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Endo I > Clinical Examination and Testing > Flashcards

Clinical Examination and Testing Flashcards

1
Q

what is the outline for clinical exam and testing

A
  • chief complaint and vital signs (pt interview and med hx + meds)
  • intraoral exam
  • radiographs
  • thermal and EPT Testing
  • evaluate for cracks
  • development of tentative diagnosis
  • consults as needed
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2
Q

what are the 4 things included in medical hx and meds

A
  • medical hx - blood glucose, PT time, pregnancy test
  • rx medications (dose and frequency)
  • supplements or other non rx drugs
  • chief complaint and relevant dental hx
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3
Q

what should you do in the intraoral exam

A
  • if its an emergency or pain related do a problem focused exam
  • if its a new patient do the prescribed exam sequence
  • palpation/percussion testing, perio probing and mobility testing in the area of suspicion
  • note tissue color, swelling, DST and inconsistencies or irregularities
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4
Q

how many probing should you take on the area of suspicion and what should you look for

A

6, blanching is important

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5
Q

how should you test mobility

A

wiggle the tooth and put a mirror on the lingual

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6
Q

what should you look for when palpating

A

-tenderness
- swelling
- unusual texture, color or composition
- DST

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7
Q

A DST is usually associated with:

A

CAA

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8
Q

pulp in a CAA is expected to be

A

necrotic

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9
Q

is there pain associated with CAA and why

A

minimal or none due to drainage

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10
Q

do you need to use anesthesia to remove or repair DST

A

no

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11
Q

where should you start in percussion

A

adjacent teeth to establish a baseline and maintain a constant percussion technique across all teeth

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12
Q

how many teeth should you do percussion on

A

at least two on each adjacent side of the AOS

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13
Q

what are the appropriate radiographs needed and why

A
  • PA films to see surrounding tissues
  • straight on and angled PA
  • bite wing on posteriors to determine restorability
  • all must be diagnostic in quality
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14
Q

what is a pulp sensibility test

A

assessment of the pulp sensory response

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15
Q

how do you do thermal and EPT testing

A
  • teeth are isolated and dried
  • place cold cotton pellet on facial tooth surface
  • patients hand should go up immediately
  • observe the seconds until patients hand goes down
  • go to next tooth and repeat
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16
Q

what are you looking for in thermal and EPT testing

A
  • what is normal for this patient
  • what is decidedly different for a particular tooth
  • the time to recover is much more important than the severity of pain reported
17
Q

what is the normal amount of time pain should linger after cold or EPT

A

3-8 seconds

18
Q

what is the amount of time after a thermal or EPT test that would indicate endo tooth

A

20-30 seconds

19
Q

sensitivity to cold is considered a symptom of:

A

early pulpal inflammation

20
Q

sensitivity to hot is a symptom of____; indicating that _____

A

late stage pulpal inflammation; gas is being produced via deterioration of the pulp

21
Q

if patient is sensitive to hot what will bring them relief

A

cold water

22
Q

when is heat testing done

A

only if the patient’s CC is pain produced by warm liquids

23
Q

how do you do heat testing

A
  • isolate 1 tooth at a time with rubber dam
  • heat water to 140 degrees F and drip on isolated tooth
  • keep cold water handy to cool tooth if hot sets it off
24
Q

what would no response on a single tooth with a normal base line indicate

A

necrotic pulp and RCT is indicated

25
Q

what do you do if no response on most or all of teeth

A

-probably an older person
- test with EPT

26
Q

you will routinely get no response on:

A
  • young permanent teeth
  • teeth immediately following trauma (recheck in 2-4 weeks)
  • look for injury on tooth
27
Q

how do you use to EPT

A
  • dry the teeth and isolate with cotton rolls
  • place small dab of tooth paste on facial of each tooth to be tested
  • develop base line first
28
Q

what should you suspect if you have symptoms on a tooth with no caries, no trauma, no restorations

A
  • an axial crack
29
Q

how do you prove an axial crack

A
  • radiographs
  • biting tests with tooth slooth
  • periodontal probing
  • transillumination
30
Q

what will an axial crown fracture show in transillumination

A

it will not allow light to pass through the line of fracture

31
Q

what do you do if a crack has extended to root

A

extract

32
Q

what do you do if positive tooth sleuth test and pt responds to cold

A

crown

33
Q
A

Endo I (13 decks)

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