06 Diagnosis Flashcards
Parulis
intraoral dental sinus
Stoma
associated with sinus tract (the opening)
primary endo radiograph is:
the periapical radiograph
how much mobility would indicate that the tooth has a poor prognosis for endo treatment?
if the tooth is depressible or moves 2-3 mm
what are the different periapical tests?
- percussion
- palpation
- bite
what are the sensibility (vitality) tests?
- cold
- ept to confirm
- heat (if indicated by symptoms)
during palpation, a painful response indicates:
periapical inflammation
during percussion, a painful response indicates:
periapical inflammation
analysis of percussion and palpation readings (+’s mean what?)
N=no pain
+=Slight pain
++=Moderate pain
+++= severe pain
sensitivity (esp rebound) when biting can indicate:
a cracked tooth or cusp
cold testing is more effective on anterior or posterior teeth?
anterior
what is an abnormal response to a cold test?
Prolonged severe (at least compared to other adjacent teeth)
false negatives on cold tests could be the result of what?
- receded or constricted pulp or
- transference of stimulus to adjacent teeth or soft tissue
what cotton pellet for cold testing
large #2 cotton (especially for testing thru full coverage crowns
what else can be used for cold testing?
Endo Ice, just as effective as CO2 snow. may even have a quicker response
analysis of cold readings:
0=No pain (not normal, necrotic)
+= slight pain, immediately reversed
++= moderate pain immediately reversed
+++= severe pain that does not go away when stimulus is removed
EPT Method:
- teeth isolation and drying with air syring
- toothpaste on electrode as conductor
- patient touches the metal handle (complete circuit)
- electrode placed on buccal or occlusal surface
can EPT be performed on full coverage crowns?
NO
method for heat testing
- hot water
- dry rubber prophy cup (frictional)
- heated gutta percha
- **rubber dam isolation, not a routine test, only when major symptom is heat sensitivity
transillumination
identify fractures
what are the possible pulpal diagnosis?
- normal pulp
- reversible pulpitis
- symptomatic irreversible pulpitis
- asymptomatic irreversible pulpitis
- necrotic pulp
- previously treated
- previously initiated
what are the possible periapical diagnosis?
- normal
- symptomatic apical periodontitis
- asymptomatic apical periodontitis
- acute apical abscess
- chronic apical abscess
cold test +++
Symptomatic irreversible pulpitis
if there is swelling/pus
acute or chronic apical abscess
-positive to percussion and palpation
chronic apical abscess
gradual onset, little or no discomfort, and intermittent discharge of pus through an associated SINUS TRACT
- percussion negative
- may be palpation positive if sinus tract is palpated
