AAE endo diagnoses

Question 1

normal pulp

Answer 1

symptom free and normally responsive to pulp testing

- transient/mild response to thermal cold testing, lasts only 1-2s after removed

Question 2

reversible pulpitis

Answer 2

inflammation should resolve and pulp return to normal following management of aetiology
discomfort when stimulus e.g. cold/sweet is applied, goes away within a couple of seconds following removal of stimulus
typical aetiologies: exposed dentine, caries or deep Rxs. Tx this to resolve
no significant radiographic changes in PA region
no spontaneous pain, not TTP

Question 3

symptomatic irreversible pulpitis

Answer 3

vital inflamed pulp incapable of healing, RCT indicated
sharp pain upon thermal stimulus, lingering pain (often >30s after stimulus removal), spontaneous and referred pain
may be accentuated by postural changes e.g. lying down/bending over
OTC analgesics typically ineffective
common aetiologies: deep caries, extensive Rxs, fractures exposing pulp
may be difficult to diagnose as inflammation hasn’t yet reached PA tissues so not TTP

Question 4

asymptomatic irreversible pulpitis

Answer 4

vital inflamed pulp incapable of healing, RCT indicated
no clinical symptoms, normal response to thermal testing usually
may have had trauma/deep caries that would likely result in exposure following removal

Question 5

pulp necrosis

Answer 5

death of pulp, need RCT
non-responsive to testing, asymptomatic
by itself doesn’t cause apical periodontitis unless canal infected
some teeth might not respond to pulp testing: calcification, recent trauma, just not responding

Question 6

prev treated

Answer 6

canals obturated (not medicaments)
non-responsive

Question 7

prev initiated

Answer 7

partial therapy e.g. pulpotomy/pulpectomy

may/may not respond to pulp testing

Question 8

normal apical tissues

Answer 8

not sensitive to percussion or palpation testing

radiographically LD intact, PDL space uniform

Question 9

symptomatic apical periodontitis

Answer 9

inflammation, usually of apical periodontium, producing clinical symptoms involving a painful response to biting and/or percussion or palpation
+/- radiographic changes - depending on stage of disease, may be normal width of PDL or may be periapical radiolucency
severe pain to percussion and or palpation is highly indicative of a degenerating pulp and RCT needed

Question 10

asymptomatic apical periodontitis

Answer 10

inflammation and destruction of the apical periodontium that is of pulpal origin
appears as an apical radiolucency, does not present clinical symptoms (no TTP)

Question 11

chronic apical abscess

Answer 11

inflammatory reaction to pulpal infection and necrosis characterised by gradual onset, little/no discomfort and intermittent discharge of pus through associated sinus tract
radiographically typically signs of osseous destruction e.g. radiolucency
identify source of draining sinus tract - place GP cone and take radiograph

Question 12

acute apical abscess

Answer 12

inflammatory reaction to pulpal infection and necrosis chraracterised by rapid onset, spontaneous pain, extreme tenderness of tooth to pressure, pus formation and swelling of associated tissues. May be mobile
may be no radiographic signs of destruction
often malaise, fever, lymphadenopathy

Question 13

condensing osteitis

Answer 13

diffuse radiopaque lesion representing a localised bony reaction to a low-grade inflammatory stimulus usually seen at the apex of the tooth
usually symptom-free