Diagnosis

Question 1

What is the pulpal dx?
- normally asymptomatic
- mild/moderate transient (short-lasting) response to thermal and electrical pulp test

Answer 1

normal pulp

Question 2

What is the pulpal dx?
- symptomatic
- cause = pulpal irritant
- not considered disease
- positive cold test = hypersensitivity + transient, sharp pain
- no spontaneous pain

Answer 2

reversible pulpitis

Question 3

What is the pulpal dx?
- asymptomatic
- physiologically and microscopically comparable to symptomatic irreversible pulpitis, but w/o symptoms

Answer 3

asymptomatic irreversible pulpitis

Question 4

What is the pulpal dx?
- symptomatic = spontaneous pain (intermittent or constant)
- irreversible damage to pulp, will not fully heal without irritant removal
- cold test = lingering pain
- EPT not useful
- radiographs usually insufficient
- posture changes may exacerbate pain due to increased BP

Answer 4

symptomatic irreversible pulpitis

Question 5

What is the pulpal dx?
- rarely symptomatic
- often, occurs from long term lack of blood supply to the pulp
- includes partial or total
- anterior teeth may appear with crown discoloration
- untreated leads to PDL thickening, sensitivity to percussion and periapical disease

Answer 5

necrotic pulp

Question 6

What is the pulpal dx?
- natural pulp tissue has been removed due to pulp therapy

Answer 6

previously treated pulp

Question 7

Used to cold test teeth

Answer 7

endo-ice (dichlorodifluromethane, -30 degrees C) sprayed onto a cotton pellet

Question 8

Pulpal test that determines the presence of vital sensory fibers in the pulp. Can only indicate if the tooth is vital or non-vital, not severity. This is the LEAST reliable pulp vitality test.

Answer 8

EPT (electric pulp test)

Question 9

contraindicated to EPT

Answer 9

cardiac pacemaker

Question 10

What is the periapical dx?
- asymptomatic (no pain on palpation and percussion)

Answer 10

normal

Question 11

What is the periapical dx?
- asymptomatic
- radiographs useful, visualization of apical radiolucency (confirms necrotic pulp)

Answer 11

asymptomatic apical periodontitis

Question 12

What is the periapical dx?
- symptomatic (pain on percussion, intense and throbbing)
- inflammation around tooth apex
- PDL contains localized inflammatory infiltrate

Answer 12

symptomatic apical periodontitis

Question 13

Symptomatic apical periodontitis
- If tooth is vital –>
- If necrotic tooth –>

Answer 13

If tooth is vital –> occlusal adjustment

If necrotic tooth –> endo therapy (due to belief that infection originated from pulp spreading to apical tissues)

Question 14

What is the periapical dx?
- acute, rapid swelling + severe pain
- apex contains purulent exudate/liquefaction necrosis of tissue

Answer 14

acute apical abscess

Question 15

What is the periapical dx?
- no/less swelling or discomfort (than acute) due to the presence of draining sinus tract

Answer 15

chronic apical abscess