 μA indicates an increase in the electrical excitability of the pulp; more than 6 μA indicates a decrease.
EDI of baby teeth during the period of resorption of their roots.
From 2-6 μA to the complete absence of electrical excitability, depending on the state of the innervation apparatus, the development of inflammatory phenomena in the pulp.
EDI of permanent teeth during their eruption and root formation.
The innervation apparatus is not developed, the root is formed at 1/3-1/2 of its length, electrical excitability is absent or sharply reduced: 200-150 μA. The elements of the subodontic nerve plexus, simple nerve endings in the area of the pulp horns are determined, the root is formed at 2/3 of its length: 30-60 μA. Developed innervation apparatus, root formed: 2-6 µA
EDI for caries.
Electrical excitability can decrease to 20-25 μA.
EDI for pulpitis and periodontitis.
When the coronal pulp is damaged, the electrical excitability is 7-60 μA. A slight decrease in electrical excitability to 20-25 μA with the appropriate clinic indicates a limited process, i.e. about focal pulpitis and reversible inflammatory changes. A pronounced decrease in electrical excitability (25-60 μA) indicates the prevalence of the process in the coronal pulp. A reaction of 61 -100 μA indicates the death of the coronal pulp and the transition of inflammation to the root pulp. 101-200 µA corresponds to the complete death of the pulp, while periodontal receptors react to the current. In the presence of periapical changes (periodontitis, radicular cyst), electrical excitability may be completely absent.
EDI for diseases of the trigeminal nerve.
With trigeminal neuralgia, the electrical excitability of the intact teeth in the affected area is not changed. With neuritis of the I-III branches of the trigeminal nerve, the electrical excitability of the intact teeth in the affected area may decrease, up to the complete absence of electrical excitability.
EDI for dental trauma.
A decrease in the electrical excitability of teeth is possible, due to both pathological changes in the pulp and traumatic neuritis.
EDI for jaw tumors.
Gradual reduction in the excitability of the teeth in the affected area.
Purpose of EDI.
Differential diagnosis,
- determination of the extent of prevalence and localization of the pathological process,
- choice of treatment method and monitoring the effectiveness of therapy.
Indications for EDI in dentistry:
Caries,
- pulpitis,
- periodontitis,
- radicular cyst.
- trauma to teeth and jaws,
- sinusitis,
- osteomyelitis.
- actinomycosis,
- tumors of the jaws,
- neuritis of the facial and trigeminal nerve.
- radiation damage,
- orthodontic treatment.
Contraindications.
A tooth covered with an artificial crown
- anesthesia of the maxillofacial area
Equipment
EOM-1, EOM-3. "Puptest 2000".
Technique and methodology of electroodontodiagnosis:
The passive electrode is in the patient's hand. The tooth is isolated from saliva and thoroughly dried with cotton balls, the active electrode is placed on sensitive points of the tooth: the middle of the cutting edge - on the front teeth, the top of the buccal cusp - on the premolars, the top of the anterior buccal cusp - on the molars. In carious teeth, electrical excitability is checked from the bottom of the carious cavity. (The study is carried out from 3 different points of the carious cavity, the minimum value is taken into account). When conducting EDI from the bottom of the tooth cavity, the active electrode is placed in turn at the mouth (projection of the mouth) of each root canal. A minimum current strength (threshold) is applied, causing a feeling of a slight prick, jolt, and mild pain.
The EDI method was introduced into dental practice by Lev Rubin in 1949, and due to its effectiveness, the research became widespread outside the USSR. A special device allows you to determine the threshold for excitation of dental pulp receptors using an electric current passing through it.Electroodontometry helps to get an idea of the condition of dental tissues, identify the functionality and sensitivity of the nervous system.
During inflammatory processes and changes in the pulp, not only the structure of the tissue changes, but also degeneration of nerve receptors occurs, which affects their electrical excitability. A special device helps to identify the presence of the disease and determine treatment methods. EDI is an additional research method. The diagnosis is established by comparing all the information obtained during examination, x-rays, CT scans, and laser diagnostics.
What is the method of electroodontodiagnosis?
Nerve endings located in the tooth tissue are capable of conducting current. Depending on the state of the neurovascular endings, the reaction to the impact may change - this is what the research method is based on. The higher the current strength to which the nerves are capable of reacting, the deeper and stronger the spread of pathological processes.
The affected pulp has less electrical excitability than healthy teeth. A weak reaction to current is observed in periodontitis, pulpitis, deep caries, jaw tumors, during resorption of the roots of baby teeth (we recommend reading: pulpitis of baby teeth in children: causes and methods of treatment). A complete absence or too weak a reaction occurs in teeth that are just emerging and have underdeveloped roots. Depending on the indicators of response to irritation, the specialist makes a conclusion about the condition of the tissues. Electroodontic diagnostics is carried out for:
- assessing the condition of nerve endings in the tooth;
- calculating the length of the root canal;
- determining the quality of mineralization of tooth enamel;
- measuring the tone of the blood vessels of the tooth.
