Diagnosis Flashcards
Subjective and Clinical exam quote
Berman and Hartwell
Examine both the suspected tooth and ______ and _______
Adjacent teeth and opposing jaw
Bender
Taking NSAIDs before diagnostic testing
McClanahan – affects results
Fowler – no effect
______% agreement between clinical and histological diagnosis (Ricucci)
84-97%
First-line pulp sensitivity test
Cold testing
Basis of cold testing
outward hyrdodynamic fluid flow stimulates A delta fibers
Trowbridge
What is Endo Ice
tetrofluoroethane
Overall ice testing accuracy
90%
Jespersen
When to use heat test
When chief complaint includes heat sensitivity.
Heat sensitivity in a previously treated tooth indicates
Untreated anatomy
Keir
Basis of EPT
Ionic changes in dentinal fluid stimulates A delta fibers
Bender
Basis for heat testing
inward hydrodynamic fluid flow stimulates A delta fibers
When is EPT more useful
Calcified teeth
to rule out pulpal necrosis
What to use during orthodontic treatment
thermal tests (not EPT)
ideal placement of EPT electrode
Incisal edge or cusp tip
EPT and pacemakers
safe to use according to Wilson
EPT accuracy
75%. High rate of false positives, EPT should be a secondary measure generally
What do pulp tests check for?
Sensitivity, not vitality
True measure of vitality?
Blood flow
Doppler flowometry
pulse oximetry
Assessment of the PDL
Percussion
Palpation
biting
Percussion tests for
mechanical allodynia
Palpation tests for
soft tissue swelling, bony expansion
Periodontal exam includes
Probing depths
mobility
furcation invovlement
Other tests
Transillumination
tooth slooth
methylene blue staining
selective anesthesia
Most common radiograph for endodontic diagnosis
PA
Radiograph to assess existing restorations, caries, periodontal health, pulp chamber anatomy
Bitewing
Digital radiographs require ______% less radiation compared to traditional films
22%
Digital vs traditional radiographs for diagnostic yield
no difference
Diagnostic accuracy increases from _____ to ______% when using 1 PA vs 3 PAs from different angles
74% to 90%
There is at least ______% magnification in 2D radiographs
5%
CBCT is considered _______ compared to CT for dental purposes
superior
What makes CBCT scans dimensionally accurate?
The cubic voxels
Compared to CBCT, traditional radiographs miss _____% of lesions in the posterior maxilla
34%
Major draw-backs with CBCT
radiation dose, cost, contrast resolution, beam hardening, liability risk
Gold standard image for endo
Micro-CT
CBCT imaging can change diagnoses and treatment plans _____% of the time
62%
Should abide by _____ when considering obtaining CBCT
ALARA
IAN is ____mm away from the second premolar apex and ______mm away from the second molar apex
4.7mm and 3.7mm
Fractures usually involve
Mandibular second molar, then maxillary premolars and molars
Endodontic lesions that drain through the periodontal pocket
Perio-endo lesions.
Perio-endo lesions are a form of
CAA, sinus tract through the PDL
Periodontal disease unlikely to cause endodontic disease unless
The periodontal disease reaches the apex
Langeland
Chronic pulpal inflammation usually following carious or traumatic exposure in a young patient
Pulp polyp
