Effect of different stripping techniques on pulpal temperature: in vitro study
ABSTRACT Introduction: Proximal stripping of enamel is a routine clinical procedure employed in orthodontics to create space or for balancing tooth size discrepancies. This procedure may result in heat transfer to the pulp, predisposing it to histopathological changes and necrosis of the pulp tissue. Objective: To measure the temperature changes in the pulp chamber during different stripping procedures. Methods: 80 proximal surfaces of 40 extracted human premolar teeth were stripped using four techniques: diamond burs in air-rotor handpiece with air-water spray; diamond burs in micromotor handpiece, with and without a coolant spray; and hand-held diamond strips. A J-type thermocouple connected to a digital thermometer was inserted into the pulp chamber for evaluation of temperature during the stripping procedure. Results: An increase in the pulpal temperature was observed for all stripping method. Diamond burs in micromotor handpiece without coolant resulted in the higher increase in temperature (3.5oC), followed by hand-held diamond strips (2.8oC), diamond burs in air-rotor with air-water spray (1.9oC); and the smallest increase was seen with diamond burs in micromotor handpiece with coolant (1.65oC). None of the techniques resulted in temperature increase above the critical level of 5.5oC. Conclusion: Frictional heat produced with different stripping techniques results in increase in the pulpal temperature, therefore, caution is advised during this procedure. A coolant spray can limit the increase in temperature of the pulp.