The device has a high diagnostic value for analyzing 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, and tissue inflammation.
Readings and EDI tables
During practice, dentists have established a correspondence between the disease the patient is supposed to have and the numbers appearing on the device. Normally, sensitivity occurs at a current of 2-6 microamps; if the indicator changes, the tissue is damaged and requires treatment.
If caries is present, 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.
| Tissue damage | Device values |
| Mild carious formations (spot, superficial and medium caries) | Indicator 2-6 µA or within normal limits |
| Deep caries | Electrical excitability will be 10-12 µA. Sometimes the indicator reaches a value of 20 µA - this reaction is typical for deep caries and when necrotic tissue is close to the pulp, which can soon become inflamed. |
| Pulpitis | The readings are in the range of 20-100 µA. In case of acute focal disease, when the damage has not affected the root, the value will be 20-25 µA, in case of diffuse disease – up to 30 µA. Chronic pulpitis of the fibrous form is noticed by dentists at numbers of 30-40 μA; with the gangrenous type, numbers of 60-100 μA will appear on the screen. |
| Periodontitis | The value will go off scale beyond 100 μA, and sometimes reach 150-300. This means that the process of pulp necrosis has begun. |
In addition to eliminating caries and its complications, the device is used to diagnose other conditions. Specialists use EDI to identify diseases: neuritis and trigeminal neuralgia, cysts (contacting teeth are checked).
The sensitivity of patients fluctuates significantly when exposed to electric current, so the doctor focuses on relative numbers. To do this, a healthy tooth (symmetrical) is diagnosed, taking the data as the physiological norm for a particular person.
Equipment for EDI
Electroodontometry is a popular and informative method for obtaining information about the condition of the soft tissues of 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 diagnostics to be made with high accuracy. Among the imported devices, Vitapulp, Gentle Plus, Pulptester are often used, but it is worth considering that on the models the scale is presented not in μA value, but in conventional units.
The following models of domestic devices 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 independently, so the help of an assistant is required.
Stages of the procedure
Diagnostics in dentistry is carried out to identify pathological changes in tissue. It competes with radiography and checking the condition of teeth using a laser, but the first method does not always have the desired effect, and transillumination is applicable exclusively on the front teeth. Both methods help to detect the problem, and electroodontodiagnosis provides information about its nature.
To obtain results, the patient first takes an X-ray, which helps the doctor determine which areas need to be examined. Diagnosis of EDI is not very informative in the following cases:
During one study, it is not advisable to check more than 3-4 teeth in a row affected by pulpitis and deep caries. The body adapts to the action of the current, and inhibitory processes develop in the medulla oblongata. Oral sensitivity 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. Other surfaces require regular disinfection, but sterilization is not required. The device charges the battery or connects it to the network. The doctor selects the angle of attachment of the active electrode and inserts it into the desired socket on the control unit, then the device is turned on and configured. It is advisable not to twist the wires of the device.
Before starting the procedure, the current rise rate for diagnostics is set. Some devices have a sound signal function and illumination of the work area to facilitate the specialist’s work and conveniently take readings.
Patient preparation
To obtain reliable data, it is advisable to first clean the areas under study from plaque and tartar. In this case, you should not use devices that intensively act on tissue: ultrasound, kinetic treatment. 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 part of the oral cavity being examined is prepared:
- isolate the tooth from contact with metals (prosthesis parts, fillings);
- clean teeth from soft plaque using a cotton swab with an antiseptic (3% peroxide);
- dry the cavity from saliva using cotton balls.
The patient holds the passive wire with his hand (in modern models of devices it is hung on the lower lip using a hook). During the procedure, you need to hold the electrode firmly to ensure good contact. The patient must respond to the stimulus by pressing a button. The sterile electrode is inserted into the EDI attachment by a specialist, 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
To carry out the procedure, the research tip is placed on sensitive areas. It is pre-treated with a conductive gel-based preparation. The tip is lightly pressed against the tooth, and the device begins to generate impulses. At the first unpleasant feeling, the patient presses a button and the device records the readings. This will be the current strength to which the problem area reacted.
The test is carried out at points where the reaction occurs at minimum values: at the incisors in the middle of the cutting edge, at the premolars on the buccal cusp, at the molars on the anterior buccal cusp - they have the greatest resistance. During the examination, sensations of burning, pain, jolting or tingling appear.
