Advertisement

Clinical Oral Investigations

, Volume 23, Issue 3, pp 1121–1132 | Cite as

Detection of pulsed blood flow through a molar pulp chamber and surrounding tissue in vitro

  • S. Knörzer
  • K.-A. Hiller
  • M. Brandt
  • A. Niklas
  • J. Putzger
  • G. J. Monkman
  • S. N. Danilov
  • S. D. Ganichev
  • I. Schulz
  • G. SchmalzEmail author
Original Article
  • 109 Downloads

Abstract

Objectives

Due to severe limitations of dental pulp sensitivity tests, the direct recording of pulsed blood flow, using photoplethysmography (PPG), has been proposed. In vivo evaluation is methodologically difficult and in vitro models have hitherto been adversely influenced by shortcomings in emulating the in vivo situation. Consequently, the aim of this study was to test an improved data acquisition system and to use this configuration for recording pulsed blood in a new model.

Materials and methods

We introduced a PPG signal detection system by recording signals under different blood flow conditions at two wavelengths (625 and 940 nm). Pulsed blood flow signals were measured using an in vitro model, containing a molar with a glass pulp and a resin socket, which closely resembled in vivo conditions with regard to volumetric blood flow, pulp anatomy, and surrounding tissue.

Results

The detection system showed improved signal strength without stronger blanketing of noise. On the tooth surface, it was possible to detect signals emanating from pulsed blood flow from the glass pulp and from surrounding tissue at 625 nm. At 940 nm, pulp derived signals were recorded, without interference signals from surrounding tissue.

Conclusion

The PPG-based method has the potential to detect pulsed blood flow in small volumes in the pulp and (at 625 nm) also in adjacent tissues.

Clinical relevance

The results show the need for clear differentiation of the spatial origins of blood flow signals of any vitality test method to be applied to teeth.

Keywords

Dental pulp tests Laser Doppler flowmetry Photoplethysmography Pulpal blood flow Pulp vitality 

Notes

Funding

The work was supported by the DFG projects (SCHM 386/3, GA-501/10 and MO 2196/1), the Linkage Grant of IB of BMBF at DLR and OTH-Regensburg Applications Center “Miniaturisierte Sensorik” (SappZ) funded by the Bavarian Government.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

