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Endodontics > After Midterm: Lec Diagnosis I > Flashcards

After Midterm: Lec Diagnosis I Flashcards

1
Q

When to place crowns on necrotic teeth:

A

never

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2
Q

Restorative tx is dependent on:

A

pulpal health

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3
Q

Emergency tx is often related to:

A

endo tx

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4
Q

TF? Pins to support a large resto will probably kill the pulp one day.

A

T

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5
Q

TF? A pin must touch the pulp in order to kill it.

A

F

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6
Q

TF? We must have caries in order for the pulp to become necrotic.

A

F

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7
Q

Aspects of post-restorative evaluations:

A

pt discomfort or RG finding

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8
Q

Key to effective tx:

A

accurate dx

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9
Q

Steps in dx:

A

chief complaint, Medical and Dental hx, oral exam, pulp tests, rg interpretation, data alysis, differential dx

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10
Q

When to look at rg to diagnose:

A

last

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11
Q

How to chose testing method:

A

replicate the pts chief complaint

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12
Q

Questions to ask person in pain:

A

type of pain (hot, cold, biting), triggers

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13
Q

What to ask if the tooth causing pain has a resto:

A

when done, symptoms before resto, did dentist say it was deep or there was nerve exposure?

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14
Q

What to look for extraorally if pt is in pain:

A

swelling

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15
Q

What to look for intraorally if pt is in pain:

A

sinus tracts, cracks, probing depth

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16
Q

TF? Sinus tract is the same as fistula.

A

F

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17
Q

Cracks and sinus tracks can lead to:

A

necrosis

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18
Q

Did he explain when to do each type of test based on pts description of the pain?

A

check

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19
Q

Can a necrotic tooth have hot/cold pain?

A

no

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20
Q

Can a tooth have a lesion if it a vital tooth

A

no

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21
Q

% of time we should know issue via pulp testing:

A

99%

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22
Q

Questions to ask during data analysis:

A

pulp test result coincide, match RG’s?

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23
Q

RGL, but tooth is vital, issue or what to do next:

A

retest, maybe you did the test wrong

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24
Q

5 endo tests:

A

EPT, cold, heat, percussion, palpation (of mucosa)

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25
Q

3 pulpal endo tests:

A

EPT, cold, heat

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26
Q

2 periradicular tests

A

percussion, pallpation

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27
Q

What do percussion and palpation test?

A

PDL

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28
Q

Steps of EPT:

A

isolate, dry, conductive medium w tip on mid-B, not resto or gingiva, pt touch handle

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29
Q

Why not to dry tooth with air syringe:

A

if they are having sensitivity they will jump

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30
Q

What would happen if you contact gingiva during EPT:

A

false positive

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31
Q

What is the conductive medium we use for EPT?

A

toothpaste

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32
Q

Where to place tip of EPT pulp tester:

A

MID-B

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33
Q

How is the circuit of the EPT test completed?

A

pt touches handle

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34
Q

EPT numbers go from:

A

0-80

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35
Q

80 on EPT indicated:

A

necrotic pulp

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36
Q

TF? 79 means the pulp is probably not necrotic.

A

F. probably necrotic

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37
Q

Anything over this value is considered a false positive:

A

70

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38
Q

What is the importance of the numbers on the EPT?

A

none

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39
Q

What is endo ice:

A

1, 1, 1,2-tetrafluoroethane

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40
Q

Temp of endo ice:

A

-26.2’C (-15.88F)

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41
Q

Why are cotton pellets better for pulp testing than Q-tip?

A

more sa for cotton pellet

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42
Q

Most important step to remember when doing EPT:

A

dry the tooth!!!!

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43
Q

Where to spray endo ice:

A

in sink, away from ppl

44
Q

no response at mid-buccal + recession, what to do next?

A

Slide down to the CEJ, may hit gingiva for a sec

45
Q

EPT, false positives:

A

EPT touching gingiva

46
Q

TF? Endo ice touching gingiva can lead to false positive.

A

F

47
Q

Prolonged exposure of gingiva to endo ice can lead to:

A

tissue damage

48
Q

What to record after endo ice testing:

A

severity and duration of pain

49
Q

Material for heat testing:

A

gutta-percha stopping (white gutta percha)

50
Q

2 MOA’s for heat testing:

A

movement of dentinal fluid, inc intrapulpal pressure

51
Q

In which direction does dentinal fluid move with heat?

A

inward

52
Q

How is the procedural set up for heat testing different for heat testing than EPT or cold?