To control the correctness of the procedure, EDI device settings are tested 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 receive unreliable results:
- if the conductor touches 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 to the procedure
Electroodontodiagnosis is a convenient and quick way to identify pathology in a 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 causing excessive sensitivity in an area of the mouth;
- inability to completely dry the area from saliva;
- fibrous pulpitis in chronic form;
- temporary loss of sensitivity during the action of jaw anesthesia;
- hypertonic disease;
- presence of a pacemaker;
- It is not carried out in areas with installed amalgam fillings and on artificial crowns.
The specialist must carefully monitor the location of the electrode, the presence of liquid in the mouth, and the contact of fillings - incorrect diagnostics will give a false positive result. The patient’s attitude is important: if he is very nervous, he can signal sensations that have appeared when the device has not yet applied voltage.
Electroodontodiagnostics (abbreviated as EOD) is a method of assessing the condition of the pulp by checking its response to electric current. It is not painful to do, but discomfort may occur during diagnosis.
Electroodontodiagnosis not only helps to identify pathological changes in the pulp, but is also used to monitor the results of treatment. It can be performed as a supplement and alternative to x-rays if x-rays are not possible for some reason.
Application in dentistry
The method of electrodiagnostics was first introduced into dental practice by the Soviet scientist Lev Rubin in 1949. Soon EDI became widespread beyond the borders of the USSR. In 1980, this was the only method that could analyze the condition of the pulp.
At the present stage, EDI competes with radiographic examination, diagnostics with light (transillumination) and the KaVo DIAGNOdent laser device.
However, radiographic examination is not always effective; transillumination is only applicable when examining anterior teeth. Both methods, together with laser diagnostics, only visualize the pathology, but do not provide complete information about its nature.
However, for accurate research results, doctors must first conduct X-ray diagnostics (or diagnostics with laser, light), and only then - EDI. Even before the procedure begins, the dentist should have an idea in which area the pathological changes have occurred.
Diagnodent laser device
The essence of the EDI technique
The nerve endings of the pulp, like any other, are capable of conducting current. The reaction to such electrical stimulation (electrical excitability) differs depending on the state of the neurovascular tissue.
The higher the current strength to which the tooth reacts, the more widespread the pathological processes are.
For example, an inflamed pulp has less electrical excitability than a healthy one. If healthy molars react to a current voltage of 2-6 μA, then with pulpitis the electrical excitability decreases to 7-90 μA. And for periodontitis (inflammation of the tissue between the tooth root and the bone) – up to 100 µA or more.
A reduced response to EDI is also observed in primary teeth during the period of root resorption, and with jaw tumors. A complete absence or, conversely, too low electrical excitability is characteristic of erupting teeth with insufficiently formed roots. Based on their differences in the response of pulp irritation to current, the dentist draws a conclusion about its condition.
Indications
EDI is effective in diagnosing diseases such as:
- carious lesions of the crown, including pulpitis;
- traumatic injuries of the dentofacial apparatus;
- tumor diseases of the jaw, including root apex cyst;
- purulent inflammation of the jaw bones;
- actinomycosis of the maxillofacial area (fungal infection);
- sinusitis that has spread to the bone walls of the jaw; paralysis and paresis of the facial nerves.
It is also justified when determining the degree of radiation damage to enamel and dentin.
Devices
For EDI, devices called electroodontometers are used:
- EOM-1 and 3;
- OD-2;
- OD-2M is a modernized odontometer that allows the use of alternating and direct current from the city network.
Portable electronic and digital testers are also used:
- Pulptest-Pro IVN-1;
- Pulp Tester;
- Analytic.
Technique of the procedure
- The patient is seated and a rubber mat is placed under his and the doctor’s feet.
- The tooth being diagnosed is isolated from saliva and dried with cotton wool.
- The active electrode is placed on the teeth, the passive electrode is given to the patient’s hand or fixed on the back of the hand, depending on the model of the device.
- A current is supplied, during which the patient may feel warmth, a slight burning sensation, or a jolt. He immediately notifies the doctor about all his reactions by sound or gesture (raising his hand, for example).
It is very important that during EDI the active electrode does not touch the gums and mucous membrane of the oral cavity, and the enamel does not become wet; for this, it is periodically dried.
The electrical excitability of each tooth is checked twice, and the average value is taken to make a conclusion about the condition of the pulp. Incisors and canines react to current faster, their enamel and dentin are thinner, premolars and molars react more slowly.
Contraindications
Electroodontodiagnosis is not performed on teeth with artificial crowns and in cases of temporary loss of sensitivity in the maxillofacial area during the period of anesthesia. The procedure is also contraindicated for patients with pacemakers or amalgam fillings.
results
To obtain reliable results from EDI, it is necessary to exclude any contact of the electrodes with metals and saliva. The psychological attitude of the patient is very important, since out of fear people can signal a reaction to the current even when voltage has not yet been applied to the device.
Prices for electroodontic diagnostics
The average cost of an EDI procedure in dental clinics in Moscow is 300 rubles. In St. Petersburg and Nizhny Novgorod – 200-250 rubles. This is slightly cheaper than other methods for diagnosing caries and pulpitis.
On our website you can find a list of clinics that successfully diagnose diseases of the dental system using electroodontodiagnosis.
This diagnostic method is based on assessing the sensitivity of the tooth nerve to electric current. With the help of such manipulations, the dentist can select the optimal treatment option and most rationally distribute the load on the damaged tooth.
The technique itself originated and has been used more than half a century ago. However, it began to gain popularity 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 tissue to electric current. The normal resistance level is 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 electroodontic diagnostic method is based on a current that penetrates the tooth tissue, or rather the pulp. Fabrics have the ability to conduct electricity and respond to current. Therefore, it is possible to evaluate how irritated the pulp is. The electrical conductivity of tissues depends on the amount of liquid they contain. Therefore, to achieve the most realistic results, before the procedure, the patient is removed all possible moisture with cotton swabs. However, it will not be possible to remove the water from the tooth itself. The largest amount of moisture is in the pulp. In the course of scientific research, special points were identified, with the help of which the diagnostic result is revealed.
The purpose of the electroodontodiagnosis technique 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 tooth tissues)
- (inflammation caused by infection of bone tissue)
- Tumors of the jaws
- Actinomycosis (an infectious chronic tissue-generating disease)
- Periodontitis (inflammatory disease, often found as a complication of caries, generates connective tissue between the tooth and the socket)
- (chronic inflammatory process in periodontium)
- Trauma to teeth or jaw
- Radiation damage
- Sinusitis
EDI indicators in dentistry
Each dental disease has its own characteristics of the device. A healthy tooth, when exposed to electric current, gives a reaction of 2-6 μA. The more inflammation, the worse the tissue reacts to current. When an inflammatory process occurs in the tissues, the performance of the electrical device increases. Thus, 20-40 µA indicates the presence of pathologies or infections in the initial stages. When the current increases to 60 μA, this indicates necrosis of the coronal pulp; above 60 μA, this indicates gangrenous infections in the pulp. If the drug readings go off scale beyond 100 µA, then the infectious process takes place in the ligamentous apparatus. However, the opinion: “the higher the indicators, the higher the degree of tissue damage” is erroneous. The reaction to electric current is checked in several areas of the tooth. For healthy tissues, the indicators will be the same and within normal limits at each point. Depending on the difference in reaction in areas of the tooth, specialists evaluate the degree of tissue damage and the possibility of their treatment.
The given indicators are typical for teeth with permanent dentition, since in teeth with reduced functionality, the sensitivity of the pulp is reduced.
Table of EDI in dentistry
For electroodontic diagnostics in dentistry, four types of devices are used:
- IVN-1
- EOM-1
- EOM-3
- OD-2 (an improved version of the device, used for odontodiagnostics, can operate not only on alternating current, but also on direct current). The performance standards for devices operating on direct current are different from those with alternating current.
Pulp tester – device for electroodontic diagnostics
Before the electroodontic diagnostic procedure, it is necessary to prepare the device and the patient for use.
The patient is seated comfortably in a chair and advised about the sensations that may arise during the diagnostic process. This may include tingling, vibrations or tremors. It is important that the patient communicates how he feels to the doctor in a timely manner. A rubber mat is placed on the floor for insulation. The EDI device is grounded.
Before diagnosis, the patient is removed all possible fluid from the oral cavity. The tooth that will be exposed to current is dried with cotton balls in the direction from the cutting edge to the middle. If there is a filling on the tooth, 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 device 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 first tested on healthy teeth. If the indicators are normal, then we begin to diagnose diseased tissue areas. In some cases, the tissue response to electric current may be distorted:
- if the conductor touches metal structures in the oral cavity (piercing);
- if the patient took 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 average of the two available values, and this result is considered the most correct.
When conducting a study, you must strictly follow the instructions for use of the drug and always listen to the opinion of your doctor.
EDI device
Electroodontodiagnostics of the tooth is considered the most cost-effective and high-quality research option. The price of the procedure ranges from 150 to 400 rubles. To this cost should be added cleaning of teeth, removal of soft dentin and filling of teeth, if necessary. This is significantly cheaper than other screening options. These price quotes are average. The cost of EDI diagnostics in dentistry depends on the clinic where the procedure is performed, region and location.
Many patients have already used the electroodontic diagnostic method and were extremely satisfied. This research method allows the doctor to correctly recognize 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 electroodontic diagnostics (chronic diseases), this method cannot be considered the only correct one. To achieve maximum effect in such cases, several research methods are used.