References

  1. 1.
    Levin LG (2013) Pulp and Periradicular testing. J Endod 39:S13–S19.  https://doi.org/10.1016/j.joen.2012.11.047 CrossRefGoogle Scholar
  2. 2.
    Mejàre IA, Axelsson S, Davidson T et al (2012) Diagnosis of the condition of the dental pulp: a systematic review. Int Endod J 45:597–613.  https://doi.org/10.1111/j.1365-2591.2012.02016.x CrossRefGoogle Scholar
  3. 3.
    Chen E, Abbott PV (2009) Dental pulp testing: a review. Int J Dent 2009:365785–365712.  https://doi.org/10.1155/2009/365785 CrossRefGoogle Scholar
  4. 4.
    Yu C, Abbott PV (2007) An overview of the dental pulp: its functions and responses to injury. Aust Dent J 52:S4–S6.  https://doi.org/10.1111/j.1834-7819.2007.tb00525.x CrossRefGoogle Scholar
  5. 5.
    Allen J (2007) Photoplethysmography and its application in clinical physiological measurement. Physiol Meas 28:R1–R39.  https://doi.org/10.1088/0967-3334/28/3/R01 CrossRefGoogle Scholar
  6. 6.
    Fein ME, Gluskin AH, Goon WW et al (1997) Evaluation of optical methods of detecting dental pulp vitality. J Biomed Opt 2:58–73.  https://doi.org/10.1117/12.261679 CrossRefGoogle Scholar
  7. 7.
    Oikarinen KS, Kainulainen V, Särkelä V et al (1997) Information of circulation from soft tissue and dental pulp by means of pulsatile reflected light: further development of optical pulp vitalometry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 84:315–320CrossRefGoogle Scholar
  8. 8.
    Carlson KA, Jahr JS (1993) A historical overview and update on pulse oximetry. Anesthesiol Rev 20:173–181Google Scholar
  9. 9.
    Jafarzadeh H, Rosenberg PA (2009) Pulse oximetry: review of a potential aid in endodontic diagnosis. J Endod 35:329–333.  https://doi.org/10.1016/j.joen.2008.12.006 CrossRefGoogle Scholar
  10. 10.
    Schnettler JM, Wallace JA (1991) Pulse oximetry as a diagnostic tool of pulpal vitality. J Endod 17:488–490.  https://doi.org/10.1016/S0099-2399(06)81795-4 CrossRefGoogle Scholar
  11. 11.
    Jafarzadeh H (2009) Laser Doppler flowmetry in endodontics: a review. Int Endod J 42:476–490.  https://doi.org/10.1111/j.1365-2591.2009.01548.x CrossRefGoogle Scholar
  12. 12.
    Kimura Y, Wilder-Smith P, Matsumoto K (2000) Lasers in endodontics: a review. Int Endod J 33:173–185CrossRefGoogle Scholar
  13. 13.
    Dick SK, Chistyakova GG, Terekh AS et al (2014) Characterization of blood flow rate in dental pulp by speckle patterns of backscattered light from an in vivo tooth. J Biomed Opt 19:106012.  https://doi.org/10.1117/1.JBO.19.10.106012 CrossRefGoogle Scholar
  14. 14.
    Stoianovici C, Wilder-Smith P, Choi B (2011) Assessment of pulpal vitality using laser speckle imaging. Lasers Surg Med 43:833–837.  https://doi.org/10.1002/lsm.21090 CrossRefGoogle Scholar
  15. 15.
    Yoon M-J, Kim E, Lee S-J et al (2010) Pulpal blood flow measurement with ultrasound Doppler imaging. J Endod 36:419–422.  https://doi.org/10.1016/j.joen.2009.12.031 CrossRefGoogle Scholar
  16. 16.
    Cho Y-W, Park S-H (2014) Use of ultrasound Doppler to determine tooth vitality in a discolored tooth after traumatic injury: its prospects and limitations. Restor Dent Endod 39:68–73.  https://doi.org/10.5395/rde.2014.39.1.68 CrossRefGoogle Scholar
  17. 17.
    Niklas A, Hiller KA, Jaeger A et al (2014) In vitro optical detection of simulated blood pulse in a human tooth pulp model. Clin Oral Investig 18:1401–1409.  https://doi.org/10.1007/s00784-013-1115-z CrossRefGoogle Scholar
  18. 18.
    Miwa Z, Ikawa M, Iijima H et al (2002) Pulpal blood flow in vital and nonvital young permanent teeth measured by transmitted-light photoplethysmography: a pilot study. Pediatr Dent 24:594–598Google Scholar
  19. 19.
    Karayilmaz H, Kirzioğlu Z (2011) Comparison of the reliability of laser Doppler flowmetry, pulse oximetry and electric pulp tester in assessing the pulp vitality of human teeth. J Oral Rehabil 38:340–347.  https://doi.org/10.1111/j.1365-2842.2010.02160.x CrossRefGoogle Scholar
  20. 20.
    Siddheswaran V, Adyanthaya R, Shivanna V (2011) Pulse oximetry: a diagnostic instrument in pulpal vitality testing—an in vivo study. World J Dent 2:225–230CrossRefGoogle Scholar
