Module 3: Diagnosis

Question 1

What is the primary radiograph in endo?

Answer 1

PA

Question 2

What does the BW radiograph help evaluate

Answer 2

Restorability

Question 3

What type of radiograph has limited use in endo.

Answer 3

Panorex

Question 4

What should you be looking at on the radiograph?

Answer 4

Bone levels
Existing restorations
Pulp chamber space
Root canal space and morphology

Question 5

What are the initial goals of Clinical Diagnostic Tests?

Answer 5

To reproduce the patient’s complaint

Use control teeth to establish a baseline

Question 6

What are two important pieces of information you can get from perio testing?

Answer 6

Probing depths

Mobility

Question 7

Why is perio testing so important?

Answer 7

You must be sure the tooth is sound periodontically before committing to RCT

Question 8

What are the 3 periapical tests?

Answer 8

Percussion
Palpation
Bite

Question 9

What are the 3 Sensibility (Vitality) tests

Answer 9

Cold
EPT
Heat

Question 10

In the Palpation test, what are we trying to determine?

Answer 10

How far the inflammation has extended

Question 11

What does a painful response indicate in the palpation test?

Answer 11

Periapical inflammation

Question 12

What is the most valuable of the 3 periapical tests?

Answer 12

Percussion

Question 13

What is the percussion test good at indicating?

Answer 13

The offending tooth

Question 14

What does a sore reaction to the percussion test indicate?

Answer 14

Periapical inflammation

Question 15

What is the VCU scale for percussion and palpation readings

Answer 15

N = No Pain
\+ = Slight
\++ = Moderate
\+++ = Severe

Question 16

What pathosis is the biting force test especially useful for?

Answer 16

Cracked teeth

Question 17

What is rebound sensitivity a good indicator for?

Answer 17

Cracked teeth/Fractured cusp

Crack flexes and then rebounds causing pain

Question 18

What instrument is used for a bite test

Answer 18

Tooth Sleuth

Question 19

What is the temperature of endo ice

Answer 19

-26 C

Question 20

What is the chemical in endo ice

Answer 20

1,1,1,2-tetrafluoroethane

Question 21

Which set of teeth is cold testing more effective on: Anterior or Posterior?

Answer 21

Anterior

Question 22

What surface is the cotton pellet placed on during cold testing

Answer 22

Buccal

Question 23

What would you consider an abnormal response to the cold test?

Answer 23

Prolonged, severe pain

Question 24

How does a necrotic pulp respond to a cold test?

Answer 24

No response

Question 25

What could cause a false positive on a cold test?

Answer 25

Transference of stimulus to adjacent teeth or soft tissue

Question 26

What could cause a false negative on a cold test

Answer 26

Receded on constricted pulp

Question 27

Can you cold test through full coverage crowns?

Answer 27

Yes

Question 28

What kind of cotton pellet it used for cold testing

Answer 28

Large #2

Question 29

What is the VCU response grading to cold testing?

Answer 29

``` 0 = No Pain + = Slight and immediate reversal ++ = Moderate and immediate reversal +++ = Severe that does not go away immediately ```

Question 30

Does a 0 on a cold test always mean a dead pulp?

Answer 30

No

Question 31

Why does the EPT always restart at zero after breaking contact

Answer 31

To reduce chances of giving patient a shock

Question 32

Is EPT more important than cold testing?

Answer 32

No, it is secondary to cold test

Question 33

Can you perform an ept on crowns?

Answer 33

Not on full coverage Metal or PFM

Question 34

What does an 80/80 reading on the EPT indicate?

Answer 34

No response to electrical stimulation

Question 35

What is transillumination good at identifying?

Answer 35

Longitudinal cracks

Question 36

What are the 2 diagnoses that must be made for an official endo diagnosis

Answer 36

Pulpal AND Periapical

Question 37

What is the pulp diagnosis when the pulp is symptom free and normally responsive to vitality testing?

Answer 37

Normal pulp

Question 38

What are the diagnostic findings for a Normal pulp diagnosis

Answer 38

Cold response of + | Or no cold response with receded or sclerotic pulp (recorded as 0)

Question 39

What is the pulp diagnosis based upon subjective and objective findings indicating that the inflammation should resolve and the pulp return to normal

Answer 39

Reversible pulpitis

Question 40

What are the diagnostic findings for reversible pulpitis

Answer 40

Cold response of ++ | No root canal needed

Question 41

What pulpal diagnosis is defined as findings that indicate the vital inflamed pulp is incapable of healing

Answer 41

irreversible pulpitis

Question 42

What are the two additional descriptors that can be used to describe the pulp diagnosis

Answer 42

Symptomatic and Asymptomatic

Question 43

What is the clinical diagnosis that indicates the death of the pulp

Answer 43

Pulp necrosis

Question 44

What are the diagnostic findings for Pulp necrosis

Answer 44

0 for Cold Test | 80/80 for EPT

Question 45

What does Previously Treated mean

Answer 45

Tooth has had endo tx and the canals are obturated with filling material

Question 46

What are the diagnostic findings for previously treated

Answer 46

Will respond to cold and ept the same way necrotic pulp do....unless there is still vital pulp tissue in the tooth

Question 47

What is Previously Initiated Therapy

Answer 47

RCT started but not finished yet

Question 48

What is the PA diagnosis for a tooth with normal periradicular tissues with an intact lamina dura and uniform PDL space

Answer 48

Normal apical tissues

Question 49

What is the PA diagnosis for inflammation of the apical periodontium that produced clinical symptoms like painful response to biting and percussion. It may or MAY NOT be associated with an apical radiolucency

Answer 49

Symptomatic apical periodontitis

Question 50

How could you describe the diagnosis "Asymptomatic apical periodontitis"

Answer 50

Inflammation of apical periodontium that is of pulpal origin. It appears as an apical RL with no clinical symptoms

Question 51

What is the worst symptomatic diagnosis for perio

Answer 51

Acute apical abscess

Question 52

What is the diagnosis for a patient that has a gradual onset with little or no discomfort along with intermittent discharge of pus via sinus tract

Answer 52

Chronic apical abscess

Question 53

What pulp diagnosis would you give a tooth that has cold test score of ++?

Answer 53

Reversible pulpitis

Question 54

What pulp diagnosis would you give a tooth with a cold test score of +++?

Answer 54

Irreversible pulpitis

Question 55

What would the pulp diagnosis be for a cold test of 0 and an 80/80 ept?

Answer 55

Necrotic pulp

Question 56

What is the PA ddx for a tooth that scores: N for percussion N for palpation

Answer 56

Normal apical tissues

Question 57

What perio ddx would you give to a tooth with pain response to biting that may or may not have a response to palpation?

Answer 57

Symptomatic apical periodontitis

Question 58

What is the perio ddx for a tooth with an apical RL and: N for percussion N for palpation

Answer 58

Asymptomatic apical periodontitis

Question 59

What is the expected response to percussion and palpation testing for a chronic apical abscess?

Answer 59

Percussion negative | Palpation might be positive if sinus tract is palpated