Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ICS - ENDODONTOLOGY > 2: Systemic Pulpal & Periradicular Diagnosis > Flashcards

2: Systemic Pulpal & Periradicular Diagnosis Flashcards

1
Q

how is subjective information gained?

A

talk to patient prior to clinical examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

patient’s chief complaint: how should information be recorded?

A

in patient’s own words

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

past medical history:

  • keep history updated how often?
  • what to remember about older patients?
A
  • each visit to dentist

- older patients tend to have more complicated medical problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

past medical history: conditions that require special consideration for endodontic treatment?

A
  • radiation therapy of oral tissues
  • disorders of immune system
  • cardiac conditions
  • latex allergy
  • hepatitis
  • bleeding disorders
  • steroid replacement therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

history of present complaint: obtained by?

why should patients be handled with care? in what type of environment?

A
  • questions and answers regarding history of present symptoms
  • because of pain, apprehension and altered emotional state. environment should be friendly and compassionate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

dental history: what should be noted?

A
  • why patient attended
  • any recent treatment?
  • when did problem begin
  • what factors influence the present complaint?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

significant aspects of pain? elaborate on each

A

location: ask pt to point to the tooth, location can be difficult if inflammation has not spread to pl?

character/intensity: more intense, more disruptive to lifestyle. intense pain: recent onset, no relief from analgesics. can be caused by irreversible pulpitis, acute apical abscess. long standing pain not as intense.

origin: spontaenous or provoked. spontaenous intense pain = severe pulpal/periradicular pathology
duration: intermittent or continuous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

continuous pain:
with thermal stimulus - indicates?
with application of pressure - indicates?

A
  • irreversible pulpitis

- periradicular pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

collection of medical and dental history, identification of signs and symptoms - what diagnosis can the clinician reach?
what else is required to collect more info to confirm diagnosis?

A
  • tentative diagnosis

- will require objective examination to confirm tentative diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

objective examination: gained by? x3

A

clinical examination
special investigations
radiographs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

clinical examination: what are the extraoral and intraoral tissues? what to examine for?

A

extraoral: general appearance, facial asymmetry, swelling, TMJ, lymph nodes

intraoral:
- soft tissues: lips, oral mucosa, cheeks, tongue, palate, attached gingiva.
check for discoloration, inflammation, sinus tracts

  • dentition: check discoloration, fractures, toothwear, caries, large restorations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

clinical tests: 4 different types?

A
  • mirror and probe: check discoloration, caries, fracture, defective restorations, sinus/fistula
  • periodontal examination
  • periapical tests: TTpercussion, TTpalpation, pulp sensibility
  • radiographic examination: cone beam, CT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q 
periodontal examination:
- differentiates between? 
probing?
- helps detect?
mobility? 
- caused by? 
- what causes it to decrease?
A
  • differentiate between periodontal and pulpal pathology
  • probing is a diagnostic aid to bone and soft tissue destruction. teeth suspected of perio disease should always be probed
  • mobility: caused by lack of pl support, or acute infection. successful RCT can decrease mobility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

mobility:
specific causes? what kinds of origins?
other causes?

A
  • LOA
  • inflammation of PDL
  • can be pulpal or periodontal origin
  • other causes include root fracture, trauma, occlusal trauma, orthodontic tooth movement, abnormally short roots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

periradicular tests: what 3 movement to carry out?

A
  • percussion
  • palpation
  • mobility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are control teeth and what is their purpose (x3)?

A
  • healthy teeth that should be tested first
    3 reasons:
  • patient knows what to expect
  • dentist can observe patient’s response
  • can then determine if stimulus is capable of evoking a response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

percussion:
determines what?
severe response: how? indicates?
mild to moderate response: indicates?

A
  • percussion determines the presence of PERIRADICULAR inflammation
  • severe pain is sharp, causing patient to withdraw. indicates periradicular inflammation
  • mild/moderate: indicates periodontal inflammation, periodontal disease
18
Q

percussion: how to carry out?
what if there is severe subjective pain?
what must be done first?

A
  • tap on incisal or occlusal surface with mirror handle, held perpendicular to crown
  • then only use gentle apical pressure applied digitally
  • test control teeth first
19
Q

palpation: determines what? positive response indicates? how to carry out? what must be done first?

A
  • determines if inflammation has extended periapically
  • indicates periradicular inflammation
  • firm finger pressure applied to mucosa
  • use control tooth
20
Q

pulp sensibility testing: stimulates what nerve fibres? positive response does not guarantee ___, but indicates what?