  21. 21.
    Ingólfsson AR, Tronstad L, Hersh EV, Riva CE (1994) Efficacy of laser Doppler flowmetry in determining pulp vitality of human teeth. Endod Dent Traumatol 10:83–87CrossRefGoogle Scholar
  22. 22.
    Polat S, Er K, Akpinar KE, Polat NT (2004) The sources of laser Doppler blood-flow signals recorded from vital and root canal treated teeth. Arch Oral Biol 49:53–57.  https://doi.org/10.1016/S0003-9969(03)00197-3 CrossRefGoogle Scholar
  23. 23.
    Soo-ampon S, Vongsavan N, Soo-ampon M et al (2003) The sources of laser Doppler blood-flow signals recorded from human teeth. Arch Oral Biol 48:353–360.  https://doi.org/10.1016/S0003-9969(03)00011-6 CrossRefGoogle Scholar
  24. 24.
    Akpinar KE, Er K, Polat S, Polat NT (2004) Effect of gingiva on laser Doppler pulpal blood flow measurements. J Endod 30:138–140.  https://doi.org/10.1097/00004770-200403000-00003 CrossRefGoogle Scholar
  25. 25.
    Hartmann A, Azérad J, Boucher Y (1996) Environmental effects on laser Doppler pulpal blood-flow measurements in man. Arch Oral Biol 41:333–339.  https://doi.org/10.1016/0003-9969(95)00133-6 CrossRefGoogle Scholar
  26. 26.
    Roebuck EM, Evans DJP, Stirrups D, Strang R (2001) The effect of wavelength, bandwidth, and probe design and position on assessing the vitality of anterior teeth with laser Doppler flowmetry. Int J Pediatr Dent 10:213–220.  https://doi.org/10.1046/j.1365-263x.2000.00194.x CrossRefGoogle Scholar
  27. 27.
    Polat S, Er K, Polat NT (2005) Penetration depth of laser Doppler flowmetry beam in teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 100:125–129.  https://doi.org/10.1016/j.tripleo.2004.11.018 CrossRefGoogle Scholar
  28. 28.
    Ikawa M, Vongsavan N, Horiuchi H (1999) Scattering of laser light directed onto the labial surface of extracted human upper central incisors. J Endod 25:483–485.  https://doi.org/10.1016/S0099-2399(99)80286-6 CrossRefGoogle Scholar
  29. 29.
    Kakino S, Miwa Z, Kirimoto A, et al (2007) A new multi-wavelength optical-plethysmograph for quantitative determination of pulpal hemoglobin content and oxygen level using green and near-infrared LEDs. Proc SPIE 6425:642508–642508–9. doi:  https://doi.org/10.1117/12.699628
  30. 30.
    Kakino S, Kushibiki S, Yamada A, Miwa Z (2013) Optical measurement of blood oxygen saturation of dental pulp. ISRN Biomed Eng 2013:1–6.  https://doi.org/10.1155/2013/502869 CrossRefGoogle Scholar
  31. 31.
    Lindberg L-G, Öberg PA (1993) Optical properties of blood in motion. Opt Eng 32:253–257.  https://doi.org/10.1117/12.60688 CrossRefGoogle Scholar
  32. 32.
    Kim S (1985) Microcirculation of the dental pulp in health and disease. J Endod 11:465–471.  https://doi.org/10.1016/S0099-2399(85)80219-3 CrossRefGoogle Scholar
  33. 33.
    Path MG, Meyer MW (1980) Heterogeneity of blood flow in the canine tooth in the dog. Arch Oral Biol 25:83–86.  https://doi.org/10.1016/0003-9969(80)90081-3 CrossRefGoogle Scholar
  34. 34.
    Hock J, Nuki K, Schlenker R, Hawks A (1980) Clearance rates of Xenon-133 in non-inflamed and inflamed gingiva of dogs. Arch Oral Biol 25:445–449.  https://doi.org/10.1016/0003-9969(80)90050-3 CrossRefGoogle Scholar
  35. 35.
    Schulz I, Putzger J, Niklas A, et al PPG signal acquisition and analysis on in vitro tooth model for dental pulp vitality assessment. ARC 2012. Submission 16Google Scholar
  36. 36.
    Hiller K-A, Christa T, Niklas A et al (2013) An in-vitro-model of a human jaw for testing optical properties. J Dent Res 92(Spec. Issue A):3716Google Scholar
  37. 37.
    Diaz-Arnold AM, Wilcox LR, Arnold MA (1994) Optical detection of pulpal blood. J Endod 20:164–168.  https://doi.org/10.1016/S0099-2399(06)80327-4 CrossRefGoogle Scholar
  38. 38.
    Kahan RS, Gulabivala K, Snook M, Setchell DJ (1996) Evaluation of a pulse oximeter and customized probe for pulp vitality testing. J Endod 22:105–109.  https://doi.org/10.1016/S0099-2399(96)80283-4 CrossRefGoogle Scholar
  39. 39.
    Friebel M, Roggan A, Müller G, Meinke M (2006) Determination of optical properties of human blood in the spectral range 250 to 1100 nm using Monte Carlo simulations with hematocrit-dependent effective scattering phase functions. J Biomed Opt 11:034021.  https://doi.org/10.1117/1.2203659 CrossRefGoogle Scholar
