Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS3 Endo > Endodontics- Diagnosis > Flashcards

Endodontics- Diagnosis Flashcards

1
Q

What are the 5 steps in the process of diagnosis

A
  1. why is the patient seeking advice
  2. history and symptoms prompting visit
  3. objective clinical tests
  4. correlation of objective findings and subjective details to create differential diagnosis
  5. formulation of definitive diagnosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What are the main fibres that cause dental pain?

A

A -delta fibres
C fibres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

With regards to dental pain what kind of pain is felt from A-delta fibres?

A

sharp pricking sensation

early shooting pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

With regards to dental pain what kind of pain is felt from C fibres?

A

Dull, aching or burning

late dull pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the definition of an endodontic emergency ?

A

Pain and or swelling caused by various stages of inflammation or infection of the pulpal and /or periapical tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can it be difficult to discriminate location of pulpal pain?

A

referred pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are some general rules when dealing with referred pain in teeth?

A

-always radiates to ipsilateral side (same side)
- anterior teeth seldom refer pain to other teeth or opposite arch
- posterior teeth often refer to opposite arch or periauricular area, but rarely to anterior teeth
- mandible posterior teeth refer pain to periauricular area (ear) more often than maxillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What things are included in an endodontic examination?

A
  • extraoral exam
  • intraoral exam
  • soft tissue exam
  • intraoral swelling
  • sinus tracts
  • palpation
  • percussion
  • mobility
  • periodontal exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can be seen here?

A

spreading cellulitis
eye closed due to swelling of a maxillary tooth
(would send to max fax in ambulance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give 4 examples of sensibility/vitality testing- pulp tests

A
  • thermal
  • electric
  • laser doppler flowmetry
  • pulse oximetry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What should be used for heat tests?

A

hot gutta percha- use vaseline

hot water and dental dam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why should you not place too much heat on a tooth?

A

it can cause irreversible pulpitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is an electric pulp test and what fibres are primarily affected?

A

electric current used to stimulate sensory nerves

primarily A-delta fast conducting fibres

(unmyelinated C-fibres may not respond)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the stages of carrying out an EPT?

A

-dry teeth and isolate
-probe place on incisal edge or cusp (close to pulp horn proximity)
- conducting medium used
- circuit completed
- current slowly increases until response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Does EPT have any correlation between threshold and pulp condition?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Does EPT give any indication of reversibility of inflammation?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

True/False: EPT of teeth with open apices is reliable

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name some examples of other special tests…

A

bite test (frac finder or tooth sleuth)

test cavity

staining and trans-illumination

selective anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How many pre-op radiographs should be required?

A

two from different angulations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When assessing a radiograph what order should you review it?

A

crown

pulp

apex/bone/soft tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name 7 pulpal diagnoses?

A

Normal Pulp
Reversible Pulpitis
Symptomatic Irreversible Pulpitis
Asymptomatic Irreversible Pulpitis
Pulp Necrosis
Previously Treated
Previously Initiated Therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the definition of a normal pulp?

A

Pulp is symptom-free and normally responsive to pulp testing

Pulp may not be histologically normal

“Clinically” normal pulp results in a mild or transient response to thermal cold testing, lasting no more than one to two seconds after the stimulus is removed

Compare the tooth in question with adjacent and contralateral teeth. Test other teeth first so that the patient is familiar with the experience of a normal response to cold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How should reversible pulpitis be treated?

A

appropriate management of the aetiology

23
Q

Reversible pulpitis, when a stimulus is applied does discomfort only apply for a short period of time or long

A

discomfort only for a few seconds

24
Q

What three things can cause reversible pulpitis

A

exposed dentine

caries

deep restorations

25
Q

Is the pain experiences with reversible pulpitis spontaneous?

A

no

26
Q

What are the characteristics of symptomatic irreversible pulpitis ?

A

Characteristics may include sharp pain upon thermal stimulus, lingering pain (often 30 seconds or longer after stimulus removal), spontaneity (unprovoked pain) and referred pain

27
Q

What is meant by symptomatic irreversible pulpitis and how is it treated?

