Diagnosis Flashcards
What is your diagnostic goal?
- Recognize a problem
- Determine the cause
- Develop a treatment plan
What is a good way to write up your Endodontic Diagnosis write up?
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?
What are some limitations to be aware of in the pulpal diagnosis process?
- Diagnostic testing - imprecise
- Patient processing and feedback - imprecise
- Lack of pulpal proprioception (cannot localize)
- Referred pain
- Misdiagnosis by referring dentist
What are 5 fives you can test the pulp?
- Cold
- Hot
- EPT
- Bur
- Test Cavity
What are 4 ways you can test the Periradiular tissues?
- Percussion
- Biting
- Palpation
- Perio Probing
What is the Endo ice test actually testing?
Evaluates nerve resonse - not pulpal blood flow
What kind of cotton pellet do you want to use when conducting a cold test?
Fluffy cotton pellet
What surface do you place the endo ice on?
Facial surface
What is it helpful to do when endo ice testing?
Establish controls
What types of things can yield a False Positive for a thermal test?
- Anxiety
- Gingival Response
- Adjacent teeth
- Saliva
- Periradicular Response
When can yield a Fale Negative for a Pulpal Response when doing thermal tests?
- Calcified canals
- Indequate stimulus
- Restorations
- Immature Tooth
- Trauma
If you cannot dupliate CC with Endo ice (cracks, open margins) what is an option?
- Simulate “real-world” activity
- Single tooth RD isolation
- Establish control responses first
For a heat thermal test, what is an option?
- Heat is primary factor of CC
- Cold test inconclusive
- single tooth RD isolation
- Establish control responses first
Why is the Electric Pulp Test a good plan B and not plan 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
What are some things that an Electric Pulp Test requires?
- Requires patient education & cooperation
- Requires dry tooth structure
- Requires condcuting medium
- Ineffective through some dental restorations
What can give some false positives for an EPT test?
- Anxiety
- Restorations
- Gingival Conduction
What can give some false negatives for the Electric Pulp Test?
- Inadequate contact
- Immature tooth
- Recent trauma
What does a percussion test help detect?
Periradicular inflmmation (not pulpal status)
What does Apical Palpation help detect?
Refelcts cortical plate penetration
What does a bite test help detect?
Suspect cracked tooth
What are some other tests you can do for diagnosis? one is last resort…
- Transillumination
- Selective Anesthesia
- Test Cavity - Last Resort
What are the 7 Pulpal Diagnoses?
- Normal Pulp
- Reversible Pulpitis
- Symptomatic Irreversible Pulpitis
- Asymtomatic Irrerversible Pulpitis
- Pulpal Necrosis
- Previously Initiated Therapy
- Previousy Treated
What are the 6 Apical Diagnoses?
- Normal Apical Tissues
- Symptomatic Apical Periodontitis
- Asymptomatic Apical Periodontitis
- Acute apical abscess
- Chronic apical abscess
- Condening Osteitis
In the Reversible Pulpitis, the pulp is capble of ______
Healing
