diagnosis in endodontics

Question 1

definition of diagnosis

Answer 1

the identification of the nature of an illness or other problem by examination of the symptoms.

Question 2

type of pain

Answer 2

odontogentic or non odontogenic
(tooth structures or facial pain)

Question 3

dental pain A-delta fibres

Answer 3

sharp pricking sensation
early shooting pain

Question 4

dental pain C fibres

Answer 4

dull, aching or burning
late dull pain

Question 5

endodontic emergency

Answer 5

pain and or swelling caused by various stages of inflammation or infection of the pulpal and /or periapical tissues.

Question 6

questions to ask during endo emergency

Answer 6

Where is the pain ? ( maxilla / mandible , front or back of mouth)
What does it feel like (short sharp / dull ache)
How bad is it?
How long is it there for? ( constant/ few minutes)
Does anything take pain away? (pain killers / cold)
What makes it worse? (heat, chewing)
Does it keep you awake at night?
Does the pain come on randomly / spontaneously?
Have you had this before?
Have you had any dental work recently?
Have you suffered any trauma?

Question 7

what provokes referred pain

Answer 7

intense stimulation of C-fibres leading to intense slow, dull pain

Question 8

referred pain

Answer 8

always radiates to IPSILATERAL side

Anterior teeth -> other teeth or opposite arch

Posterior teeth -> opposite arch or periauricular area, but seldom to anterior teeth

Mandibular posterior teeth refer pain to periauricular area more often than maxillary

Question 9

types of pulp tests

Answer 9

thermal
electrics
laser doppler flowmetry
pulse oximetry

Question 10

sensibility testing

Answer 10

contra-lateral teeth should be tested

assumption made that nerve fibres in pulp correlates to intact blood supply – not appropriate

problems with multi-rooted teeth

Question 11

cold sensibility

Answer 11

Hydrodynamic forces
Cold/Hot tests
Frozen Carbon Dioxide (-78 degrees celcius)
Ice less reliable
Ethyl chloride
Refrigerant spray
Dry and isolate
Close to pulp horn
Fairly reliable

Question 12

electric pulp test

Answer 12

electric current used to stimulate sensory nerves

primarily A-delta fast conducting fibres
unmyelinated C-fibres may or may not respond

Dry teeth and isolate
Probe place on incisal edge or cusp tip )pulp horn proximity)
Conducting medium used
Circuit completed
Current slowly increases until response