endodontic diagnosis

Question 1

dental history

Answer 1

1) questions, listening, pieces are put together
2) no all diagnoses are cut and dry
3) referred pain, false positives, sensitivity

Question 2

normal pulp

Answer 2

1) little to no sensitivity to temperature
2) cold response diappears when stimulus is removed

Question 3

reversible pulpitis

Answer 3

1) history of recent restoration
- or shallow caries present
2) sensitivity to air, cold, or food
3) symptoms resolve quickly after stimulus is removed = not lingering
4) radiographically normal apex

Question 4

irreversible pulpitis

Answer 4

1) lingering pain response to pulp
2) history of spontaneous pain
3) the pulp cannot survive now
4) can also radiate to TMJ or ear
5) widened PDL
6) can be sensitive to heat in end stage
7) percussion sensitive

Question 5

asymtomatic irreversible pulpitis

Answer 5

1) caries to pulp, but no pain
2) hyperplastic pulpitis: pulp polyp
- epithelial lining on top
3) root canal needs to be done

Question 6

pulp necrosis

Answer 6

1) asymptomatic
2) sinus tract may be present
3) usually radiolucent
4) cause symptoms when acutely infected
- percussion sensitive
- may be swollen
- may have mobility

Question 7

previously treated

Answer 7

1) has had endodontic treatment

Question 8

previously initiated

Answer 8

1) RCT started previously

Question 9

normal apical tissues

Answer 9

1) intact PDL
2) not sensitive to percussion or palpation

Question 10

apical periodontitis

Answer 10

1) this is what endodontists treat
- asymptomatic vs symptomatic

Question 11

asymptomatic apical periodontitis

Answer 11

1) not sensitive to percussion
2) periapical radiolucency is present

Question 12

symptomatic apical periodontitis

Answer 12

1) sensitive to percussion
2) the PA radiolucency may or may not be there

Question 13

acute apical abcess

Answer 13

1) fast onset
2) swelling
3) pain
4) may have trismusc

Question 14

chronic apical abscess

Answer 14

1) presence of sinus tract
- any time this is there, it is CAA!!!
2) intermittent drainage
3) usually not much pain

Question 15

chief complaint

Answer 15

1) tell me about your tooth
- stimulus
- duration
- frequency of pain
- spontaneity
- throbbing
- history of dental procedures

Question 16

health history

Answer 16

1) TN
2) coronary artery disease
3) diabetes
4) artificial joints
5) rickets
6) history of cancer
7) medications
8) bisphosphonate
9) immunocompromised

Question 17

acute cellulitis

Answer 17

1) pus takes the path of least resistance
2) spread is determined by muscle attachment

Question 18

intraoral

Answer 18

1) look for different color
2) swelling
3) Rinn XCP for x-rays

Question 19

physiologigy of pulpal pain

Answer 19

1) c fibers and a deltas

Question 20

a delta fibers

Answer 20

1 )pulp dentin
2) myelinated
- fast
3) large diameter
4 )dentin sensitivity to cold

Question 21

c fibers

Answer 21

1) heat thermoreceptor for pain
2) steady, dull, gnawing
3) prolonged/spontaneous

Question 22

tentative diagnosis

Answer 22

1) cold / heat test
2) electrical test
3) selective anesthesia test
4) vital test cavity
5) tooth slooth
6 )fiber optic light

Question 23

tooth trauma

Answer 23

1) concussion
2) to avulsion

Question 24

trace sinus tracts

Answer 24

1) find the stoma
- put GP in it to find the source
2) internal tooth resorption can perforate through
3) sinus tract
- epithelium to non epithelium
4) fistula
- epithelium to epithelium

Question 25

caries removal

Answer 25

1) if the pulp is exposed, RCT indicated

Question 26

palpation

Answer 26

1) do it where the tips of the roots are

Question 27

percussion

Answer 27

1) usually the more percussion sensitive tooth is the one that needs RCT

Question 28

bite test

Answer 28

1) squeeze and release 2) fractured cusp - bite on each cusp on each (hurts on release)

Question 29

cold test

Answer 29

1) dry the tooth 2) tell us if it is lingering

Question 30

probing

Answer 30

1) find the bottom of the sulcus - be done with pulp testing 2) isolated deep pockets can mean fracture

Question 31

heat test

Answer 31

1) need to be wet 2) must wait between teeth

Question 32

electric pulp test

Answer 32

1) dry tooth 2) electrolyte and have them complete circuit 3) vital and necrotic

Question 33

transillumination and methylene blue

Answer 33

look for cracks

Question 34

cracked tooth syndrome

Answer 34

1) cannot see fracture on radiogaph 2) if pulp tests normally, 80% does not need RCT

Question 35

anesthetic test

Answer 35

1) no sure which arch 2) do IA block

Question 36

cavity test

Answer 36

1( drill into it until dentin - until they feel it 2) if they do not, then it is necrotic 3) if not, EPT

Question 37

TMD

Answer 37

1) can cause tooth pain 2) surgery and medication

Question 38

if you cannot find the symptoms

Answer 38

1) do not know diagnosis 2) dont do RCT 3) source of pain will localize