endo emergencies

Question 1

one tooth theory

Answer 1

1) there is only one tooth that can be causing unbearable pain at one time
2) dental or nonodontogenic reasons?
- perio, endo, occlusion

Question 2

diagnosis

Answer 2

1) never look at PAs before BWX
2) pulpal and PA status before treatment
3) only 73% can localize the tooth if odontogenic (if only in the pulp)
- 89% patient can localize periradicular pain

Question 3

clinical diagnosis

Answer 3

1) sensitivity, percussion, palpation, mobility, EPT, sinus tract, transillumination, tooth color, periodontal probing

Question 4

radiographic diagnosis

Answer 4

1) insert gutta percha >= #40
2) will go directly to the tooth

Question 5

diagnosis of painful teeth

Answer 5

1) hypersensitivity
- vital
2) reversible pulpitis (vital)
3) symptomatic irreversible pulpitis
- vital pulp
4) acute apical abscess (nonvital)
5) necrotic pulp with symptomatic apical periodontitis (nonvital)

Question 6

hypersensistivity

Answer 6

1) fast onset, short, piercing, localized
2) mainly sensitive to cold
3) treatment of cervical area with precipitating agents (exposed dentinal tubules)
4) or blockage of tubules
5) replacement of leaking restorations

Question 7

reversible pulpitis

Answer 7

1)acute stabbing, localized pain
2) exacerbated by cold
3) goes away within 20 secs
4) leaking restorations, new restorations, cracks, exposed dentin
5) caries lesion or trauma, NO periapical radiolucency

Question 8

irreversible pulpitits

Answer 8

1) sharp pain that can be referred
2) more than 30 seconds
3)heat and cold triggers it
4)no, minimal percussion and mobility

Question 9

emergencies

Answer 9

1) perception of pain
2) reaction to pain

Question 10

irreversible pulpitis treatment

Answer 10

1) pulptomy <22 years
- eugenol, corticosteroid prep or sterile cotton pellet and ZOE filling
2) pulpectomy
- CaOH2 and temporary filling
3) therapy
- coronal flaring, instrumentation, NaOCl irrigation, radiographic length, pep to apical size >= #25

Question 11

necrosis

Answer 11

1) periapical lesion
2) spontaneous pain, dull throbbing
3) partial vitality can be possible
4) possibly referred pain or radiating pain
5) tooth may feel elongated
6) can cause
- symptomatic apical periodontitis
- symptomatic apical abscess
7) sensitivity testing is negative
- EPT, CO2

Question 12

acute apical abcess

Answer 12

1) drain abscess through debridement
2) incise and drain
3) never leave tooth open to oral cavity
4) antibiotics have no additional benefit
- only when there are systemic complication