Overview

The success of endodontic therapy depends fundamentally on accurate diagnosis of pulpal and periapical conditions. Conventional diagnostic tests such as percussion, palpation, and thermal/electric pulp testing have been widely employed for decades. However, they are inherently limited by subjectivity, variability in patient responses and an inability to directly measure pulp vascularity, which is the true determinant of pulp vitality. The evolution of diagnostic modalities in dentistry has introduced advanced imaging techniques and biological vitality tests including Cone Beam Computed Tomography, Optical Coherence Tomography, Pulse Oximetry, Laser Doppler flowmetry and Near-Infrared Transillumination. These technologies have enhanced diagnostic accuracy, reproducibility, and patient comfort. This article provides a comprehensive and professional evaluation of conventional diagnostic methods alongside advanced diagnostic aids, elaborating on their principles, clinical applications, limitations, and comparative utility in endodontics.

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