Semester

Summer

Date of Graduation

2025

Document Type

Thesis

Degree Type

MS

College

School of Dentistry

Department

Not Listed

Committee Chair

Samuel Dorn

Committee Member

Jerry Bouquot

Committee Member

Steven B. Whitaker

Committee Member

R. Constance Wiener

Abstract

Introduction: The formulation of a pulpal diagnosis is crucial to prescribe appropriate treatment recommendations for endodontics. The application of a cold stimulus to the tooth’s surface utilizing the refrigerant 1,1,1,2-Tetrafluoroethane (R-134a) is a common way to obtain a pulpal diagnosis. Cotton as a form of applicator is used to absorb the R-134a and create a temperature change in the pulp. There is limited research if there is a better material than cotton to generate this cold response. No studies to date have been found to determine if a sponge as an applicator would generate a more significant cold response than a form of cotton.

The research hypothesis is that the e-Dx® sponge will create a greater temperature drop in an extracted tooth than the other carriers tested over time.

The null hypothesis is there will be no significant difference in the temperature change registered in an extracted tooth depending upon the nature of the applicator (e-Dx® sponge (Jordco®), #2 cotton pellet, or cotton swab) to transfer R-134a.

Methods: A single mandibular incisor was selected after confirming canal space radiographically. The apical 3mm of the root was sectioned, a size #15 K-file used to remove impediments, and a thermocouple wire threaded into the canal to the full coronal extent of the canal. The tooth was embedded in acrylic, and the wire closed into place with composite resin. To simulate intraoral conditions, the tooth was placed in an incubator at 37°C prior to sample collecting. The e-Dx® sponge, #2 cotton pellet, and cotton swab were used for sample collection after saturation of R-134a for 5s onto the applicator. The application of R-134a was repeated for 10 samples with each applicator, discarding the applicator after each use. Temperature change from baseline was recorded at 5s, 10s, and 15s. A linear mixed model was used to assess the data over time for each group. Statistical inferences were based on ANOVA at a significance level of p < 0.05. Mean temperature changes at 5s, 10s, and 15s were recorded relative to baseline.

Results: ANOVA analysis showed the e-Dx® sponge performed better than the cotton pellet, cotton swab, and control (p< 0.0001), the #2 cotton pellet maintained cold better than the cotton swab and control (p< 0.0001), and the cotton swab performed the worst, having little effect on temperature change on the simulated pulp of the extracted tooth (p< 0.0526). Mean temperature changes at 5s, 10s, and 15s were 0.69, 3.82, and 6.97 for the sponge; 0.69, 2.64, 4.31 for the #2 cotton pellet; and 0.17, 0.45, and 1.08 for the cotton swab.

Conclusion: Within the limitations of this in-vitro study, it is suggested that the e-Dx® sponge applicator would provide for a better transfer of cold from R-134a than a #2 cotton pellet or cotton swab during sensibility testing.

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