Endo Exam and Testing I

Question 1

An endo diagnosis consists of 2 parts:

Answer 1

pulpal
periapical

Question 2

the pulpal diagnosis consists of

Answer 2

status of the nerve tissue
C- nerve fiber
A- nerve fiber
detection of temperature and sharpness

Question 3

C nerve fibers detect what kind of pain

Answer 3

dull spontaneous ache

Question 4

A nerve fibers detect what kind of pain

Answer 4

sharp acute intense pain

Question 5

the periapical diagnosis consists of

Answer 5

status of the tissues surrounding the apex

proprioceptive (pressure sensing) nerve fibers

Detects chewing pressure and percussion

Question 6

What do we need to do correctly for proper treatment

Answer 6

diagnose

Question 7

If you don’t know the diagnosis after taking the history of the patient, then

Answer 7

you haven’t taken enough history

Question 8

what do you use to verify your diagnosis

Answer 8

the patient exam

Question 9

what is the order of the diagnostic exam

Answer 9

SOAP
Subjective
Objective
Assessment/Appraisal
Plan

Question 10

The chief complaint is

Answer 10

what the patient tells you in their own words

Question 11

what are subjective findings

Answer 11

what the patient is telling you. They may not be accurate

Question 12

What must be addressed even if you find other things wrong

Answer 12

Chief complaint

Question 13

medical history should be reviewed by the dentist how often

Answer 13

every visit

Question 14

what medical conditions can mimic odontogenic pain

Answer 14

TB
Uncontrolled diabetes
Iron deficiency
leukemia
Sickle cell
multiple myeloma
acute maxillary sinusitis

Question 15

Sickle cell may cause what type of pain

Answer 15

bone pain and loss of trabecular bone pattern- mimic odontogenic
pain and bone loss of Endodontic origin

Question 16

Radiation therapy may cause what type of pain

Answer 16

increased sensitivity of teeth and osteoradionecrosis

Question 17

Multiple Myeloma may cause what type of pain

Answer 17

unexplained mobility of teeth(Floating Tooth)

Question 18

Trigeminal neuralgia, referred pain from cardiac angina, and multiple sclerosis may cause what type of pain

Answer 18

mimic tooth pain

Question 19

Acute maxillary sinusitis may cause what type of pain

Answer 19

posterior quadrant mimic tooth pain. Teeth may be
extremely sensitive to cold and percussion

Question 20

what is a systemic contraindication to endodontic therapy

Answer 20

uncontrolled diabetes or a recent myocardial infarction within the past 6 months

Question 21

What are the 5 basic directions of questioning

Answer 21

Localization (where)
Commencement (when)
Intensity (1-10)
Provocation/Attenuation (produces or reduces pain)
Duration (how long)

Question 22

what are objective findings

Answer 22

What you as the doctor clinically see and your findings

What does the extra oral exam show? Swelling, Redness, tender to palpate etc.

What does the x-ray show

Intraoral exam findings

All tests findings - percussion, thermal, observation, palpation, periodontal
probing and patient’s response to the tests.

Record normal as well as abnormal. Why?

Question 23

what are extraoral exam findings

Answer 23

asymmetries and swelling, redness, and demeanor of patient upon arrival

palpation of submandibular and cervical lymph nodes (hard tender?)

Question 24

if lymph nodes and hard, tender and
enlarged may indicate that

Answer 24

the infection has moved from localized to more systemic
infection

Question 25

Ludwig’s Angina

Answer 25

Large firm red bi-lateral swelling under the chin into neck (dangerous)

Question 26

External sinus tract

Answer 26

a stoma (opening) that never heals until generally, heal and closes once offending tooth is treated

Question 27

Extraoral facial swelling is usually Endodontics in origin because

Answer 27

diffuse facial swelling from a periodontal abscess is rare

Question 28

detail a Canine space infection

Answer 28

Loss of definition in the nasolabial fold to swollen red eye Long rooted maxillary central incisors can also cause this swelling but more likely to cause the upper lip to be swollen

Question 29

Buccal space infection Maxilla

Answer 29

Extraoral swelling in posterior cheek Usually from the buccal roots of maxillary premolar and molars

