Technical Problems

Question 1

Do we place the patient on abx if there is systemic involvement?

Answer 1

diabetic patient- yes, place them on ABX even if they weren’t running a fever.

Question 2

what is chronic apical abscess characterized by?

Answer 2

often lack of any noticeable symptoms and a sinus tract!

Question 3

if you track a sinus tract, what size cone should you use and why?

Answer 3

at least a 30 so you don’t get any bending

Question 4

what does condensing osteitis mean?

Answer 4

usually from some kind of low grade chronic reaction

Question 5

If condensing osteitis is symptomatic, what should you do?

Answer 5

treat endodontically because this will eventually resolve this.It’s typically associated with an irreversible pulpits.

Question 6

T/F

If you are dealing with an asymptomatic condensing osteitis case, you should always treat with endo

Answer 6

FALSE!!! Not necessary. You want to watch this tooth

Question 7

When should you test the tooth?

Answer 7

ALWAYS test the tooth!

Question 8

T/F

There is a HIGH correlation between histology and clinical symptoms?

Answer 8

NOT AT ALL!!!

We are merely extrapolating a diagnosis.

You cannot tell the histologic condition of the pulp by doing these testings. You need the 4 things to add up to a diagnosis, not just one item.

Question 9

T/F

Percussion is ENDO SPECIFIC?

Answer 9

FALSE

If someone is percussion sensitive in the absence of pulpal, this will not produce symptoms.

Question 10

what is the point of palpation?

Answer 10

localize swelling,
is it diffuse swelling, fluctuant, firm, paruli etc.

NOT itself a diagnosis.

Use palatal, lingual, buccal facial etc. See if there is a sinus tract along that

Question 11

what does percussion test show?

Answer 11

inflammation of the PDL

Could be endo or iatrogenic. This can often be a hyper occlusion problem and mimic endo issues

Question 12

percussion positive or percussion negative more indicative?

Answer 12

percussion positive- 90% of the time the patient can localize the tooth

Question 13

T/F

Cold/EPT measures blood supply?

Answer 13

NO it doesn’t!!!! at best measures the presence of nerve fibers

Question 14

T/F

EPT is very effective in teeth with limited fluid flow through the tubules due to dental sclerosis?

Answer 14

TRUE

Question 15

T/F

You want the teeth to be slightly wet when conducting EPT?

Answer 15

NO! bone dry! can give a false positive

Question 16

T/F

EPT is reliable in patients under 17

Answer 16

FALSE

Question 17

link between hyperthyroidism and EPT?

Answer 17

hypercalcemia! could give unreliable results

Question 18

EPT is specific and COLd is senstive? T/F?

Answer 18

TRUE

think of teeth “sensitive” to cold

Question 19

when should you use a heat test?

Answer 19

if patient tells you these have pain to hot liquids

Question 20

can you use a heat test for crowns/

Answer 20

yes

Question 21

in ___ the tooth will respond to perc/biting tests regardless of where the pressure is applied

Answer 21

Apical periodontitis

Question 22

in ____, perc/biting test will elicit pain only hone applied in a specific direction to a cusp or section of the tooth

Answer 22

cracked tooth or fx of a cusp

Question 23

if the tooth cannot refelct light, what does this mean?

Answer 23

crack in the dentin.

If you try to prep and temp, this will not work

Question 24

T/F

If the crack of tooth is ONLY in enamel, the tooth will not transilluminate light.

Answer 24

false, it still will

Question 25

what arch is selective anesthesia most effective?

Answer 25

maxillary arch. you can sort of block out a select few teeth.

IA will numb the entire quad.

Question 26

what is the last resort for endo testing?

Answer 26

test cavity.
no anesthesia to see if the tooth is vital.

SCARY