A

Vital inflamed pulp is incapable of healing and that root canal treatment is indicated

28
Q

How might pain be accentuated with symptomatic irreversible pulpitis?

A

postural changes such as lying down or bending over

29
Q

Are OTC analgesics effective in treating the pain from symptomatic irreversible pulpitis?

A

no

30
Q

What are some of the common aetiologies for symptomatic irreversible pulpitis?

A

deep caries

extensive restorations

fractures exposing the pulpal tissues

31
Q

What are the primary tools for assessing pulpal status for irreversible pulpitis?

A

dental history

thermal testing

32
Q

What is the definition of asymptomatic irreversible pulpitis?

A

vital inflamed pulp is incapable of healing and that rool canal treatment is indicated

33
Q

Does asymptomatic irreversible pulpitis respond normally to thermal testing?

A

yes

34
Q

Definition of pulp necrosis

A

diagnostic category indicating death of the dental pulp, necessitating root canal treatment

35
Q

Would a tooth with pulp necrosis respond normally to pulp testing?

A

no- non responsive

36
Q

How might you diagnoses pulp necrosis?

A

pain to percussion

radiographic evidence of osseous breakdown

(UNLESS canal if infected)

37
Q

What are some reasons why teeth might be non-responsive to pulp testing?

A

calcification

recent history of trauma

simply the tooth is just not responding

38
Q

Definition of “previously treated” and how would this tooth typically respond to thermal or electric pulp testing

A

clinical diagnostic category indicating that the tooth has been endodontically treated

the tooth typically does NOT respond to thermal or electric pulp testing

39
Q

What is meant by “previously initiated”

A

clinical diagnostic category indicating that the tooth has been previously treated by partial endodontic therapy such as pulpotomy and pulpectomy

40
Q

if a tooth has been previously initiated how will it respond to pulp testing?

A

it may or may not respond to pulp testing

41
Q

Name 6 apical diagnoses

A

Normal Apical Tissues
Symptomatic Apical Periodontitis
Asymptomatic Apical Periodontitis
Chronic Apical Abscess
Acute Apical Abscess
Condensing Osteitis

42
Q

How would you define a tooth that has normal apical tissues?

A
  • not sensitive to percussion or palpation testing and radiographically, the lamina dura
  • surrounding the root is intact and the periodontal ligament space is uniform
43
Q

When carrying out percussion testing etc, which teeth should you begin with?

A
  • comparative testing for percussion and palpation should always begin with normal teeth as a base line for the patient
44
Q

How would you define symptomatic apical periodontitis

A

represents inflammation, usually of the apical periodontium

45
Q

How would a tooth with symptomatic apical periodontitis respond to percussion/palpation?

A

painful response

46
Q

How might symptomatic apical periodontitis present on a radiograph?

A

change in width of the periodontal ligament or there may be a periapical radiolucency

47
Q

How would a tooth with aymptomatic apical periodontitis respond to percussion/palpation?

A

no pain

48
Q

How would you define a chronic apical abscess? and how is it characterised

A

inflammatory reaction to pulpal infection and necrosis

gradual onset, little or no discomfort and an intermittent discharge or pus through an associated sinus tract

49
Q

What is the definition of an acute apical abscess?

A

inflammatory reaction to pulpal infection and necrosis

50
Q

How is an acute apical abscess characterised?

A

RAPID onset, spontaneous pain, extreme tenderness of the tooth to pressure, pus formation and swelling of associated tissues

51
Q

What are some other things a patient may experience if they have an acute apical abscess?

A

malaise

fever

lymphadenopathy

52
Q

What is this apical diagnosis?

A

condensing osteitis

53
Q

What is the definition of condensing osteisis?

A

diffuse radiopaque lesion representing a localised bony reaction to a low-grade inflammatory stimulus usually seen at the apex of the tooth

54
Q

name 5 treatment options for an apical pathology..

A

root canal treatment

re root canal treatment

extract the tooth

monitor/don’t intervene

surgical intervention

55
Q
A

BDS3 Endo (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions