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BDS 3: Oral Surgery > L3 Pain Diagnosis and Indications for Extractions > Flashcards

L3 Pain Diagnosis and Indications for Extractions Flashcards

1
Q

What are the features of reversible pulpitis through history taking?

A
  • Provoked pain with stimulus (cold or sweet)
  • Short lived
  • Sharp pain
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2
Q

Clinical findings of reverisble pulpitis.

A
  • Caries, tooth usually restorable
  • Vital
  • Hypersensitive to ethyl chloride
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3
Q

Radiographic findings associated with reversible pulpitis.

A

Caries in the crown of the tooth, not into the pulp. Normal apical tissues.

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4
Q

What is a differential diagnosis for reversible pulpitis?

A

Dentine hypersensitivity.

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5
Q

How is reversible pulpitis treated?

A

Caries removal and restoration.

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6
Q

What are the features of irreversible pulpitis through history taking?

A
  • Spontaneous intense pain
  • Cold water may help the pain, e.g. patient comes into practice holding cold water against their face
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7
Q

Clinical findings of irreversible pulpitis.

A
  • Deep caries, into or very close to the pulp
  • Sensibility testing may be positive or negative
  • Usually not TTP
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8
Q

Radiographic findings of irreversible pulpitis.

A

Caries close to, or into, the pulp
Normal apical tissues.

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9
Q

How is irreversible pulpitis treated?

A

RCT or extraction.
In E+E full RCT would not be completed, would remove the pulp, irrigate and place a temporary filling.

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10
Q

What are the features of acute apical periodontitis through history taking?

A
  • Sever aching pain
  • Disrupting sleep
  • Analgesia may not help
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11
Q

Clinical findings of acute apical periodontitis.

A
  • Deep caries involving the pulp OR severe periodontal disease (perio-endo lesion)
  • Negative response to sensibility testing, tooth is non-vital
  • TTP
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12
Q

Radiographic features of acute apical periodontitis.

A
  • PDL widening
  • May or may not be an apical area
  • If there is an apical area, it is referred to as an acute exacerbation of a chronic apical periodontitis
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13
Q

What are the treatment options for acute apical periodontitis?

A

RCT or extraction.

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14
Q

What are the features of chronic apical periodontitis through history taking?

A
  • Tooth not painful
  • Incidental finding
  • May be a history of previous pain which has settled
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15
Q

Clinical findings of chronic apical periodontitis.

A
  • Deep caries involving pulp, tooth broken down
    OR
  • Severe periodontal disease (perio-endo lesion)
  • Non-vital
  • Not TTP

May see this in patients with teeth that have been crowned for a long time or previously root treated.

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16
Q

Radiographic findings of chronic apical periodontitis.

A

Apical radiolucency.

17
Q

What are the treatment options for chronic apical periodontitis?

A
  • RCT
  • Extraction

Pt may prefer to have tooth left alone

18
Q

What are the features of an acute apical abscess through history taking?

A
  • Severe pain (not always in pain)
  • Swelling
  • May be generally unwell and pyrexic
19
Q

Clinical findings of acute apical abscess.

A
  • Swelling intra-orally and potential extra-oral swelling due to pus collection
  • May be perio or endo in origin
  • Non-vital tooth
  • TTP
20
Q

Radiographic findings of acute apical abscess.

A

Similair to chronic apical periodontitis.
- PDL widening
- May or may not be an apical area

If there is an apical area it is known as an acute exacerbation of a chronic apical abscess.

21
Q

What is the treatment option for an acute apical abscess?

A
  • Drain abscess
  • Antibiotics prescribed if systemically unwell
22
Q

What are the features of a chronic apical absccess through history taking?

A
  • Not typically painful
  • ‘Pimple on gum’
  • Small swelling which come and goes (drains)
  • Bad taste
23
Q

Clinical findings of a chronic apical abscess.

A
  • Small/draining sinus on gingivae
  • Non-vital tooth
  • Not TTP
  • Can place GP point to see which tooth is affected if struggling to identify, not routine
24
Q

Radiographic findings of chronic apical abscess.

A

Apical radiolucency

25
Q

What are the treatment options for a chronic apical abscess?

A

RCT or extraction

BDS 3: Oral Surgery (3 decks)

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