  40. 40.
    Vongsavan N, Matthews B (1993) Experiments on extracted teeth into the validity of using laser Doppler techniques for recording pulpal blood flow. Arch Oral Biol 38:431–439.  https://doi.org/10.1016/0003-9969(93)90215-8 CrossRefGoogle Scholar
  41. 41.
    Margolis J (1957) Initiation of blood coagulation by glass and related surfaces. J Physiol 137:95–109CrossRefGoogle Scholar
  42. 42.
    Ketterl W (1983) Age-induced changes in the teeth and their attachment apparatus. Int Dent J 33:262–271Google Scholar
  43. 43.
    Benedict RP (1984) Fundamentals of temperature, pressure and flow measurements. John Wiley & SonsGoogle Scholar
  44. 44.
    Oikarinen K, Kopola H, Mäkiniemi M, Herrala E (1996) Detection of pulse in oral mucosa and dental pulp by means of optical reflection method. Endod Dent Traumatol 12:54–59CrossRefGoogle Scholar
  45. 45.
    Hoke JA, Burkes EJ, White JT et al (1994) Blood-flow mapping of oral tissues by laser Doppler flowmetry. Int J Oral Maxillofac Surg 23:312–315.  https://doi.org/10.1016/S0901-5027(05)80117-1 CrossRefGoogle Scholar
  46. 46.
    Hirmer M, Danilov SN, Giglberger S et al (2012) Spectroscopic study of human teeth and blood from visible to terahertz frequencies for clinical diagnosis of dental pulp vitality. J Infrared Milli Terahz Waves 33:366–375.  https://doi.org/10.1007/s10762-012-9872-3 CrossRefGoogle Scholar
  47. 47.
    Ganichev S, Prettl W (2006) Intense terahertz excitation of semiconductors. Oxford University Press on DemandGoogle Scholar
  48. 48.
    Olbrich P, Karch J, Ivchenko EL et al (2011) Classical ratchet effects in heterostructures with a lateral periodic potential. Phys Rev B 83:165320.  https://doi.org/10.1103/PhysRevB.83.165320 CrossRefGoogle Scholar
  49. 49.
    Lechner V, Golub LE, Olbrich P et al (2009) Tuning of structure inversion asymmetry by the δ-doping position in (001)-grown GaAs quantum wells. Appl Phys Lett 94:242109.  https://doi.org/10.1063/1.3156027 CrossRefGoogle Scholar
  50. 50.
    Alfano R, Lam W, Zarrabi H et al (1984) Human teeth with and without caries studied by laser scattering, fluorescence, and absorption spectroscopy. IEEE J Quantum Electron 20:1512–1516.  https://doi.org/10.1109/JQE.1984.1072351 CrossRefGoogle Scholar
  51. 51.
    Ikawa M, Horiuchi H, Ikawa K (1994) Optical characteristics of human extracted teeth and the possible application of photoplethysmography to the human pulp. Arch Oral Biol 39:821–827.  https://doi.org/10.1016/0003-9969(94)90012-4 CrossRefGoogle Scholar
  52. 52.
    Hammer M, Schweitzer D, Michel B et al (1998) Single scattering by red blood cells. Appl Opt 37:7410–7418CrossRefGoogle Scholar
  53. 53.
    Meinke M, Müller G, Helfmann J, Friebel M (2007) Empirical model functions to calculate hematocrit-dependent optical properties of human blood. Appl Opt 46:1742–1753CrossRefGoogle Scholar
  54. 54.
    Huerre A, Jullien MC, Theodoly O, Valignat MP (2016) Absolute 3D reconstruction of thin films topography in microfluidic channels by interference reflection microscopy. Lab Chip 16:911–916.  https://doi.org/10.1039/C5LC01417D CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • S. Knörzer
    • 1
    • 2
  • K.-A. Hiller
    • 1
  • M. Brandt
    • 3
  • A. Niklas
    • 4
  • J. Putzger
    • 5
  • G. J. Monkman
    • 6
  • S. N. Danilov
    • 5
  • S. D. Ganichev
    • 5
  • I. Schulz
    • 6
  • G. Schmalz
    • 1
    • 7
    Email author
  1. 1.Department of Conservative Dentistry and PeriodontologyUniversity Medical Center Regensburg, University of RegensburgRegensburgGermany
  2. 2.Private practiceAmbergGermany
  3. 3.Department of OrthodonticsUniversity Hospital of RTWH AachenAachenGermany
  4. 4.Private practiceKulmbachGermany
  5. 5.Department of PhysicsUniversity of RegensburgRegensburgGermany
  6. 6.Mechatronics Research UnitUniversity of Applied Sciences RegensburgRegensburgGermany
  7. 7.Department of PeriodontologyUniversity of BernBernSwitzerland

Personalised recommendations