Pulpal and Periradicular Disease Flashcards
When should a thorough ad complete update of the patient’s medical history be taken?
if the patient has not been seen in over a year
why should intraoral swellings should be visualized and palpated?
to determine whether they are diffuse or localized, firm or fluctuant
Which is the correct term: sinus tract or fistula?
sinus tract
If a patient is experiencing acute sensitivity or pain on mastication, how can this symptom be duplicated?
percussion
What does pain to percussion indicate?
inflammation in the periodontal ligament
What does pain to percussion indicate about pulp vitality?
nothing
Causes of inflammation of PDL (4)
- physical trauma
- occlusal prematurities
- periodontal disease
- extension of pulpal disease into PDL space
Why should clinicians tell the patient what will transpire during pulp testing?
more accurate clinical testing, as it reduces anxiety
Where should a clinician tap for percussion testing?
incisal or occlusal surface
What is indicated if a patient feels pain on horizontal percussion?
occlusal interference
What does a positive response to palpation indicate?
active periradicular inflammatory process
What does mobility indicate?
compromised periodontal attachment apparatus
Does mobility tell us anything about pulp vitality?
nope!
When should mobility be considered abnormal?
when exceeds 1mm
In what scenario would endo not help decrease periodontal pocketing?
if the tooth was originally vital with an associated deep perio pocket
What is endo ice spray?
1,1,1,2, tetrafluoroethane
When cold testing, where should the cotton pellet be placed?
midfacial area of tooth / crown
Can cold testing be performed through an existing crown?
yes!
what does a response to EPT testing indicate?
some viable nerve fibers are present in the pulp and are capable of responding
can EPT testing be performed through an existing crown?
nope! (needs to be in contact with natural tooth structure)
If a tooth responds with pain to bite test regardless of where the pressure is applied, what is the diagnosis?
periradicular periodontitis
If a tooth responds with pain to bite test in one direction to one cusp, what is the diganosis?
cracked tooth or fractured cusp
What radiographs are indicated for posterior teeth?
1 PAs and 1 BW
What radiographs are indicated for anterior teeth?
2 PAs
