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Endo Questions for the RWE Faculty:

In this area, users are encouraged to ask questions from the RWE Faculty regarding Endodontics in General and the EndoSequence Technique.

Endo Questions for the RWE Faculty:: EPT test for orthodontically treated teeth


Joined: September 2014

Rank: Rookie

Posts: 5

Hello Dr Nasseh,

I have recently found a scientific article that was revealing  that the teeth after an orthodontic treatment respond better to cold than to EPT. Both tests stimulate the A-fibers within the pulp. What makes it different? Why the teeth respond to a higher value of the EPT but they respond easily to cold test? 
Thank you!


Joined: August 2013

Rank: Faculty General

Posts: 299

In reply to Alexandru Paraschiv Dobriceanu Hi Alexandru! One possible hypothesis would be that orthodontic movement creates pressure resorption apically and simulates open apex cases, where such teeth have a notoriously unpredictable vitality response. Also, teeth following trauma do not respond properly to cold response but may do better with EPT. Keep in mind that cold's response is limited to peripheral A-Delta fibers in dental tubules as cold testing's response mechanism is fluid movement in dentinal tubules (Hydrodynamic Theory) whereas EPT has a direct mechanism of action by stimulation of A-Delta fibers, and even potentially of some c fibers in some cases.  This could be possible explanation. Keep in mind that Ortho is literary "slow trauma." Finding similarities to cases of acute trauma would not be that far fetched. :) Cheers.