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Endotontics > Diagnosis > Flashcards

Diagnosis Flashcards

1
Q

7 diagnosis of pulpal

A
  1. Normal pulp
  2. Reversible pulpitis
  3. Assymptomatic Irreversible pulpitis
  4. sympotomatic irreversible pulpitis
  5. pulp necrosis
  6. Previously treated
  7. Previously initiated therapy
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2
Q

Normal pulp
Characteristics
What makes you know
What part of diagnosis?

A

Responds normal to cold

symptom free and normal responses to pulp testing

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3
Q

Reversible Pulpitis
Characteristics
What makes you know
What part of diagnosis?

A

Based upon subjective and objective findings indicating that the inflammation should resolve and the pulp return to normal

hypersensative, but NO LINGERING

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4
Q

Symptomatic Irreversible Pulpitis
Characteristics
What makes you know
What part of diagnosis?

A

LINGERING
will respond + to cold testing

subjective/ objective findings indicating that the vital inflamed pulp is incapable of healing.

LINGERING THERMAL PAIN
SPONTANEOUS PAIN
REFERRED PAIN

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5
Q

Asymptomatic Irreversible Pulpitis
Characteristics
What makes you know
What part of diagnosis?

A

normal response to cold

no clinical symptoms but inflammation produced by caries, caries excavation, trauma

there is inflammation present

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6
Q

Pulp Necrosis
Characteristics
What makes you know
What part of diagnosis?

A

No response to cold or EPT testing is negative

pulp is nonresponsive to pulp testing
cold -, heat -, EPT -

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7
Q

Previously treated
Characteristics
What makes you know
What part of diagnosis?

A

Part of PULPAL diagnosis
There is FILLING MATERIAL present within the canal

canals are obturated with various filling materials other than intracranal medicaments

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8
Q

Previously initiated therapy
Characteristics
What makes you know
What part of diagnosis?

A

Part of the PULPAL diagnosis

Root canal tx has been initiated - but only with partial endodontic therapy

like pulpectomy (total removal of the nerve– crown and root) or pulpotomy (pulpal tissue removed from coronal part of tooth)

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9
Q

7 apical diagnosis

A
  1. Normal apical tissue
  2. Symptomatic apical periodontitis
  3. Asymptomatic apical periodontitis
  4. Acute apical abscess
  5. chronic apical abscess
  6. Condensing osteitis
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10
Q

Normal apical tissue
Characteristics
What makes you know
What part of diagnosis?

A

Part of the APICAL diagnosis
percussion -, swelling -, sinus tract -

teeth with normal periradicular tissues that are not sensative to percussion or palpation testing

lamina dura is intact and the periodontal ligament space is uniform

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11
Q

Symptomatic Apical Periodontitis
Characteristics
What makes you know
What part of diagnosis?

A

APICAL DIAGNOSIS

PERCUSSION +,
+/- APICAL RADIOLUSCENCY – there may or may not be a radioluscency present at the apex – like there can be or there cannot be

inflammation is present - there is also a painful response to biting or percussion or palapation

it might or might not be associated with a radiolucent area

IF PERCUSSION + IT HAS TO BE THIS

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12
Q

Asymptomatic Apical periodontitis
Characteristics
What makes you know
What part of diagnosis?

A

part of APICAL diangosis

PERCUSSION WILL BE NEGATIVE
THERE WILL BE AN APICAL LESION

inflammation and destruction of apical periodontium THAT IS OF PULPAL ORIGIN and appears as a radiolucent area, and does not produce clinical symptoms

ex) – shadow present but no lesion

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13
Q

Acute apical abscess
Characteristics
What makes you know
What part of diagnosis?

A

part of APICAL diagnosis

SWELLING INDICATES THIS

percussion can be +!!!

an inflammatory reaction to pulpal infection and necrosis characterized by rapid onset, spontaneous pain, tenderness of the tooth to pressure, pus formation, and swelling of associated tissues

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14
Q

Chronic apical abscess
Characteristics
What makes you know
What part of diagnosis?

