Diagnosing

Question 1

What is the correct order for choosing a diagnosis from an X-ray?

Answer 1

• Restorability → Location of disease (apical/marginal/total)
  → Acute vs chronic → Prognosis → Treatment decision

Question 2

Deep caries destroying the crown to bone level on X-ray – diagnosis?

Answer 2

• Caries dentis profunda non restaurabilis
• (deep non-restorable caries). Treatment: Extraction

Question 3

Irreparable crown fracture on X-ray – diagnosis?

Answer 3

• Fractura coronae dentis irreparabilis
• (irreparable crown fracture).
• Treatment: Extraction

Question 4

Vertical root fracture on X-ray – diagnosis?

Answer 4

• Fractura verticalis radicis dentis (vertical root fracture).
• Treatment: Extraction

Question 5

Widened apical PDL with pain but no clear radiolucency – diagnosis?

Answer 5

• Periodontitis periapicalis acuta serosa
• (acute serous apical periodontitis).
• Treatment: RCT or extraction

Question 6

Ill-defined apical radiolucency with severe pain and swelling – diagnosis?

Answer 6

• Periodontitis periapicalis acuta purulenta
• (acute purulent apical periodontitis).
• Treatment: Drainage + RCT or extraction

Question 7

Well-defined apical radiolucency with loss of lamina dura – diagnosis?

Answer 7

• Periodontitis periapicalis chronica granulomatosa
• (chronic granulomatous apical periodontitis).
• Treatment: RCT or extraction

Question 8

Diffuse poorly confined apical radiolucency extending beyond the apex – diagnosis?

Answer 8

• Periodontitis periapicalis chronica granulomatosa diffusa
• (diffuse chronic granulomatous apical periodontitis).
• Treatment: RCT or extraction

Question 9

Small localised apical radiolucency confined to the apex – diagnosis?

Answer 9

• Periodontitis periapicalis chronica granulomatosa localisata
• (localised chronic granulomatous apical periodontitis).
• Treatment: RCT or extraction

Question 10

Minimal apical radiolucency with fibrotic/sclerotic changes and long history – diagnosis?

Answer 10

• Periodontitis periapicalis chronica fibrosa
• (chronic fibrous apical periodontitis).
• Treatment: Observation or RCT

Question 11

Apical radiolucency with sinus tract marker leading to apex – diagnosis?

Answer 11

• Periodontitis periapicalis chronica cum fistula
• (chronic apical periodontitis with fistula).
• Treatment: RCT or extraction

Question 12

Acute painful apical pus collection – diagnosis?

Answer 12

• Abscessus periapicalis acutus
• (acute periapical abscess).
• Treatment: Drainage + RCT or extraction

Question 13

Long-standing apical abscess with minimal symptoms – diagnosis?

Answer 13

• Abscessus periapicalis chronicus
• (chronic periapical abscess).
• Treatment: RCT or extraction

Question 14

Horizontal bone loss with intact apex – diagnosis?

Answer 14

• Periodontitis chronica
• (chronic periodontitis).
• Treatment: Periodontal therapy

Question 15

Severe generalised bone loss with marked mobility – diagnosis?

Answer 15

• Periodontitis chronica gravis
• (advanced chronic periodontitis).
• Treatment: Extraction

Question 16

Vertical marginal bone loss adjacent to root – diagnosis?

Answer 16

• Periodontitis marginalis chronica
• (chronic marginal periodontitis).
• Treatment: Periodontal therapy or extraction

Question 17

Acute marginal inflammation with suppuration – diagnosis?

Answer 17

• Periodontitis marginalis acuta purulenta
• (acute purulent marginal periodontitis).
• Treatment: Drainage ± extraction

Question 18

Localised periodontal pus collection – diagnosis?

Answer 18

• Abscessus parodontalis (periodontal abscess).
• Treatment: Drainage or extraction

Question 19

Marginal bone loss AND apical radiolucency affecting same tooth – diagnosis?

