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BDS3.5 Endodontics > Endodontic Assessment and Diagnosis > Flashcards

Endodontic Assessment and Diagnosis Flashcards

1
Q

What is required for making a diagnosis?

A

Verbal history, Clinical examination, Special investigations

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2
Q

What can pain cause for the patient?

A

Reduced sleep, Physical and/or emotional distress, Confusion, Reduced ability to cooperate, Abrupt communication

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3
Q

What can we use to take a pain history?

A

SOCRATES

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4
Q

How to take a trauma history?

A

Time, date, location of incident, Loss of consciousness, dizziness after?, MH - focus on tetanus status, seizures, bleeding disorders, allergies, any other injuries, What happened?, Emergency treatment - type, time, location, Current symptoms, Current concerns

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5
Q

What to include in an extra oral examination?

A

Swellings - record site and size, Assess body temp, Note any difficulties in swallowing, Note any malaise, Manage or arrange urgent referral

Extra oral swelling is rare

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6
Q

What is a serious but rare complication of endodontic pathology?

A

Extraoral swelling

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7
Q

What is Ludwigs angina?

A

Bilateral swelling of the submental, sublingual and submandibular spaces that can compromise the airway

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8
Q

What 4 things should you check on the intraoral exam?

A

Soft tissues, Periodontal, Hard tissues, Occlusal

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9
Q

What is fremitus?

A

Vibration / movement within the tooth when teeth come into contact with each other

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10
Q

What special tests can be used for the detection and diagnosis of endodontic pathology?

A

Pulp tests, PDL tests, radiographs, periodontal

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11
Q

What are pulp tests used for?

A

Thermal sensitivity - hot/cold, Electric

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12
Q

What PDL tests can we do?

A

Vertical percussion, lateral percussion

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13
Q

What radiographs can we take?

A

Intraoral PA, CBCT

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14
Q

What perio tests can we do?

A

6PPC, recession, bop, suppuration, mobility

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15
Q

What other tests can we do?

A

Transillumination, Tooth sleuth

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16
Q

Where should pulp test stimulus be applied?

A

At the point of the nerve plexus without contacting gingivae or other intraoral soft tissues

17
Q

What are the different things we can use for cold tests?

A

Ethyl chloride - -5°C, Tetrafluroethane - -26°C, Others inc those in Endofrost - -50°C

18
Q

Which patients are more likely to have false positives in cold tests?

A

Anxious patients, young patients, partially vital teeth, if in contact with gingival tissues or metallic restorations

19
Q

When are you more likely to get false negatives for a cold test?

A

Heavily restored teeth, older patients, traumatised teeth, partially vital teeth if undergoing orthodontics, alcohol, sedative drugs

20
Q

Why are you more likely to get a false negatives in older patients with cold tests?

A

Due to secondary and tertiary dentine

21
Q

How to do a percussion test?

A

Tap occlusal aspect of tooth with back of mirror

22
Q

Reasons for a positive response for percussion tests

A

Occlusal trauma, Excessive orthodontic forces, Acute/advanced periodontal disease, Apical periodontitis, Abscess of endodontic origin

23
Q

What can percussion tests tell us?

A

Can indicate if there is something going on in the periapical tissues

24
Q

How should we record clinical findings of special investigations?

A

In a table / matrix of the clinical findings, Include adjacent/contralateral teeth for comparison

25
Q

What are some different methods to detect cracks?

A

Tooth sleuth, transillumination, magnification, radiographs for larger cracks

26
Q

What is Normal pulp?

A

A clinical diagnostic category in which the pulp is symptom-free and normally responsive to pulp testing

27
Q

What is Reversible pulpitis?

A

A clinical diagnosis based on subjective and objective findings indicating that the inflammation should resolve and the pulp return to normal.

28
Q

What is Symptomatic irreversible pulpitis?

A

A clinical diagnosis based on subjective and objective findings indicating that the vital inflamed pulp is incapable of healing. Additional descriptors: lingering thermal pain, spontaneous pain, referred pain.

29
Q

What is Asymptomatic irreversible pulpitis?

A

A clinical diagnosis based on subjective and objective findings indicating that the vital inflamed pulp is incapable of healing. Additional descriptors: no clinical symptoms but inflammation produced by caries, caries excavation, trauma.

30
Q

What is Pulp necrosis?

A

A clinical diagnostic category indicating death of the dental pulp. The pulp is usually nonresponsive to pulp testing.

31
Q

What is Previously treated?

A

A clinical diagnostic category indicating that the tooth has been endodontically treated and the canals are obturated with various filling materials other than intracanal medicaments.

32
Q

What is Previously initiated therapy?

A

A clinical diagnostic category indicating that the tooth has been previously treated by partial endodontic therapy (e.g. pulpotomy, pulpectomy).

33
Q

What is Normal apical tissues?

A

Teeth with normal periradicular tissues that are not sensitive to percussion or palpation testing. The lamina dura surrounding the root is intact, and the periodontal ligament space is uniform.

34
Q

What is Symptomatic apical periodontitis?

A

Inflammation, usually of the apical periodontium, producing clinical symptoms including a painful response to biting and/or percussion or palpation. It might or might not be associated with an apical radiolucent area.

35
Q

What is Asymptomatic apical periodontitis?

A

Inflammation and destruction of apical periodontium that is of pulpal origin, appears as an apical radiolucent area, and does not produce clinical symptoms

36
Q

What is Acute apical abscess?

A

An inflammatory reaction to pulpal infection and necrosis characterized by rapid onset, spontaneous pain, tenderness of the tooth to pressure, pus formation and swelling of associated tissues

37
Q

What is Chronic apical abscess?

A

An inflammatory reaction to pulpal infection and necrosis characterized by gradual onset, little or no discomfort, and the intermittent discharge of pus through an associated sinus tract.

38
Q

What is Condensing osteitis?

A

Diffuse radiopaque lesion representing a localized bony reaction to a low-grade inflammatory stimulus, usually seen at apex of tooth.

39
Q

Which diagnoses do we need for every case of endodontic pathology?

A

Pulpal diagnosis and periapical diagnosis

BDS3.5 Endodontics (8 decks)

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