Clinical History and Examination Flashcards

1
Q

What does a severe response to percussion suggest?

A

periapical inflammation - SHARP pain, patient withdraws.

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2
Q

What are some symptoms of paracetamol overdose? What systems may be affected? Where must the patient be referred?

A
  • Abdominal pain, feel sick, vomit.
  • Liver or kidney failure.
  • Go to A and E
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3
Q

When is the working diagnosis established? What does it include?

A

AFTER HISTORY TAKING, CLINICAL EXAMINATION, SPECIAL TESTS AND SPECIAL INVESTIGATIONS

WORKING DIAGNOSIS BASED ON THE PULPAL AND PERIAPICAL DIAGNOSIS.

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4
Q

What are 4 prognostic factors for an RCT according to the european society of endodontology?

A
  • Pre-operative absence of periapical radiolucency.
  • Root canal filling with no voids.
  • RCF extending within 2mm of radiographic apex.
  • Satisfactory coronal seal.
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5
Q

What does cone beam ct do?

A
  • 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.
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6
Q

What is direct dentine stimulation? When is it used?

A

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.
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7
Q

What can be used to locate the origin of a sinus?

A
  • Use a DIAGNOSTIC GUTTA PERCHA and take a radiograph to show the origin of the infection.
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8
Q

What is the most accurate indicator of pulp vitality?

A

VASCULAR SUPPLY and not innervation.

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9
Q

3 limitations of radiographs for endodontic diagnosis?

A
  • 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.
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10
Q

What is the bite test? What material can be used to perform it?

A
  • Cracked tooth syndrome.
  • Provides displacement of fragments and stretching od odontoblastic processes –> patient feels pain on RELEASE of pressure.
  • can use a TOOTH SLOOTH.
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11
Q

Who developed the WHO probe? What is its use?

A
  • 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.
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12
Q

what is the maximum paracetamol dose for a 70kg person? What can reduce this maximum dose?

A

4g (8*500mg tablets) in 24 hours for a 70kg person.

-less if alcohol, not eat or liver problems

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13
Q

What type of CBCT is best indicated for endodontics? What is its exposure similar to?

A

Limited volume CBCT. Exposure similar to 2-3 periapicals.

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14
Q

What does pulp sensitivity testing stimulate?

A

Stimulates sensory nerve fibres.

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15
Q

What are 6 guidelines on the quality of an RCT according to the european society of endodontology?

A
  1. Rubber dam isolation.
  2. Proximity of the restoration to the apical constriction.
  3. Sufficient taper of preparation.
  4. Adequate irrigation and placement of an inter-appointment medicament.
  5. Correct extension of the obturation without extrusion.
  6. Adequate coronal seal to prevent reinfection.
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16
Q

When should CBCT not be used in endodontics?

A
  • Should NOT be used routinely for diagnosis or screening in the absence of symptoms.
17
Q

When is periapical inflammation visible on radiograph?

A

Once it has reached the cortical plate.

18
Q

How often should root canal treatment follow up be done according to the European Society of Endodontology’s Quality Guidelines?

A
  • CLINICAL + RADIOGRAPHIC follow up at least 1 year after treatment.
  • Further follow up for up to 4 years if healing on a radiographic assessment are slow and the periapical radiolucency is the same size or slowly decreasing
19
Q

What will happen to a sinus following RCT of the offending tooth?

A

May epithelialise but will still heal following RCT.

20
Q

When is CBCT indicated/ justified in endodontics?

A

Assessment and treatment of complex cases - perforations, root resorptions, complex anatomy.

21
Q

What classification for mobility is used? What are the values?

A

Hibberd 1981.
- Class 0: physiological mobility
- Class 1: perceptible mobility - Less than 1mm mobility bucco-lingually.
- Class 2: definite mobility - 1-2mm bucco-lingually.
- Class 3: gross mobility - more than 2mm bucco-lingually and/or vertical mobility.

22
Q

What does percussion determine?

A

The presence of periapical inflammation.

23
Q

What does palpation determine?

A

If there is periapical inflammation.

24
Q

What is a tentative diagnosis?

A

A PRECONCEIVED IDEA OF WHAT THE CONDITION THE PATIENT IS SUFFERING WITH MIGHT BE.
- After taking medical and dental histories and identifying signs and symptoms.

25
Q

What does a mild- moderate response to percussion suggest?

A

Periodontal inflammation - periodontal disease.

26
Q

Are radiographs required for diagnosis of periapical disease?

A

yes