Diagnosis In Endodontics Flashcards

Question

*remember we need two pre-op radiographs from different angulations for endo with a proper dental/medical history and clinical exam before making a decision on diagnosis.

Answer 1

By placing GP into the sinus and taking a radiograph.

Answer 2

``` What type of radiograph it is What teeth are present What tooth is our focus tooth What grade the radiograph is What the radiograph shows eg. large restoration, deep distally, recession of pulp etc Level of surrounding bone. ```

Answer 3

``` Normal pulp Reversible pulpitis Symptomatic irreversible pulpitis Asymptomatic irreversible pulpitis Pulp necrosis Previously treated Previously initiated therapy. ```

Answer 4

Inflammation should resolve following appropriate management of the aetiology Discomfort is experienced when a stimulus applied but only lasts a few seconds Exposed dentine (dentinal sensitivity), caries or deep restorations No significant radiographic changes in the periapical region of the suspect tooth and the pain experienced is non-spontaneous Follow up required to determine whether this inflammation has resolved Although dentinal sensitivity per se is not an inflammatory process, all of the symptoms of this entity mimic those of reversible pulpitis.

Answer 5

Vital inflammed pulp is incapable of healing and that RCT is indicated Characteristics- sharp pain upon thermal stimulus, lingering pain (often 30 seconds or longer after stimulus removal) and referred pain Pain may be made worse by postural changes OTC painkillers usually ineffective May be caused by deep caries, extensive restorations, or fractures exposing fractured tissues May be difficult to diagnose because the inflammation has not yet reached the periapical tissues- no pain to percussion -dental history and thermal testing are the primary tools for assessing pulpal status.

Answer 6

Vital inflammed pulp is incapable of healing and that RCT is indicated No clinical symptoms and usually respond normal to thermal testing but may have had trauma or deep caries that would result in exposure following removal.

Answer 7

Diagnostic category indicating the death of the pulp, needs RCT Non-responsive to pulp testing and is asymptomatic Does not by itself cause apical periodontitis (pain to percussion or radiographic evidence of ossseous breakdown)- unless the canal is infected.

Answer 8

Clinical diagnostic category indicating that the tooth has been previously endodontically treated Canals are obturated with various other filling materials other than intra canal medicaments THE TOOTH TYPICALLY DOES NOT RESPOND TO THERMAL OR ELECTRIC PULP TESTING.

Answer 9

Clinical diagnostic category indicating that the tooth has previously been treated by partial endodontic therapy such as pulpotomy or pulpectomy DEPENDING ON THE LEVEL OF THERAPY THE TOOTH MAY OR MAY NOT RESPOND TO PULP TESTING MODALITIES.

Answer 10

- normal apical tissues - symptomatic apical peridontitis - asymptomatic apical periodontitis - chronic apical absess - acute apical absess - condensing osteitis.

Answer 11

Not sensitive to percussion or palpation testing and radiographically- the lamina dura Surrounding the root is intact and the PDL space is uniform Comparative testing for percussion and palpation should always begin with normal teeth as a baseline for the patient.

Answer 12

Represents inflammation usually of the periapical periodontium Painful response to biting and or percussion/palpation May or may not be accompanied by radiographic changes (depending upon the stage of the disease, there may be normal width of the PDL or there may be a periapical radiolucency) Severe pain to percussion/palpation is highly indicative of a degenerating pulp and root canal treatment is needed.

Answer 13

Inflammation and destruction of the apical periodontium that is of pulpal origin Appears as an apical radiolucency and does not present clinical symptoms (no pain to percussion or palpation).

Answer 14

Inflammatory reaction to pulpal infection and necrosis Characterised by gradual onset, little or no discomfort and an intermittent discharge of pus through an associated sinus tract Radiographically signs of osseous destruction such as a radiolucency Sinus tract tracing possible.

Answer 15

Inflammatory response to pulpal infection and necrosis Characterised by rapid onset, spontaneous pain, extreme tenderness of the tooth and pressure, pus formation and swelling of associated tissues May be no radiographic signs of destruction and the patient often appears malaise, fever and lymphadenopathy.

Answer 16

Diffuse radiopaque lesion representing a localised bony reaction to a low grade inflammatory stimulus usually seen at the apex of a tooth.

Answer 17

-Diagnosis tooth 46- secondary caries, irreversible pulpitis, apical periodontitis (if they had swelling would also be an acute apical absess) -Multiple diagnosis for one tooth ``` Treatment options MONITOR (risks and prognosis) RCT (risks and consent) EXTRACT (risks and prosthetic options) SURGERY (not first line). ```