Apical Diagnosis

Question 1

What response would you expect from symptomatic apical periodontitis?

Answer 1

Inflammation (usually of apical periodontium)
Symptomatic
Painful response to biting & TTP
Potential Radiographic changes depending on stage of disease
- PDL width
- periapical radiolucency

Question 2

What response would you expect from asymptomatic apical periodontitis?

Answer 2

Inflammation & destruction of the apical periodontium
Appears as an apical radiolucency
No pain on percussion/palpation

Question 3

What response would you expect from a chronic apical abscess?

Answer 3

Inflammatory reaction to pulpal infection & necrosis
Gradual onset
Little or no discomfort
Discharge of pus through an associated sinus tract
Radiographically - signs of osseous destruction (e.g. Radiolucency)

Question 4

How would you identify the source of drainage in a sinus tract?

Answer 4

Place GP point into stoma & take radiograph

Question 5

What response would you expect from an acute apical abscess?

Answer 5

Inflammatory reaction to pulpal infection & necrosis
Rapid onset
Spontaneous pain
Extreme TTP
Pus formation
Swelling of associated tissues
Radiographically - may be no signs of destruction
Pt often experiences malaise, fever & lymphadenopathy

Question 6

What is condensing osteitis?

Answer 6

Diffuse radiopaque lesion representing a low-grade inflammatory stimulus usually seen at the apex of the tooth.

Question 7

What response would you expect from normal apical tissues?

Answer 7

No TTP
Radiographically - lamina dura surrounding root in tact
PDL space uniform