Response of pulp sensibility test is strongly influenced by periodontal attachment loss and gingival recession.

Introduction: To assess, in vivo, the influence of periodontal attachment loss and gingival recession on responses to pulp sensibility tests (PSTs) with cold stimuli in mandibular incisors in adult patients.
Methods: This cross-sectional study included 45 patients aged 30 to 60 years treated at a university dental health service. In each patient, 1 mandibular incisor was randomly selected for analysis. One calibrated dentist performed all periodontal assessments. Periodontal attachment loss and gingival recession were measured at 6 sites of the selected tooth followed by application of the PST on the buccal surface of the tooth by an independent operator. Each patient was asked to indicate a score for pain intensity on a numeric visual analog scale. The Pearson correlation coefficient was used to investigate and quantify the correlation between predictor variables (periodontal attachment loss and gingival recession) and reported pain. Simple and multiple linear regression analyses were performed to determine the impact of periodontal attachment loss and gingival recession on PST pain scores.
Results: Multivariate analysis showed that periodontal attachment loss contributed significantly to the prediction of pain in response to the PST (P < .001). Increases of 1 mm in periodontal attachment loss resulted in a decrease of approximately 0.5 score on the pain scale. Gingival recession also contributed as a predictor of the outcome (P < .001) with a decrease of approximately 0.7 in pain scores for every 1-mm increase in gingival recession. The correlations were in the opposite direction than expected.
Conclusions: Periodontal attachment loss and gingival recession strongly influenced reported pain in response to PST with cold stimuli. The effect of both variables was constant (ie, responses to PST decreased gradually with increases in periodontal attachment loss and gingival recession).
(Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)