A

part of APICAL diagnosis

SINUS TRACT IS PRESENT

an inflammatory reaction to pulpal infection and necrosis characterized by gradual onset, little or no dis(comfort, and the intermittent discharge of pus through an associated sinus tract

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15
Q 
Condensing osteoitis 
Characteristics 
What makes you know
What part of diagnosis?
what is special about this one?*
A

part of APICAL diagnosis and this is SPECIAL because it is not written alone - but in conjunction with one of the other 5 apical diagnosis

there is a diffuse radio-opaque lesion representing a localized bony reaction to a low grade inflammatory stimulus, usually seen at the apex of the tooth

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16
Q

Primary etiology of endo lesion?

A

BACTERIA (like perio)

+ fungi + virus

17
Q

explain Kakehashi et al 1965

A

21 germ free rats
drilled into pulp and left open

all were due to bacteria

18
Q

Dr. Herbert Schilder importance

A

Capacity to heal is 100% - x

so X is the ability of the clinician
- so if you remove all source than will

19
Q

percussion - describe

A

use a control tooth first

LIGHT tapping
must be reproducible and repeatable

*looking for a different feeling not necessarily pain

looking for a YES or NO

20
Q

Palpation - describe what you’re looking for

A

soft tissue swelling

boney expansion

21
Q

T/F mobility is a predictor of prognosis?

A

NO - false

22
Q

describe cold test

importance?

A

MOST RELIABLE TEST we have (when using the Endo Ice)
- primary pulp test to determine vitality of pulp
- ice stick
CO2/Refrigerant Spray (Endo Ice)
- Rubber Dam Technique

Tell patient to keep up hand for as long as they feel the cold then put down hand when do not feel it anymore

This is a COMPARATIVE TEST

23
Q

types of nerve fibers and describe each funciton

A

A-alpha –> proprioception (muscle sense) ( not in pulp but in the PDL)

A- beta –> touch

A- delta –> PAIN and TEMP

C –> Pain, temperature, and itch

24
Q

A-delta and C fibers importance

A

most abundant in the pulp
A-delta on periphary more (pain and temp)
- myelinated
-even if responding to temperature it will interpret it as PAIN ONLY

C - pain, temp, and itch
- unmyelinated

25
Q

Referred pain in anterior is from?

A

From anterior teeth

Anterior teeth DO NOT refer pain from upper to lower and visa versa

26
Q

is pain referred across midline?

A

NO

27
Q

referred pain in the posterior is from? can refer pain where?

A

From the posterior teeth and posterior teeth CAN refer pain from upper to lower and visa versa

28
Q

testing tips if cannot isolate tooth causing pain? or ruling out reffered pain?

A

Anesthesia test

Cavity test - start drilling and if feel pain?

29
Q

thermal tests are valuable in differentiating between what?

A

reversible and irreversible pulpitis

30
Q

EPT test

A

Electric Pulp Testing
A positive repsonse only denotes some variable nerve fibers present and are capable of responding

RESPONSE IS EITHER PRESENT OR ABSENT
numbers are NOT significant

+/- testing
if feeling - then it is vital

31
Q

Accuracy for pulp tests

A

Cold - 86% most accurate

Electric - 81% (second best)

Heat 71% - least accurate

*use a combination of tests

32
Q

transillumination for craze line vs. crack

A

Determine if presence of a crack or not by applying a bright fibrooptic light probe to the surface

  • if craze line - light will go all the way through
33
Q

can you see a root fracture on radiograph

A

often you cannot

34
Q

use of staining?

A

Determine length and severity of cracks in the tooth

35
Q

use of a tooth sleuth or a cotton pellet?

A

Determining chance of a crack being present

when bite down where is the pain and how long does it last for?
is it present at moment you bite?
when you let go?
or both?

36
Q

if pain WHEN BITING what does this signify?

A

peri-apical or periodontal inflammation present

37
Q

if pain on moment release?

A

fracture related (likekly not inflammation related)

38
Q

can a radipgraph be used to determine the health of the pulp?

A

NO CANNOT determine by radiograph alone even if it is nectrotic

  • need periapical and bitewings

Endotontics (21 decks)

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