Does Apical Resection Affect the Pulp Sensibility of Adjacent Teeth?

Objectives: During the apical resection procedure, there is a potential risk of damaging the tissues around the surgical area, such as inhibiting neurovascular support to the pulp of adjacent teeth. The objective of this prospective clinical study was to evaluate the effect of apical resection on the sensibility of teeth adjacent to the surgery area using the thermal cold test.
Methods: The study sample included 36 patients undergoing apical resection. Sixty-nine teeth were operated surgically and total 66 adjacent teeth were evaluated for tooth sensibility. Dental sensibility was evaluated using cold spray once 1-3 days before surgery and six months after surgery. One corresponding contralateral tooth in each patient was served as control. The responses were categorized as positive, delayed positive or no response. The data was statistically analyzed using the Chi-square test (α=0.05).
Results: All of the adjacent teeth showed positive response to cold stimuli before surgery. The results of cold test of mesial adjacent teeth significantly decreased 6 months after surgery (p<0.05). The response of distal adjacent teeth to the cold test was significantly reduced too (p<0.05). Distal adjacent teeth showed more reduction in response to cold than mesial adjacent teeth (p<0.05).
Conclusions: For both mesial and distal adjacent teeth, the number of teeth that did not respond or showed delayed positive response was higher at 6 months after surgery and significantly different from baseline. It appears that apical resection can affect the pulpal response of adjacent healthy teeth to cold sensibility test. Therefore, dental clinicians should be aware of the possible effects of apical surgery on adjacent teeth and follow the sensibility and vitality of adjacent teeth.