Endodontic Examination and Diagnosis 2 Flashcards
What are the types of responses to the percussion test?
Normal (same as the other teeth no tenderness)
Tender (painful response on percussion)
Very Tender (very painful response on percussion)
Different sensation (patient says it feels “different” on percussion compated to adjacent teeth; not painful or tender)
Ankylosis (No pain; dull sound; sounds different to adjacent teeth with decreased mobility, radiograph will show)
What causes ankylosis?
External replacement resorption or other kinds of resorption
What are the types of findings on a palpation test?
Normal (same as other teeth, no tenderness)
Tender (Painful when palpating mucosa overlying the tooth root)
Very tender
Hard swelling or expansion (Tissues overlying the root look swoller on the cortical plate has expanded)
Soft swelling (tissues overlying the root are swollen and feel soft on palpation)
How is the periodontic tissue probed correctly?
Probe into the gingival sulcus regardless of the shape of the tooth overlying.
Probe all the way around the tooth.
Record the depth all around the tooth onto the perio chart
How would cracks and fractures show during a periodontic examination?
A crack or fracture could show as a sudden deep drop into the periodontic tissue
How are draining sinuses detected on radiograph?
Gutta percha point is placed in a draining sinus (traces the origin of the draining sinus) and this is then seen on radiograph
Which radiographs are best for endodontic diagnosis?
Periapical radiographs are most important for endodontic diagnosis
Bitewings are useful but periapical radiographs are more idea
Panoramic radiographs are not very useful for endodontic diagnosis
How does optic transillumination work?
Fiber optic transillumination uses a good light source which shows changes within tooth structure such as a crack.
The lighting is done all around the tooth at different angles to uncover everything.
What can fiber-optic transillumination be used for?
Tooth coloured restorations can be hard to see, this can be made easier with the use of transillumination
Cracks and fractures can be seen easily with transillumination
How can magnification assist in endodontic diagnosis?
Only helps if you know what you’re looking for
How can magnification be done?
Loupes attached to glasses (can help identify things)
What is a biting test?
Test for pain when biting / chewing
What can a biting test tell us?
Cusp flexure (cracks)
Apical periodontitis (infected canal)
Lateral perodontitis (crack and periodontal disease)
How can individual cracks be detected?
Cannot see cracks until they appear on buccal surface so this can be tested for by making the bit on individual cusps. Most commonly a fracfinder or tooth slooth (tooth slooth doesn’t have a serrated border)
How is a crack positive test observed?
Pain when they bite
Pain when they release the bite
Pain when wriggling the fracfinder/tooth slooth
