endodontic diagnoses

Question 1

a patient presents with short, sharp pain that is worse with cold, sweet and sometimes hot stimuli that is never spontaneous, a radiograph shows no significant periodontal involvement - what is your diagnosis?

Answer 1

reversible pulpitis

Question 2

a patient complains of spontaneous pain that is worse with cold and hot stimuli and lingers when the stimulus is removed, no periapical changes are detected radiographically - what is your diagnosis?

Answer 2

irreversible pulpitis

Question 3

what factors would suggest to you that a patient’s irreversible pulpitis is advanced?

Answer 3

pain is temporarily relieved by cold and tooth is TTP

Question 4

what endodontic condition will show no obvious canal on a radiograph?

Answer 4

pulp canal calcification

Question 5

what are the causes of pulp canal calcification?

Answer 5

trauma and irritants

Question 6

when would RCT be required for pulp canal calcification?

Answer 6

if evidence of pulpal necrosis

Question 7

if a patient has a necrotic pulp and perforation of the root, what is your diagnosis and will RCT be possible?

Answer 7

internal resorption and no RCT should not be attempted with perforation

Question 8

what are the symptoms of pulpal necrosis?

Answer 8

no symptoms less inflammation has spread to periapical tissues and no response to sensibility tests (non-vital pulp)

Question 9

what fibre types are involved in dentine hypersensitivity?

Answer 9

A-delta (and c???)

Question 10

a patient presents with sensitive teeth and acid erosion, what is your diagnosis?

Answer 10

dentine hypersensitivity due to tooth surface loss

Question 11

define cracked tooth syndrome

Answer 11

incomplete fracture of a posterior tooth with a vital pulp

Question 12

what treatment would you provide for dentine hypersensitivity?

Answer 12

duraphat varnish to form calcium fluoride globules in the tubules

Question 13

a patient presents with sharp, shooting pain that occurs when biting hard objects and worsens on release and is sensitive to thermal changes - the patient is unable to localise the pain - what is your diagnosis?

Answer 13

cracked tooth syndrome

Question 14

what can cause cracked tooth syndrome?

Answer 14

occlusal forces or trauma and abnormal chewing habits

Question 15

what causes hyper plastic pulpitis?

Answer 15

large carious lesions in young people

Question 16

a patient’s tooth is TTP and uncomfortable to chew with - radiographically you see a widened lamina dura - what is your diagnosis?

Answer 16

symptomatic periapical periodontitis

Question 17

what cause related to RCT can result in periapical periodontitis?

Answer 17

over-instrumentation and RCF beyond apex

Question 18

a patient arrives in surgery with a swollen, suppurated, painful tooth that has become mobile - what is your diagnosis?

Answer 18

acute periapical abscess

Question 19

how would you treat acute periapical abscess?

Answer 19

drain through the root canal and RCT or extract

Question 20

a patient has had a little discomfort from his tooth over the last few months and sometimes pus comes from the related sinus - what investigation would you acquire in this case and what would you expect to see?

Answer 20

a radiograph to see a radiolucency on the bone suggesting chronic periapical abscess

Question 21

what is ankylosis?

Answer 21

replacement resorption after trauma, replantation or luxation injuries

Question 22

name 4 types of external resorption

Answer 22

ankylosis/replacement resorption, pressure resorption, systemic resorption, idiopathic resorption

Question 23

what systemic diseases can cause systemic resorption?

Answer 23

hyperparathyroidism, paget’s disease, turner’s syndrome, gaucher’s syndrome