Question 30

Buccal space infection Mandibular

Answer 30

Usually from mandibular premolar and mandibular 1st molar 2nd and 3rd molars may also be the cause but infections with these two teeth are just as likely to exit the lingual

Question 31

With a buccal space infection why is there swelling and disappearance of the nasolabial folds

Answer 31

Roots on maxillary lie superior to the attachment of the buccinator muscle Roots on the mandibular lie inferior to the attachment of the buccinator muscle

Question 32

Extraoral swelling associated with mandibular incisors generally will swell in what space

Answer 32

submittal or submandibular spaces

Question 33

Infections associated with any mandibular teeth that exit the alveolar bone on the lingual and are inferior to the mylohyoid muscle attachment, will be noted as

Answer 33

swelling in the submandibular space

Question 34

How should you examine intraoral swelling

Answer 34

Visualize and palpate to determine if firm, diffuse or fluctuant In Anterior palate - most frequently from maxillary lateral incisors or maxillary 1st premolar

Question 35

Swelling in the posterior palate is most likely associated with

Answer 35

the palatal roots of maxillary molars

Question 36

Severe infections involving the maxillary and mandibular molars can extend into the ___________ space, resulting in swelling of the tonsillar and pharyngeal areas

Answer 36

parapharyngeal

Question 37

Sinus tract

Answer 37

communication directly from the source through an opening in the gingiva called the stoma. Sometimes lined with epithelium

Question 38

Fistula

Answer 38

an abnormal pathway between two organs or from one epithelium-lined surface to another epithelium-lined surface.

Question 39

Will there be much pain if an intraoral sinus tract is present

Answer 39

no

Question 40

Sinus tract may have a _____ adjacent to the offending tooth or the infection may exit at a distant site

Answer 40

stoma

Question 41

Alveolar hard tissue near ______ should be palpated with index finger to try and detect any abnormalities.

Answer 41

apices (check the other side to see if it is symmetrical or or abnormal)

Question 42

Tender areas may indicate

Answer 42

periradicular inflammation which may be Endodontics or periodontic in origin

Question 43

When apical inflammation develops after pulp necrosis, the inflammatory process may burrow its way through the

Answer 43

facial cortical bone and begin to affect the overlying mucoperiosteum (may feel tender before the swelling appears)

Question 44

Tenderness to percussion or biting, indicates

Answer 44

that there is inflammation around the tooth(periapical). The proprioceptive nerve fibers around around the tooth (PDL) and not in the tooth

Question 45

Inflammation apically (Apical Periodontitis) can be caused from the presents of bacteria originating from

Answer 45

the nerve (pulp) in the offending tooth

Question 46

Start with contralateral tooth so the patient knows

Answer 46

what “normal” feels like

Question 47

Percuss adjacent teeth both _____________ to help confirm offending tooth

Answer 47

medially and distally

Question 48

Percussion tells _______ about the vitality of the pulp

Answer 48

nothing

Question 49

Increased mobility indicates

Answer 49

a compromised periodontal attachment but tells nothing of the vitality of the tooth

Question 50

Mobility occurs because of

Answer 50

Acute or chronic trauma Periodontal disease Root fractures Rapid orthodontic movement Extension of pupal disease into the PDL

Question 51

Any mobility greater than ___ should be considered abnormal

Answer 51

+1

Question 52

Mobility +1

Answer 52

The first distinguishable sign of movement greater than normal

Question 53

Mobility +2

Answer 53

Horizontal tooth movement no greater than 1 mm

Question 54

Mobility +3

Answer 54

Horizontal tooth movement greater than 1 mm, with or without the visualization of rotation or vertical repressibility

Question 55

Wide areas of deep probing indicate

Answer 55

periodontal etiology whereas isolated

Question 56

narrow pocketing may indicate

Answer 56

a vertical root fracture or an infection that is draining through the sulcus from a non-vital tooth

Question 57

Class I Furcation involvment

Answer 57

can be probed but not to a significant depth

Question 58

Class II Furcation involvment

Answer 58

can be entered but not probed completely through other side

Question 59

Class III Furcation involvment

Answer 59

can be probed completely through opposite side