A

vaseline on tooth

53
Q

Fxn of vaseline on tooth:

A

to prevent GP from sticking

54
Q

Instrument to wrap GP around:

A

Glick

55
Q

What does the Glick look like?

A

plastic on one end, plugger on other

56
Q

Is there a bunsen burner always available in oral surgery clinic or emergency clinic so we don’t always have to run down to get our own?

A

check

57
Q

When to heat Glick for heat testing:

A

before and after wrapping GP around it

58
Q

What to record after heat testing:

A

severity and duration

59
Q

How to position mirror handle when pulp testing:

A

along long axis of tooth

60
Q

Palpate here to here:

A

healthy tooth to tooth in question

61
Q

Finger to use for palpating

A

index

62
Q

Gently roll finger along here for palpation:

A

vestibule

63
Q

Check for this during palpation:

A

pt discomfort, swelling and/or break in cortical plate

64
Q

Other endo tests:

A

Anesthetic, Cavity (next semester)

65
Q

If pain during percussion but not pulp issue, what to suspect:

A

inflammation of PDL

66
Q

inflammation of PDL can be due to:

A

high occlusion, trauma, torquing forces, clenching, bruxism, pdd

67
Q

Torquing forces can be caused by:

A

ortho, RPD

68
Q

How to tell if pain to percussion is due to pdd

A

hor and ver percussion have different responses

69
Q

Is all percussion pain of endo origin?

A

no

70
Q

What does percussion tell you about the pulp?

A

nothing

71
Q

Pain during palpation may be due to:

A

inflammation of mucosa

72
Q

What can lead to inflammation of mucosa:

A

extension of inflammation/infection through cortical plate

73
Q

How does EPT test indicate vitality of a tooth, what fibers?

A

via neural response (A-fibers)

74
Q

TF? EPT indicates health of pulp.

A

F. (just whether alive or dead, right? check)

75
Q

How to activate C fibers with EPT:

A

leave the instrument on tooth longer

76
Q

Population on which EPT testing will not work:

A

Adolescents, 5y after tooth eruption for the plexus of Rashkow

77
Q

How many yrs after eruption will the plexus of Rashkow develop and EPT testing to work?

A

5y

78
Q

TF? Necrotic, healthy, and vital are all dx:

A

F. vital is not, pulp could be dying and not dead

79
Q

TF? Inflamed pulps are vital.

A

T, but not healthy

80
Q

of test required to determine necrosis:

A

2

81
Q

It may be difficult to determine if a tooth is necrotic if the tooth is:

A

crowned

82
Q

Reasons for false positives for EPT:

A

poor isolation (#1), touching metal/ gingiva, pus in canal

83
Q

Only true false positive that is not fault of dentist technique:

A

suppurative fluid in canal

84
Q

Reasons for false negatives for EPT:

A

extreme calcification, poor contact/lack of contact medium, dead battery

85
Q

Which can test further down, EPT or hot/cold testing?

A

EPT

86
Q

Is EPT more likely to have false positive or negative?

A

positive

87
Q

TF? Thermal test only determine whether or not the pulp is alive.

A

F. help to determine condition of pulp

88
Q

Normal response to thermal testing:

A

pain

89
Q

How to determine if there is an issue if the normal response to hot/cold testing is pain:

A

compare to healthy tooth

90
Q

Thermal test response depends on:

A

dentinal fluid in tubules

91
Q

Dentinal fluid comes from:

A

odontoblasts

92
Q

Pulp dead, what else are dead?

A

odontoblasts, no pain, no fluid

93
Q

Types of thermoreceptors the pulp has:

A

none

94
Q

What can the pulp feel?

A

pain, not hot or cold

95
Q

Jumpy patients most likely have:

A

inflamed PDL

96
Q

Always do this if your first test is endo ice:

A

after pain is gone touch tooth with only a cotton pellet, might be the PDL

97
Q

When might you get false positive w/ thermal tests:

A

pressure on tooth w inflamed PDL

98
Q

When might you get false negative w/ thermal tests:

A

calcified pulp, not enough Endo ice, or heat GP enough, waiting too long before placing on tooth, testing multiple teeth wo respraying or reheating

99
Q

More common w thermal testing, false neg or pos?

A

false neg

100
Q

Review slide 58

A

ok

101
Q

Can thermal can be done through crown?

A

yes, esp if metal

102
Q

What to test if a pt is experiencing pain in a given quadrant:

A

the entire quadrant

103
Q

When might the entire quadrant not respond to pain?

A

referred pain

104
Q

TF? EPT number reflects whether the pain is lingering or not.

A

F

105
Q

Lingering pain duration is usually in the:

A

minutes

Endodontics (22 decks)

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