ASSESSMENT OF PULP VITALITY IN THE PRESENCE OF CONCOMITANT PERIODONTAL LESIONS: CHALLENGES AND PROPOSAL FOR IMPROVEMENT USING MODERN DIGITAL TECHNOLOGIES
DOI:
https://doi.org/10.32782/2786-7684/2026-2-1Keywords:
endodontics, periodontology, endo-periodontal lesions, tooth, pulp, periodontium, periodontitis, diagnosis, pulp vitality, intraoral scanning, pulse oximetryAbstract
Introduction. Currently, only a limited number of studies address the potential application of pulse oximetry for assessing tooth vitality in the presence of concomitant periodontal pathologies, particularly in endo-periodontal lesions. Therefore, further clarification of these possibilities, as well as the development of proposals to improve this method under such clinical conditions, represents a relevant and justified task in modern dental practice. Objective of the research. To analyze the limitations of current methods for assessing pulp vitality in the presence of concomitant periodontal pathology, to systematize existing approaches for their optimization, and to develop a technically grounded proposal for improvement using modern digital technologies. Materials and methods. Study had a theoretical-analytical and engineering-conceptual design and was based on a comprehensive review of contemporary literature regarding methods for assessing pulp vitality in the presence of periodontal pathology, as well as on the analysis and interpretation of current technological solutions in biophotonics and digital dentistry. Based on this analysis, a methodologically and technically substantiated concept of an integrated opto-diagnostic system was proposed as an approach to improve pulp vitality assessment using modern digital technologies. Results and discussions. The factors limiting the widespread clinical application of pulse oximetry in dentistry include: 1) the need to develop a universal adaptive sensor design compatible with the variable morphology of teeth; 2) the need to optimize the power and stability of the light flux considering scattering effects within dental hard tissues (including diffraction and light dispersion); 3) influence of ambient light on measurement outcomes. In response to these limitations, an engineering-based concept of integrating a pulse oximetry sensor module into an intraoral scanner was proposed, forming a unified opto-diagnostic system. The integration of optical capabilities of intraoral scanners, particularly the use of the near-infrared spectrum, with the pulse oximetry principle of photoplethysmographic signal detection enhances light transmission through dental hard tissues and improves the detection of the pulsatile component of the signal. Conclusions. Despite the high potential of pulse oximetry as an objective method for assessing pulp vitality, its clinical application is limited by several factors, including the lack of specialized dental sensors, light scattering in hard tissues, anatomical variability, and the absence of standardized diagnostic thresholds. In response, a concept of integrating a pulse oximetry module with an intraoral scanner is proposed, which may optimize optical probing conditions, improve photon transport efficiency, and enhance the signal-to-noise ratio.
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