endodontic diagnoses Flashcards
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?
reversible pulpitis
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?
irreversible pulpitis
what factors would suggest to you that a patient’s irreversible pulpitis is advanced?
pain is temporarily relieved by cold and tooth is TTP
what endodontic condition will show no obvious canal on a radiograph?
pulp canal calcification
what are the causes of pulp canal calcification?
trauma and irritants
when would RCT be required for pulp canal calcification?
if evidence of pulpal necrosis
if a patient has a necrotic pulp and perforation of the root, what is your diagnosis and will RCT be possible?
internal resorption and no RCT should not be attempted with perforation
what are the symptoms of pulpal necrosis?
no symptoms less inflammation has spread to periapical tissues and no response to sensibility tests (non-vital pulp)
what fibre types are involved in dentine hypersensitivity?
A-delta (and c???)
a patient presents with sensitive teeth and acid erosion, what is your diagnosis?
dentine hypersensitivity due to tooth surface loss
define cracked tooth syndrome
incomplete fracture of a posterior tooth with a vital pulp
what treatment would you provide for dentine hypersensitivity?
duraphat varnish to form calcium fluoride globules in the tubules
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?
cracked tooth syndrome
what can cause cracked tooth syndrome?
occlusal forces or trauma and abnormal chewing habits
what causes hyper plastic pulpitis?
large carious lesions in young people
a patient’s tooth is TTP and uncomfortable to chew with - radiographically you see a widened lamina dura - what is your diagnosis?
symptomatic periapical periodontitis
what cause related to RCT can result in periapical periodontitis?
over-instrumentation and RCF beyond apex
a patient arrives in surgery with a swollen, suppurated, painful tooth that has become mobile - what is your diagnosis?
acute periapical abscess
how would you treat acute periapical abscess?
drain through the root canal and RCT or extract
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?
a radiograph to see a radiolucency on the bone suggesting chronic periapical abscess
what is ankylosis?
replacement resorption after trauma, replantation or luxation injuries
name 4 types of external resorption
ankylosis/replacement resorption, pressure resorption, systemic resorption, idiopathic resorption
what systemic diseases can cause systemic resorption?
hyperparathyroidism, paget’s disease, turner’s syndrome, gaucher’s syndrome
