Pulpal and periapical diagnosis

Question 1

what pulpal diagnosis is suitable for endodontic tx

Answer 1

irreversible pulpitis
pulpal necrosis

Question 2

what periapical diagnosis is suitable for endodontic tx

Answer 2

periapical disease

Question 3

types of endodontic tx

Answer 3

stepwise
indirect pulp capping
direct pulp capping
pulpotomy

Question 4

6 pulpal diagnosis

Answer 4

clinically normal
reversible pulpitis
irreversible pulpitis
pulpal necrosis
previously initiated tx
previously tx

Question 5

reversible pulpitis symptoms

Answer 5

short sharp pain - not spontaneous
reacts to cold, sweet, sometimes hot
no radiographic changes apically

Question 6

causes of RP

Answer 6

caries into dentine
fractures
restorative procedures
trauma

Question 7

RP tx

Answer 7

conservative pulp therapy in conjunction with removal of the cause and pathway of irritation

Question 8

symptoms of symptomatic IP

Answer 8

sharp pain on thermal stimulus with lingers for 30 seconds
spontaneous pain when unprovoked
excruciating pain with may be relieved by cold
referred pain
accentuated by postural changes

Question 9

symptoms of asymptomatic IP

Answer 9

no clinical symptoms
usually respond normally to sensitivity testing
may have had trauma or deep caries

Question 10

treatment for IP

Answer 10

RCT/ pulpotomy
xLA

Question 11

Breakdown of pulpal tissue allowing bacteria to colonise the root canal system

Answer 11

pulpal necrosis

Question 12

pulpal necrosis symptoms

Answer 12

usually none unless inflammation has progressed to periapical tissues
no response to sensibility testing

Question 13

what has been done to canals if ‘previously treated therapy’

Answer 13

located, cleaned and shaped
access cavity dressing

Question 14

5 periapical diagnosis

Answer 14

normal
symptomatic periapical periodontitis
asymptomatic periapical periodontitis
acute periapical abscess
chronic periapical abscess

Question 15

pulpal status of symptomatic periapical periodontitis

Answer 15

irreversibly inflamed or necrotic

Question 16

causes of transient periodontitis

Answer 16

chemicals used in RCT
occlusal trauma
RCT over-instrumentation

Question 17

symptoms of periapical periodontitis

Answer 17

discomfort when biting/ chewing
TTP
palpation may or may not be sensitive

Question 18

acute periapical abscess cause

Answer 18

bacteria have progressed to the periapical tissues and pt immune system cant defend them

Question 19

symptoms of acute periapical abscess

Answer 19

rapid onset
pain - tender to tooth
pus
mobile tooth
systemic involvement
swelling

Question 20

acute periapical abscess radiographic presentation

Answer 20

PDL may be normal
PDL may be slightly widened
may be a distinct radiolucency if acute flare up of chronic lesion

Question 21

what is a phoenix abscess

Answer 21

acute flare up of a chronic lesion

Question 22

acute apical abscess tx

Answer 22

emergency - drainage
RCT or xLA

Question 23

types of drainage for acute apical abscess

Answer 23

through an incision - if swelling is localised and fluctuant
through root canal

Question 24

Asymptomatic periapical periodontitis cause

Answer 24

bacterial products from a necrotic or pulpless tooth ingress the periapical tissues

Question 25

asymptomatic periapical periodontitis symptoms

Answer 25

non sensitive response to percussion and palpation
radiolucency around the apex

Question 26

chronic periapical abscess presentation

Answer 26

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

Question 27

chronic periapical abscess symptoms

Answer 27

non sensitive response to percussion and palpation
non responsive sensibility tests
sinus tract on buccal/ labial sulcus

radiolucency on bone

Question 28

dentine hypersensitivity symptoms

Answer 28

exaggerated sharp, transient pain

Question 29

dentine hypersensitivity causes

Answer 29

gingival recession
tooth surface loss

Question 30

how do you differentiate dentine hypersensitivity and RP

Answer 30

if there is caries, fractures, recent restorations - RP

Question 31

focal sclerosing osteomyelitis presentation

Answer 31

increased radiodensity and opacity around one or more roots

Question 32

focal sclerosing osteomyelitis tx

Answer 32

RCT

Question 33

cracked teeth symptoms

Answer 33

sharp shooting pain on biting
worse on release of pressure
sensitive to thermal changes, sweet and acidic food
difficult to localise

Question 35

5 types of cracks

Answer 35

craze lines
fractured cusp
cracked tooth
split tooth
vertical root fracture

Question 36

craze lines presentation

Answer 36

only enamel
cross marginal ridges and buccal, lingual surfaces

Question 37

how do you diagnose craze lines

Answer 37

transillumination

Question 38

fractured cusp presentation

Answer 38

complete/ incomplete fracture initiated from crown

Question 39

cracked tooth presentation

Answer 39

incomplete fracture initiated in crown and extending subgingivally, usually M-D

Question 40

split tooth presentation

Answer 40

complete fracture from crown to subgingival
central location occlusally

Question 41

vertical root fracture presentation

Answer 41

complete or incomplete fracture initiated from root

Question 42

what is the most common cause of vertical root fracture

Answer 42

RCT

Question 43

symptoms of periodontal abscess

Answer 43

rapid onset
spontaneous pain
TTP
pus
swelling
deep perio pocket