Operative dentistry aje qualtrough, jd satterthwaite la morrow, pa brunton

Electronic testers
In the past, these have been of limited value due to the high incidence
of false readings. The latest testers, however, appear to be promising
but their use is limited if full coverage restorations are in place. Pulp
testers stimulate neural tissue, and there is not necessarily a direct 
correlation between the existence of nervous tissue and a viable blood
flow. Additionally, patients’ pain thresholds vary. The actual reading
is not important, as it cannot measure any degree of degeneration.
However, testing contralateral teeth can give the clinician an indica-
tion of pulpal involvement.
Thermal tests
Cold is the more useful test as it is safer and uses a constant temper-
ature. The use of a cotton pellet soaked in a volatile liquid (for example
ethyl chloride) is a common method, though sticks of ice may also be
used. Although heat is not routinely used, it is helpful when the only
symptom is that of heat sensitivity and the patient cannot identify the
tooth. Heat may be applied with a warm stick of gutta-percha, though
care must be taken to lubricate the tooth surface to be tested with
petroleum jelly to prevent the hot gutta-percha from sticking to the
tooth and possibly causing a thermal injury. Another method of
applying heat is to isolate an individual tooth with rubber dam and
syringe hot water over the tooth.
Percussion
The most reliable indication of significant periapical inflammation 
is that of tenderness to percussion. Periodontal inflammation, which
produces milder symptoms, can be identified by finger pressure
applied to the tooth in question.
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Selective analgesia
This test has gained popularity in recent years, but is generally more
effective in localising affected areas rather than individual teeth.