Evaluation of pulpal blood flow by laser doppler flowmetry as a test of tooth vitality in long-term follow-up: case report

The reliability of laser Doppler flowmetry in a 2-probe assessment of pulpal blood flow is well known. The purpose of this case report was to determine its use as an exclusive and reliable tool for tooth vitality diagnosis in a long-term follow-up. As a result of a traumatic injury to a 24-years old Caucasian female, tooth pulp vitality was studied in 6 maxillary front teeth over 30 weeks through use of 2-probe laser Doppler flowmetry and current sensitivity tests. A similar assessment was repeated after 228 weeks. Confronted with an alveolar bone fracture with a tooth in the fracture line, one intrusion and several luxated teeth, current sensitivity tests are found not to be so reliable indicators of revascularisation as significant results are given later (7 weeks) compared to laser Doppler flowmetry tests (1 week). A pathway with ischaemia (3 weeks), hyperaemia (7 weeks) and restored blood supply in the pulp measured by laser Doppler flowmetry tests was found and avoided endodontic treatment. Teeth vascularisation evolved normally (228 weeks). Despite a high indication in all sensitivity tests for endodontic treatment, the use of laser Doppler flowmetry tests was clear, more reliable than sensitivity tests and exclusive as denervation was postponed and pulp vascularisation was evident.