endo classifications

Question 1

describe a normal pulp

Answer 1

symptom free and normally responsive to pulp testing

Question 2

describe reversible pulpitis

Answer 2

indicates inflammation, should resolve and pulp return to normal with appropriate management
discomfort to stimulus (sweet and cold) which goes away within a couple seconds once stimulus removed
typical aetiologies include exposed dentine, caries and deep restorations
no specific radiographic changes in periapical region

Question 3

describe symptomatic irreversible pulpitis
- what is it
- symptoms
- aetiologies
- radiographic changes

Answer 3

vital inflamed pulp which is incapable of healing, RCT/ XLA indicated
sharp pain to thermal stimulus, spontaneous pain , referred pain, pain accentuated by postural changes
OTC analgesics usually ineffective
common aetiologies: deep caries, extensive restorations, fractures exposing pulpal tissues
no periapical radiographic changes

Question 4

describe asymptomatic irreversible pulpitis

Answer 4

vital inflamed pulp incapable of healing
no clinical symptoms
usually normal response to thermal testing

Question 5

pulp necrosis

Answer 5

death of dental pulp
RCT indicated
non responsive to vitality testing and asymptomatic

Question 6

previously treated tooth

Answer 6

tooth has been previously endodontically treated
no response to thermal or EPT

Question 7

previously initiated therapy

Answer 7

tooth has been previously partially treated by endodontic therapy e.g pulpotomy, extirpation
depending on stage , may or may not respond to vitality tests

Question 8

describe normal apical tissues

Answer 8

not sensitive to palpation or percussion
radiographically, lamina dura intact and PDL space is uniform

Question 9

describe symptomatic apical periodontitis

Answer 9

inflammation of apical periodontium producing clinical symptoms
commonly pain on biting and pain to percussion/ palpation
May or may not be accompanied by radiographic changes
severe pain to palpation/percussion is indicative of degenerating pulp and RCT indicated

Question 10

asymptomatic apical periodontitis

Answer 10

inflammation and destruction of the apical periodontium that is of pulpal origin
appears as apical radiolucency and has no symptoms

Question 11

describe a chronic apical abscess

Answer 11

inflammatory reaction to pulpal infection and necrosis
characterised by gradual onset, little to no discomfort and pus discharge through an associated sinus tract
radiographically signs of osseous destruction (radiolucency)

Question 12

describe an acute apical abscess

Answer 12

inflammatory reaction to pulpal infection and necrosis characterised by rapid onset, spontaneous pain , extreme tenderness of tooth to pressure, pus formation and swelling of associated tissues.
May be no signs of radiographic destruction

Question 13

describe condensing (sclerosing) osteitis

Answer 13

diffuse radiopaque lesion representing localised bony reaction to low grade stimulus
usually seen at apex of the tooth