A
  • stimulates sensory nerve fibres
  • does not guarantee healthy pulp, only indicates presence of some nerve fibres carrying sensory impulses
  • use control teeth first
21
Q

pulp sensibility tests: what 3 types are there?

A
  • thermal
  • electric pulp testing
  • direct dentine stimulation
22
Q

pulp sensibility testing:
normal response - occurs in?
intense, prolonged response - suggests?
no response - indicates?

A
  • in vital pulp, or reversible pulpitis
  • suggests irreversible pulpitis
  • necrotic pulp, or false negative (immature apex, recent trauma, calcified canal)
23
Q

pulp sensibility tests: cold
what materials are used?
which teeth respond better or worse to cold tests? what is the alternative?

A
  • ethyl chloride
  • dichlorodifluoromethane (endofrost)
  • ice sticks
  • more effective on anterior teeth than posterior teeth - try electric pulp testing instead
24
Q

pulp sensibility tests: heat

what materials can be used?

A
  • hot water: isolate tooth with rubber dam, syringe one tooth at a time
  • gutta-percha heated on a flame
  • rotation of rubber prophy cup
25
Q

electric pulp testing: technique?

A
  • clean, dry, isolate tooth
  • place toothpaste on electrode
  • place tester on labial/palatal surface of tooth. avoid metal restorations
  • increase level of current until sensation is felt by pt
26
Q

EPT false positives: occur when? x4

A
  • electrode makes contact with gingiva or large amalgam restorations
  • patient is anxious
  • liquefaction necrosis (gaseous & liquefied elements within pulp can transmit electrical charges to periapical tissues)
  • tooth not dry or well isolated
27
Q

EPT false negatives: occur when?

A
  • patient is premedicated
  • inadequate contact with enamel
  • trauma
  • canal calcified
  • apex immature
  • partial necrosis
28
Q

pulp sensibility:
positive response shows?
negative response shows?
response does not reflect the degree of ______?

A
  • presence of sensory nerve fibres
  • pulpal necrosis
  • does not reflect the degree of health or disease of pulp
29
Q

pulp vitality test:

measures and assesses what? vascular supply is the most accurate marker of?

A
  • measure/assess pulpal blood flow

- pulp vitality

30
Q

laser doppler flowmetry: an optical measuring method that enables?
objective test of?

A
  • enables the number and velocity of particles conveyed by a fluid to be measured
  • objective test of presence of moving RBCs within tissue
31
Q

laser doppler flowmetry: how does it work?

A

laser light transmitted to the dental pulp, by means of fibre optic probe placed against tooth surface

32
Q

laser doppler flowmetry: indications?

A
  • pulp testing in children
  • traumatized teeth
  • monitoring revascularization of replanted teeth
  • differential diagnosis of periapical radiolucencies
33
Q

direct dentine stimulation: how to carry out? useful for? how must test be carried out?

A

cut a test cavity

  • useful for crowned teeth
  • explain test to patient, carry out preparation without anaesthesia
  • if tooth is vital; patient will feel a sudden, sharp pain when dentine is cut
34
Q

methods of special investigation?

A
  • selective anaesthesia

- transillumination: dentine cracks, fractures

35
Q

bite test: provides? patient will feel pain upon?

A
  • displacement of fragments and stretching of odontoblastic processes
  • patient will feel pain upon release of pressure
36
Q

radiographic examination:
aids what?
limitations? x3
inflammation must spread where to be visible?

A
  • diagnosis
  • pathological changes in pulp not visible, periradicular pathology not visible in early stages, 2D - more than one view often required
  • inflammation must spread to involve cortical plates to be visible
37
Q

radiographic evaluation: crown

- what to look for?

A
  • depth of restoration
  • presence of caries/recurrent caries
  • presence of tertiary dentine/pulp stones
  • size & location of pulp chamber
38
Q

radiographic evaluation: roots and periradicular area

A
  • number and morphology of roots
  • size and shape of root canals
  • presence of resorption
  • presence of periradicular pathology
  • previous root canal treatment: quality, type of material, iatrogenic defects
39
Q 
cone beam CT
produces what kind of scans of the maxillo-facial skeleton?
what dose of radiation?
captures what? 
how does the x-ray work?
A
  • 3D scans of maxillo-facial skeleton
  • lower dose of radiation
  • captures cylindrical/spherical volume of data known as field of view
  • pulsing x-ray beam gives up to 580 projection images, exposure of 2-5s. software then reconstructs 3D image from data
40
Q

CBCT can provide?

A

a more objective and accurate representation of osseous changes over time

ICS - ENDODONTOLOGY (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions