parkell Digitest II Instructions For Use Manual page 3

• A dry cotton roll should be placed in the
buccal vestibule to isolate the tooth from the lip
and cheek.
• A plastic mirror should be used to keep the tongue
off of the tooth during testing.
• Insert Tooth Probe (E) into
the open end of the Power
Unit. To enhance electrical
conductivity and contact
between tooth and probe,
apply a small amount of
toothpaste to the metal tip.
• Metal or ceramic surfaces cannot be used as
touch points for the Tooth Probes. Teeth selected
for pulp testing must possess enough exposed
enamel or dentin to allow the probe to make
contact without touching the gingiva or a metal
restoration. In certain cases, this may require the
use of a Precision Probe (included).
• Fully instruct the patient as to what you will be
doing, so they are not surprised during the test.
• Tell the patient that when the vitality test is
underway, they should carefully raise their hand
at the first sign of sensing the stimulus. This
should avoid any patient
discomfort.
Pulp Vitality Testing
with the Digitest II Pulp
Vitality Tester
1) To activate the unit, press
and hold the start button (F) for
a half second, and then release
the button. When the button is
depressed, the display will show
one row of horizontal bars if the device is set for
"SLOW", two rows for "MEDIUM", or three rows for
"FAST". When the button is released, the display
will read "00", indicating that it is ready to begin the
vitality test. The display will shut off if the unit is not
used within 14 seconds.
SLOW
2) If the desired stimulus rate
mode was displayed, the vitality
test may proceed, as detailed in
Step 4.
3) If you wish to change the
stimulus rate mode, repeatedly press and release
the button twice in quick succession. The display
will cycle between the three stimulus rate modes.
When the desired setting is displayed, press the
button one more time to let the display return to
"00", so the test may begin.
NOTE: The unit will remember the last
stimulus rate mode setting, even if the device
is powered down.
MEDIUM FAST
READY
4) Place the toothpaste-covered tip of the Tooth
Probe on the middle of the labial or lingual surface
of the tooth. Avoid soft tissue and restorations such
as crowns, amalgams or composites.
5) Depress and hold the button, and the display
number will rise, indicating that a gentle-pulse
stimulus is being automatically applied to the
E
tooth. When the patient indicates that they feel the
stimulus, release the button. The stimulus will stop
immediately. The display will freeze and hold the
final reading for approximately 14 seconds, so it
may be noted. The unit will then automatically turn
itself off.
6) The maximum stimulus reading is 64. Even if
there is no response at this level, there is still the
possibility that the tooth is vital. No sensation at this
number simply suggests that the tooth is non-re-
sponsive at the time of the test. However, since
teeth have been known to recover from traumatic
injury many days after presenting with a "non-vital"
reading, follow up testing is almost always indicated
after any initial readings. If this reading persists
over several visits, it is reasonable to assume that
the tooth is non-vital. However, this conclusion
should always be confirmed by another accepted
endodontic testing method.
7) To verify the reading, a corresponding control
F
tooth in the same arch should be tested. Molars
should be matched to molars, premolars to premo-
lars, cuspids to cuspids, and incisors to incisors.
If this is not possible because teeth are absent,
endodontically treated, or have full coverage resto-
rations, a similar tooth in the opposite arch should
be used.
Clinical Observations
• It is not possible to prepare a "table of normal
values" for pulp tester readings, because THERE
IS NO "NORMAL" IN PULP TESTING. Rather, the
clinician should perform sequential comparisons
between the subject tooth and the control tooth
at consecutive office visits, observing how the
readings are changing as time progresses. By
utilizing electric pulp testing, along with all avail-
able diagnostic information, it is often possible to
predict where the tooth's vitality is heading. This
allows the clinician to make informed decisions as
to whether endodontic therapy is appropriate, and
whether it is prudent to simply watch and wait.
• There are general anatomic trends in pulp vitality
readings. Posterior teeth generally require greater
stimulus than anteriors, probably because of the
greater thickness of enamel and dentin in pos-
terior teeth. Enamel requires a greater stimulus
than dentin or cementum, because of the higher
percentage of non-conductive mineral, and the
lower percentage of water. Cross-arch teeth, or
opposing teeth will have similar thresholds to
stimulus.
• The stimulus threshold may also be affected by
such factors as the age, gender and previous pain
history of the patient, pulp chamber size, trauma,
pathology and use of prescription and non-pre-
scription medications, or illicit drug use.