Clinical History and Examination Flashcards
What does a severe response to percussion suggest?
periapical inflammation - SHARP pain, patient withdraws.
What are some symptoms of paracetamol overdose? What systems may be affected? Where must the patient be referred?
- Abdominal pain, feel sick, vomit.
- Liver or kidney failure.
- Go to A and E
When is the working diagnosis established? What does it include?
AFTER HISTORY TAKING, CLINICAL EXAMINATION, SPECIAL TESTS AND SPECIAL INVESTIGATIONS
WORKING DIAGNOSIS BASED ON THE PULPAL AND PERIAPICAL DIAGNOSIS.
What are 4 prognostic factors for an RCT according to the european society of endodontology?
- Pre-operative absence of periapical radiolucency.
- Root canal filling with no voids.
- RCF extending within 2mm of radiographic apex.
- Satisfactory coronal seal.
What does cone beam ct do?
- Produces 3D scans of the maxillofacial skeleton at a lower dose of radiation.
- Captures a CYLINDRICAL/ SPHERICAL volume of information known as the FIELD OF VIEW.
What is direct dentine stimulation? When is it used?
Cutting a testing cavity.
1. explain procedure to patient.
2. perform without anesthesia.
if tooth is vital, patient will feel a sudden sharp pain when dentine is cut.
- useful for CROWNED TEETH.
What can be used to locate the origin of a sinus?
- Use a DIAGNOSTIC GUTTA PERCHA and take a radiograph to show the origin of the infection.
What is the most accurate indicator of pulp vitality?
VASCULAR SUPPLY and not innervation.
3 limitations of radiographs for endodontic diagnosis?
- Pathological changes in the pulp not visible.
- Periapical pathology not visible in the early stages (inflammation must reach cortical plate to be visible).
- 2D image hence multiple views may be required.
What is the bite test? What material can be used to perform it?
- Cracked tooth syndrome.
- Provides displacement of fragments and stretching od odontoblastic processes –> patient feels pain on RELEASE of pressure.
- can use a TOOTH SLOOTH.
Who developed the WHO probe? What is its use?
- Developed by the British Society of Periodontology.
- It is a SCREENING tool for periodontal assessment - it does NOT provide a diagnosis but indicates what further assessment is required.
what is the maximum paracetamol dose for a 70kg person? What can reduce this maximum dose?
4g (8*500mg tablets) in 24 hours for a 70kg person.
-less if alcohol, not eat or liver problems
What type of CBCT is best indicated for endodontics? What is its exposure similar to?
Limited volume CBCT. Exposure similar to 2-3 periapicals.
What does pulp sensitivity testing stimulate?
Stimulates sensory nerve fibres.
What are 6 guidelines on the quality of an RCT according to the european society of endodontology?
- Rubber dam isolation.
- Proximity of the restoration to the apical constriction.
- Sufficient taper of preparation.
- Adequate irrigation and placement of an inter-appointment medicament.
- Correct extension of the obturation without extrusion.
- Adequate coronal seal to prevent reinfection.