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Endo - ABGD - Oral Board Review > Diagnosis > Flashcards

Diagnosis Flashcards

1
Q

What is your diagnostic goal?

A
  • Recognize a problem
  • Determine the cause
  • Develop a treatment plan
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2
Q

What is a good way to write up your Endodontic Diagnosis write up?

A

SOAPED

  • S: Subjective findings: CC
  • O: Objective findgins: Clinical exam…Diagnostic tests…Radiographs
  • A: Assessment: Diagnosis
  • P: Plan: Comprehensive Treatment Considerations
  • E: Execution: Treatment Performed
  • D: Disposition: What’s next?
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3
Q

What are some limitations to be aware of in the pulpal diagnosis process?

A
  • Diagnostic testing - imprecise
  • Patient processing and feedback - imprecise
  • Lack of pulpal proprioception (cannot localize)
  • Referred pain
  • Misdiagnosis by referring dentist
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4
Q

What are 5 fives you can test the pulp?

A
  1. Cold
  2. Hot
  3. EPT
  4. Bur
  5. Test Cavity
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5
Q

What are 4 ways you can test the Periradiular tissues?

A
  1. Percussion
  2. Biting
  3. Palpation
  4. Perio Probing
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6
Q

What is the Endo ice test actually testing?

A

Evaluates nerve resonse - not pulpal blood flow

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7
Q

What kind of cotton pellet do you want to use when conducting a cold test?

A

Fluffy cotton pellet

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8
Q

What surface do you place the endo ice on?

A

Facial surface

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9
Q

What is it helpful to do when endo ice testing?

A

Establish controls

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10
Q

What types of things can yield a False Positive for a thermal test?

A
  • Anxiety
  • Gingival Response
  • Adjacent teeth
  • Saliva
  • Periradicular Response
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11
Q

When can yield a Fale Negative for a Pulpal Response when doing thermal tests?

A
  • Calcified canals
  • Indequate stimulus
  • Restorations
  • Immature Tooth
  • Trauma
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12
Q

If you cannot dupliate CC with Endo ice (cracks, open margins) what is an option?

A
  • Simulate “real-world” activity
  • Single tooth RD isolation
  • Establish control responses first
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13
Q

For a heat thermal test, what is an option?

A
  • Heat is primary factor of CC
  • Cold test inconclusive
  • single tooth RD isolation
  • Establish control responses first
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14
Q

Why is the Electric Pulp Test a good plan B and not plan A?

A
  • Easily misinterpreted
  • Does not reproduce CC
  • No diagnostic value with vital pulp pathosis
  • May defer if teeth respond to thermal test
  • Implies only pulpal vitality or necrosis via negative nerve response
  • A “yes or no” result…ignore the number
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15
Q

What are some things that an Electric Pulp Test requires?

A
  • Requires patient education & cooperation
  • Requires dry tooth structure
  • Requires condcuting medium
  • Ineffective through some dental restorations
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16
Q

What can give some false positives for an EPT test?

A
  • Anxiety
  • Restorations
  • Gingival Conduction
17
Q

What can give some false negatives for the Electric Pulp Test?

A
  • Inadequate contact
  • Immature tooth
  • Recent trauma
18
Q

What does a percussion test help detect?

A

Periradicular inflmmation (not pulpal status)

19
Q

What does Apical Palpation help detect?

A

Refelcts cortical plate penetration

20
Q

What does a bite test help detect?

A

Suspect cracked tooth

21
Q

What are some other tests you can do for diagnosis? one is last resort…

A
  • Transillumination
  • Selective Anesthesia
  • Test Cavity - Last Resort
22
Q

What are the 7 Pulpal Diagnoses?

A
  • Normal Pulp
  • Reversible Pulpitis
  • Symptomatic Irreversible Pulpitis
  • Asymtomatic Irrerversible Pulpitis
  • Pulpal Necrosis
  • Previously Initiated Therapy
  • Previousy Treated
23
Q

What are the 6 Apical Diagnoses?

A
  • Normal Apical Tissues
  • Symptomatic Apical Periodontitis
  • Asymptomatic Apical Periodontitis
  • Acute apical abscess
  • Chronic apical abscess
  • Condening Osteitis
24
Q

In the Reversible Pulpitis, the pulp is capble of ______

A

Healing

25
Q

Describe Asymptomatic Irreversible Pulpitis…

A
  • Pt asymptomatic
  • Episodic pain may occur
  • Caries pulp exposure of mature tooth
  • Internal Resorption
  • Hyperplastic Pulpitis (pulp polyp)
26
Q

Describe Symptomatic Irreversible Pulpitis…

A
  • Spontaneous Pain
  • Pain that wakes pt up at night
  • Throbbing pain
  • Lingering pain > 15 seconds?
  • “Lasting” pain to hot or cold
  • Deep, dull “ache”
  • Radiating Pain
  • CC may be reproduced
  • May refer apin to other sites
  • Pain may decrease as pulp becomes necrotic
27
Q

What are some examples of Previously Initiated Therapy?

A
  • Unfinished root canal treatment
  • Pulpotomy/Partial Pulpectomy
28
Q

What renders a pulpal diagnosis of previously treated?

A
  • Root canal treatment assumed completed by provider
29
Q

What are characteristics of a Normal Apex?

A
  • Non-sensitive to percussion
  • Non-sensitive to palpation
  • Intact lamina dura
  • Uniform PDL space
30
Q

What are some characteristics of Symptomatic Apical Periodontitis?

A
  • Pain - Yes
  • Swelling - None
  • Sinus Tract - None
  • Palpation - Maybe tender
  • Biting - normally painful
  • Radiograph - with or without apical radiolucency
31
Q

What apical diagnosis could this picture be?

A

Symptomatic Apical Periodontitis

32
Q

Describe Asymtomatic Apical Periodontitis…

A
  • Pain - None
  • Swelling - None
  • Sinus Tract - None
  • Palpation - WNL
  • Biting - WNL
  • Percussion - WNL
  • Radiograph - Apical Radiolucency
33
Q

Would be the likely apical diagnosis here?

A

Asymtomatic Apical Periodontitis

34
Q

Describe Acute Apical Abscess…

A
  • Pain - Normally Present
  • Swelling - Present
  • Sinus Tract - None/maybe
  • Palpation - Painful
  • Biting - Painful
  • Percussion - Painful
  • Radiograph - WNL or apical pathology
35
Q

What is the likely Apical Diagnosis?

A

Acute Apical Abscess

36
Q

Describe Chronic Apical Abscess…

A
  • Pain - None, maybe episodic
  • Swelling - None
  • Sinus Tract - Present or recent
  • Palpation - Maybe tender
  • Biting - WNL
  • Percussion - Mabye tender
  • Radiograph - Apical pathology normally present
37
Q

What is the likely Apiacal Diagnosis here?

A

Condensing Osteitis

38
Q

Describe Condening Osteitis

A
  • A localized overproduction of apical bone
  • Apices of mandibular posterior teeth
  • Chronic pulpitis or pulp necrosis
  • A low-grade inflammationof the periradicular tissues
39
Q

What drives endodontic treatment?

A

Diagnosis

Endo - ABGD - Oral Board Review (14 decks)

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