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Endodontics > Lec After Midterm 3/29 Endo Dx II > Flashcards

Lec After Midterm 3/29 Endo Dx II Flashcards

1
Q

Steps to dx:

A

chief complaint, clinical symptoms, tests, rg findings

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2
Q

Tests need to confirm:

A

chief complaint and symptons

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3
Q

TF? We are assessing objective complaints with subjective findings.

A

F. vice verse

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4
Q

How many diagnoses to come up with for every case:

A

2: pulpal and apical

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5
Q

TF? The pulp chamber is separate from the periapical diagnosis.

A

T

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6
Q

How many types of endo disease?

A

1, simply a progression

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7
Q

Direction of endo disease progression:

A

crown down

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8
Q

Endo disease progresses from ___ to ____

A

inflammation to necrosis

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9
Q

Initial irritant to pulp occurs in this region:

A

crown

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10
Q

TF? Caries can spread down canals but can not affect the periradicular tissues.

A

F. Can affect

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11
Q

What causes bone loss after crown down spread of necrosis?

A

antigens are released, can lead to osteoclastogenesis and bone loss

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12
Q

When can you see bone loss radiographically?

A

once it breaks through cortical plate

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13
Q

Once the cortical plate is broken, to where does the disease spread?

A

vestibule area: this is a sinus tract

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14
Q

Disease that can lead to pulpal necrosis wo infection:

A

sickle cell anemia (platelet aggregation around apex)

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15
Q

Diagnostic pulpal terms:

A

normal, reversible/ symptomatic irreversible/ asymptomatic irreversible pulpitis, pulpal necrosis, previously initiated therapy, previously treated

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16
Q

Diagnostic periapical terms:

A

normal apical tissues, symptomatic / asymptomatic apical periodontitis, acute / chronic apical abscess, condensing osteitis

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17
Q

Normal pulp:

A

symptom-free pulp, normal response to Ept, cold, and hot

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18
Q

Normal response to pulp testing:

A

mild pain that resolves quickly

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19
Q

EPT positive, normal or necrotic pulp?

A

normal

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20
Q

Reversible pulpitis:

A

findings indicate the inflammation should resolve and pulp return to normal, ie exposed dentin, deep caries treated, inflammation should go away

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21
Q

Test results for reversible pulpitis:

A

EPT pos, moderate response to thermai that does not linger

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22
Q

Symptomatic Irreversible Pulpitis:

A

vital inflamed pulp is incapable of healing, needs RCT:

23
Q

Test results for Symptomatic Irreversible Pulpitis:

A

EPT pos, moderate to severe response to thermal tests that lingers, spontaneous pain.

24
Q

Spontaneous pain, diagnosis:

A

symptomatic Irreversible pulpitis

25
Q

How long is lingering?

A

secs to mins

26
Q

Asymptomatic Irreversible Pulpitis:

A

vital inflamed pulp is incapable of healing, caries into pulp, internal resorption, exposed pulp, no pain

27
Q

Test results, asymptomatic Irreversible Pulpitis:

A

EPT pos, normal response to thermal no symptoms

28
Q

pulpal necrosis:

A

death of dental pulp, RCT or extraction

29
Q

Test results: pulpal necrosis:

A

EPT neg (70+), no response to thermal tests

30
Q

Previously treated:

A

endo treated, canals obturated w anything but intracanal medicaments

31
Q

When to perform pulp test on previously treated teeth:

A

never

32
Q

What portion of pulp is pulp testing getting a response from?

A

chamber

33
Q

Which tests to perform on previously treated teeth:

A

percussion, palpation, probing (apical tests)

34
Q

Previously initiated therapy:

A

tooth has been previously treated by partial endo therapy (pulpotomy: removal of pulp chamber and tissues, not canals, pulpectomy: removal of pulp tissues and canals

35
Q

Do pulp test on previously initiated therapy?

A

yes, don’t know how much of the pulp was removed, useful for determining anesthesia

36
Q

Last portion of tooth to get numb via anesthesia:

A

pulp

37
Q

Normal apical tissue:

A

normal periradicular tissues, not sensitive to percussion or palpation, LD intact, PDL space uniform, will feel like control tooth in testing

38
Q

Test results for normal apical tissues:

A

EPT pos or neg, thermal tests pos or neg (bc this is a pulp test w apical disease)

39
Q

Symptomatic Apical Periodontitis:

A

inflammation, usually of apical periodontium, painful response to bing and/ or percussion or palpation, may or may not be related w an apical RGL

40
Q

Test results for Symptomatic Apical Periodontitis:

A

At least biting, PERCUSSION OR PALPATION MUST BE POSITIVE, w any other results

41
Q

Asymptomatic Apical periodontitis:

A

inflammation / destruction of apical periodontium of pulpal origin, a RGL, no cx symptoms,

42
Q

Asymptomatic Apical periodontitis, test results:

A

MUST HAVE LEO AND PULP BE NECROTIC, EPT: neg, thermal: neg

43
Q

Acute Apical Abscess:

A

inflammatory reaction to pulpal infection and necrosis, rapid onset, spontaneous pain, tenderness of tooth to pressure, pus formation, swelling of assoc tissues, MUST SEE SWELLING

44
Q

Acute Apical abscess, test results:

A

must have swelling, necrotic pulp, EPT: neg, Thermal: neg, MAY OR MAY NOT HAVE A LESION (USUALLY NOT)

45
Q

Why don’t initial acute apical abscesses have lesions:

A

bc they occur quickly and often wo being caught by X-ray

46
Q

Chronic apical abscess:

A

inflammatory reaction to pulpal infection and necrosis, gradual onset, little or no discomfort, intermittent discharge of pus through a SINUS TRACT (must see)

47
Q

Chronic apical abscess, test results:

A

Must have a SINUS TRACT, pulp necrotic, EPT: neg, Thermal: neg

48
Q

Condensing osteitis:

A

diffuse, RGO, localized, reaction to low-grade inflammatory stimulus, usually at tooth apex

49
Q

This leads to bone build up in condensing osteitis:

A

low grade chronic inflammation

50
Q

Condensing osteitis, test results:

A

MUST HSVE RGO LESION, uncommon, VITAL PULP, may become necrotic if stimulus in increased, RGO eventually becomes RGL

51
Q

Dx, EPT: 80, no response to hot or cold, response to percussion, palpation, A mobility:

A

Pulpal dx: pulpal necrosis, periapical dx: asymptomatic apical periodontitis

52
Q

Determines the difference bw reversible and irreversible pulpitis:

A

linger pain = irreversible

53
Q

Dx: EPT: 39, strong response to cold, lingering, response to hot, inc response to percussion and normal response to palpation

A

symptomatic irreversible pulpitis, symptomatic apical periodontitis

Endodontics (22 decks)

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