Endodontics diagnosis Flashcards

1
Q

What is normal pulp diagnosis?

A
  • Pulp is symptom free and normally responsive to pulp testing
  • Mild or transient response to thermal cold testing lasting no more than 1-2 seconds after stimulus removed
  • Always test adjacent and contralateral teeth first so patient knows normal response to cold
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2
Q

What is reversible pulpitis diagnosis?

A
  • Based on findings that inflammation should resolve and pulp return to normal following appropriate management of aetiology
  • Discomfort when cold or sweet stimulus applied and goes away within couple of seconds following removal of stimulus
  • Typical aetiologies included exposed dentine (dentinal sensitivity), caries or deep restoration
  • No sig radiographic changes in periapical region of suspect tooth
  • Pain not spontaneous

Following management of aetiology the tooth requires further investigation to determine whether reversible pulpitis has returned to normal status

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3
Q

What can dentinal sensitivity closely mimic?

A
  • Reversible pulpitis
  • Symptoms closely mimic it
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4
Q

What is a Symptomatic Irreversible Pulpitis diagnosis?

A
  • Vital inflamed pulp incabable of healing and RCT indicated
  • Sharp pain upon thermal stimulus, lingering pain (often 30secs or longer after stimulus removed)
  • Spontaneous pain and referred pain
  • Can be associated with lying down
  • Over the counter analgesics typically ineffective
  • Aetiologies inc deep caries, extensive restorations, fractures exposing pulpal tissues
  • Difficult to diagnose as inflammation not yet reached periapical tissues therefore no pain or discomfort to percussion
  • Dental history and thermal testing vital for pulpal status
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5
Q

What is Asymptomatic Irreversible Pulpitis diagnosis?

A
  • Vital inflamed pulp incapable of healing and RCT indicated
  • No clinical symptoms
  • Usually responds normally to thermal testing but may have had trauma or deep caries that would likely result in exposure following removal
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6
Q

What is a Pulp Necrosis diagnosis?

A
  • Death of dental pulp, necessitating RCT
  • Pulp non-responsive to pulp testing and is asymptomatic
  • Pulp necrosis itself does not cause apical periodontitis (pain to percussion or radiographic evidence of osseous breakdown) unless canal is infected
  • May be due to calcification, recent history of trauma, simply tooth not responding so relies on testing adjacent and contralateral teeth
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7
Q

What is a previously treated diagnosis?

A
  • Tooth has been endodontically treated and canals are obturated with various filling materials other than intracanal medicament
  • Typically does not respond to thermal or pulp testing
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8
Q

What is a Previously Initiated Therapy diagnosis?

A
  • Tooth previously treated by partial endodontic therapy such as pulpotomy or pulpectomy
  • Depending on level of therapy, tooth may or may not respond to pulp testing methods
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9
Q

What is a Normal Apical Tissue diagnosis?

A
  • Not sensitive to percussion or palpation testing
  • Radiographically the lamina dura surrounding root is intact and periodontal ligament space is uniform
  • Always pulp test with adjacent and contralateral tooth
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10
Q

What is a Symptomatic Apical Periodontitis?

A
  • Represents inflammation, usually of apical periodontium
  • Painful response to biting and or percussion or palpation
  • May or may not be accompanies by radiographic changes (may be normal width of PDL or periapical radiolucency depending on progression)
  • Severe pain to percussion and or palpation highly indicative of degenerating pulp and RCT needed
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11
Q

What is Asymptomatic Apical Periodontitis diagnosis?

A
  • Inflammation and destruction of apical periodontium that is of pulpal origin
  • Appears as apical radiolucency
  • No clinical symptoms
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12
Q

What is a Chronic Apical Abscess diagnosis?

A
  • Inflammatory reaction to pulpal infection and necrosis
  • Characterised by gradual onset, little or no discomfort and intermittent discharge of pus through associated sinus tract
  • Radiographically typically signs of osseous destruction like a radiolucency
  • To identify source of draining sinus tract if present, a gutta-percha cone carefully placed through stoma or opening until it stops and radiograph taken
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13
Q

What is an Acute Apical Abscess diagnosis?

A
  • Inflammatory reaction to pulpal infection and necrosis
  • Characterised by rapid onset, spontaneous pain, extreme tenderness of tooth to pressure, pus formation and swelling of associated tissues
  • May be no radiographic signs of destruction and patient often experiences malaise, fever and lymphadenopathy
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14
Q

What is a Condensing Osteitis diagnosis?

A
  • A diffuse radiopaque lesion representing a localised bony reaction to low-grade inflammatory stimulus usually seen at apex of tooth
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