endo classifications/ diagnosis

Question 1

reversible pulpitis

Answer 1

inflammation that should resolve with appropriate management/tx
discomfort experienced to stimuli for short period (seconds)
no significant periapical radiographic changes
pain NOT spontaneous

typical aetiologies = exposed dentine, deep restorations, caries

Question 2

symptomatic irreversible pulpitis

Answer 2

inflamed pulp incapable of healing
OTC analgesics will be uneffective
pain = sharp and lingering , often spontaneous and in response to thermal stimuli. Postural changes may accentuate pain e.g when lying down
usually no TTP as inflammation not yet reached periapical tissues

RCT indicated

aetiologies: deep caries, extensive restorations, fractures exposing pulpal tissues

Question 3

asymptomatic irreversible pulpitis

Answer 3

inflamed pulp incapable of healing
RCT indicated
usually respond normal to thermal testing but may have deep caries or trauma that would expose the pulp if removed

Question 4

pulp necrosis

Answer 4

death of dental pulp
RCT indicated
usually asymptomatic
non responsive to vitality testing - make sure to compare with other teeth
necrosis doesnt cause apical periodontitis unless canal is infected

Question 5

symptomatic apical periodontitis

Answer 5

inflammation of apical periodontium
painful response to biting/ palpation/ percussion - RCT needed
depending on stage of disease may be periapical radioloucency or normal PDL space

Question 6

asymptomatic apical periodontitis

Answer 6

inflammation of apical periodontium
apical radiolucency but no pain on percusion, biting/ palpation

Question 7

chronic apical abscess

Answer 7

inflammatory reaction to pulpal infection/necrosis
characterised by slow onset, little to no discomfort and intermittent discharge of pus through a sinus tract
radiographically a radiolucency showing signs of osseous destruction
use gp point in sinus tract to identify tooth causing

Question 8

acute apical abscess

Answer 8

inflammatory reaction to pulpal infection and necrosis
characterized by rapid onset,
spontaneous pain, extreme tenderness of the tooth to pressure, pus formation and swelling of associated tissues.
may be no radiographic signs of destruction
patient often experiences malaise, fever and lymphadenopathy (swollen)

Question 9

condensing osteitis

Answer 9

diffuse radiopaque lesion representing a localized bony reaction to a low-grade inflammatory
stimulus usually seen at the apex of the tooth