s8-finals-Diagnosis

Question 1

What defines endodontic diagnosis?

Answer 1

Art and scienceof detecting deviations from health and determining their cause/nature.

Question 2

What three elements combine for accurate diagnosis?

Answer 2

Scientific knowledge,clinical experience, andcommon sense.

Question 3

What is the first step in diagnosis?

Answer 3

Recording thechief complaintin the patient’s own words.

Question 4

Why is medical history critical before endodontic treatment?

Answer 4

Identifies conditions (e.g., diabetes, hypertension) thataffect treatment planningor mimic dental pain.

Question 5

How does pregnancy impact elective endodontic treatment?

Answer 5

Avoid elective treatment in1st/3rd trimesters; safest in2nd trimesterwith minimal radiation.

Question 6

What is a key concern when treating hypertensive patients?

Answer 6

AvoidNSAIDs(interfere with antihypertensives) and controlstress/pain.

Question 7

Why might diabetics need prophylactic antibiotics for RCT?

Answer 7

Impaired healingand higher infection risk.

Question 8

When is elective dental treatment contraindicated post-MI?

Answer 8

Within6 monthsof a myocardial infarction.

Question 9

Which patients require prophylactic antibiotics for endo procedures?

Answer 9

History ofrheumatic fever,prosthetic valves,mitral valve prolapse, orcongenital heart defects.

Question 10

What systemic condition can mimic recurrent dental abscesses?

Answer 10

Acute diabetes.

Question 11

How does maxillary sinusitis mimic tooth pain?

Answer 11

Causesposterior maxillary tooth sensitivityto percussion/cold.

Question 12

What dental history details are critical for diagnosis?

Answer 12

Chronology of symptoms,past procedures/trauma, andpresent symptoms.

Question 13

What are the 5 key features of a present dental problem?

Answer 13

Localization,duration,onset,provocation,intensity (L-D-O-P-I).

Question 14

What is checked during extra-oral examination?

Answer 14

Facial asymmetry,lymph nodes,sinus tracts.

Question 15

How are lymph nodes assessed in endodontic diagnosis?

Answer 15

Palpatesubmandibular,cervical, andposterior cervicalnodes for swelling/tenderness.

Question 16

What is an intra-oral sinus tract’s clinical significance?

Answer 16

Indicatesinfection source; tracing with gutta-percha identifies involved tooth/root.

Question 17

How is an acute apical abscess differentiated from periodontal abscess?

Answer 17

Apical:non-vital,apex-focused,no bone loss. Periodontal:vital,lateral,bone loss.

Question 18

What does Grade 2 tooth mobility indicate?

Answer 18

1–2 mm horizontal movement(e.g., from trauma/periodontal disease).

Question 19

How does endodontic pathology cause isolated periodontal bone loss?

Answer 19

Periapical infectionspreads to sulcus, creatingvertical bone loss.

Question 20

What is the primary pulp sensibility test method?

Answer 20

Thermal (cold) testusing ice water/ethyl chloride.

Question 21

Why is a false-positive pulp test result possible?

Answer 21

Saliva conduction,metallic restorations, orliquefactive necrosis.

Question 22

What causes a false-negative response in electric pulp testing?

Answer 22

Trauma,partial necrosis, orpremedication(e.g., analgesics/alcohol).

Question 23

How does laser Doppler flowmetry assess pulp vitality?

Answer 23

Measuresblood flowvia laser scattering from pulp vessels.

Question 24

What is the advantage of CBCT over 2D radiography?

Answer 24

Provides3D views(axial/sagittal/coronal) to detecthidden pathosis.

Question 25

When is transillumination used in diagnosis?

Answer 25

To detect cracked teeth/fractured cusps (blocked light transmission).

Question 26

What radiographic finding suggests endodontic pathosis?

Answer 26

Break in lamina dura or periapical radiolucency at apex.

Question 27

Why might periapical lesions not appear on radiographs initially?

Answer 27

Requires 30-50% bone loss at cortical-cancellous junction to be visible.

Question 28

What patient factors limit radiographic interpretation?

Answer 28

Gag reflex, shallow palate, or anatomical overlaps.

Question 29

How does cardiac angina mimic dental pain?

Answer 29

Referred pain to left mandible; no dental pathology present.

Question 30

What's the safest analgesic for pregnant patients?

Answer 30

Acetaminophen (avoids NSAID risks).

Question 31

Why avoid vasoconstrictors in hypertensive patients?

Answer 31

May trigger dangerous BP spikes; use cautiously.

Question 32

What's the key difference between reversible/irreversible pulpitis?

Answer 32

Reversible: pain stops when stimulus removed. Irreversible: spontaneous pain persists.

Question 33

How does a periodontal abscess respond to percussion?

Answer 33

Horizontal percussion is painful (vs. vertical in apical abscess).

Question 34

What indicates a cracked tooth on examination?

Answer 34

Pain on biting in one direction + transillumination defect.

Question 35

Why test multiple teeth during pulp sensibility testing?

Answer 35

To establish baseline responses and avoid false negatives/positives.

Question 36

How does ethyl chloride work for cold testing?

Answer 36

Boils at -4°C, creating ice crystals on cotton for application.

Question 37

What's the limitation of electric pulp testing?

Answer 37

Only detects neural response, not actual pulp vitality.

Question 38

When is warm gutta-percha used for thermal testing?

Answer 38

To confirm irreversible pulpitis (lingering pain to heat).

Question 39

What's the significance of a widened PDL on radiographs?

Answer 39

Early sign of apical periodontitis or occlusal trauma.

Question 40

How does external cervical resorption appear on CBCT?

Answer 40

Asymmetrical radiolucency penetrating dentin near CEJ.

Question 41

What's the first clinical sign of pulp necrosis?

Answer 41

No response to thermal/electric tests + possible discoloration.

Question 42

Why is periodontal probing critical in endo diagnosis?

Answer 42

Differentiates endo-periodontal lesions from pure periodontal disease.

Question 43

What's the hallmark of a combined endo-perio lesion?

Answer 43

Deep narrow probing + pulp necrosis + apical radiolucency.

Question 44

How does acute apical abscess differ from phoenix abscess?

Answer 44

Phoenix abscess: chronic lesion that suddenly flares up (exacerbation).

Question 45

What's the key radiographic feature of condensing osteitis?

Answer 45

Focal periapical sclerosis (radiopacity) around apex.

Question 46

Why test adjacent/contralateral teeth during pulp testing?

Answer 46

For comparative responses (avoids misdiagnosis from patient anxiety).

Question 47

What's the most accurate method for hot pulp testing?

Answer 47

Hot water bath (controls temperature precisely).

Question 48

How does liquefactive necrosis affect pulp test results?

Answer 48

May cause false-positive pain from gas expansion in canal.

Question 49

What systemic condition requires antibiotic prophylaxis for RCT?

Answer 49

Prosthetic heart valves (high risk of endocarditis).

Question 50

What's the key difference between pulpitis and periapical abscess?

Answer 50

Pulpitis: confined to pulp. Abscess: infection reaches periapex.