Answer 19

• Laesio endodontico-parodontica (endo-periodontal lesion).
• Treatment: Prognosis-dependent

Question 20

X-ray shows widened PDL around entire root with marginal and apical involvement – diagnosis?

Answer 20

• Periodontitis totalis acuta (acute total periodontitis).
• Treatment: Extraction

Question 21

Impacted tooth visible on X-ray – diagnosis?

Answer 21

• Dens inclusus (impacted tooth).
• Treatment: Surgical extraction

Question 22

Partially erupted tooth with recurrent infection – diagnosis?

Answer 22

• Dens semi-inclusus cum pericoronitide
• (partially erupted tooth with pericoronitis).
• Treatment: Extraction

Question 23

Poorly filled root canal with persistent apical pathology – diagnosis?

Answer 23

• Therapia endodontica defectiva
• (failed endodontic treatment).
• Treatment: Retreatment or extraction

Question 24

Failed root canal that cannot be retreated – diagnosis?

Answer 24

• Therapia endodontica defectiva irreparabilis
• (non-retreatable failed endodontic treatment).
• Treatment: Extraction

Question 25

What is the safest exam answer structure when shown an X-ray?

Answer 25

Describe radiographic findings → Name one defensible diagnosis (Latin + English) → Justify treatment based on prognosis

Question 26

Answer 26

* Periodontitis periapicalis chronica granulomatosa * (Chronic granulomatous apical periodontitis) → Well-defined apical radiolucency, loss of lamina dura

Question 27

Answer 27

* Periodontitis periapicalis acuta serosa * (Acute serous apical periodontitis) → Widened apical PDL, little/no radiolucency

Question 28

Answer 28

* Abscessus periapicalis acutus * (Acute periapical abscess) → Ill-defined apical radiolucency, aggressive bone loss

Question 29

Answer 29

* Periodontitis periapicalis chronica cum fistula * (Chronic apical periodontitis with fistula) → Gutta-percha point tracing to apex

Question 30

Answer 30

* Periodontitis periapicalis chronica granulomatosa localisata * (Localised chronic granulomatous apical periodontitis) → Small, confined apical radiolucency

Question 31

Answer 31

* Periodontitis periapicalis chronica granulomatosa diffusa * (Diffuse chronic granulomatous apical periodontitis) → Spread beyond apex, poorly confined margins

Question 32

Answer 32

* Periodontitis periapicalis chronica fibrosa * (Chronic fibrous apical periodontitis) → Minimal radiolucency, sclerosis

Question 33

Answer 33

* Periodontitis chronica * (Chronic periodontitis) → Horizontal bone loss, apex normal

Question 34

Answer 34

* Periodontitis marginalis chronica * (Chronic marginal periodontitis) → Vertical/angular bone loss

Question 35

Answer 35

* Abscessus parodontalis * (Periodontal abscess) → Localised lateral bone defect

Question 36

Answer 36

* Periodontitis chronica gravis * (Advanced chronic periodontitis) → Severe bone loss ± furcation involvement

Question 37

Answer 37

* Laesio endodontico-parodontica * (Endo-periodontal lesion) → Marginal bone loss + apical radiolucency communicating

Question 38

Answer 38

* Periodontitis totalis acuta ⭐ * (Acute total periodontitis) → Widened PDL around entire root + marginal & apical destruction

Question 39

Answer 39

* Caries dentis profunda non restaurabilis * (Deep non-restorable caries) → Crown destroyed to bone level

Question 40

Answer 40

* Fractura verticalis radicis dentis * (Vertical root fracture) → J-shaped radiolucency

Question 41

Answer 41

* Fractura coronae dentis irreparabilis * (Irreparable crown fracture)

Question 42

Answer 42

* Dens inclusus * (Impacted tooth)

Question 43

Answer 43

* Dens semi-inclusus cum pericoronitide * (Partially erupted tooth with pericoronitis)

Question 44

Answer 44

* Dens supernumerarius * (Supernumerary tooth)