Pulpal Diagnosis

Question 1

What is the main reason a patient comes to see you that is the most important in the diagnosis?

Answer 1

Chief complaint

Question 2

We must obtain a______ through non-invasive means and,from this, develop a plan of action to alleviate the presenting problem

Answer 2

Clinical DX

Question 3

Most head and neck pain is of ____ orgin

Answer 3

Odontogenic

Question 4

If the pain is purely pulpal, is it easy or hard to localize?

Answer 4

Hard to localize

Question 5

____ is used to test teeth for cold sensitivity

Answer 5

Endo ice

Question 6

Can endo ice be used on teeth with crowns?

Answer 6

Yes

Question 7

____ is performed (based on Chief complaint)

Answer 7

Clinical Testing

Question 8

What are the 3 radiographs needed to diagnose pulpal issues?

Answer 8

PA
PA Shift Shot
Bitewing

Question 9

Should you do an endodontic diagnosis when the patient has taken Ibuprofen?

Answer 9

No; wait until it wears off

Question 10

If percussion will cause pain in inflammation, it is ________

Answer 10

Necrotic pulp

Question 11

T/F: Answering the question of “WHY?”usually leads to an accurate diagnosis and a more successful treatment outcome

Answer 11

True

Question 12

What are the 3 pulp statuses that can exist?

Answer 12

Normal
Inflamed (Symptomatic and Asymptomatic)
Necrotic

Question 13

–Pulp is symptom free with normal response to pulp tests

Answer 13

WNL: (Normal Pulp)

Question 14

–Inflammation of the pulp based on subjective and objective findings that should revolve and return the pulp to normal.

Answer 14

RP : (Reversible Pulpitis)

Question 15

-Vital inflamed pulp that is incapable of healing.i.e. lingering pain to cold, sensitivity to heat, spontaneous pain.

Answer 15

SIP (Symptomatic Irreversible Pulpitis)

Question 16

–Vital inflamed pulp incapable of healing. No clinical symptoms.Inflamed due to caries (chronic hyperplastic pulpitis) caries excavation (pulp exposure), trauma (fracture with exposed pulp tissue)

Answer 16

AAP (Asymptomatic Irreversible Pulpitis)

Question 17

–Death of the dental pulp (No Response to pulp tests)

Answer 17

Pulpal Necrosis (Necrosis)

Question 18

–Tooth has been endodontically treated with canals obturated with final root canal filling materials other than medicaments..

Answer 18

PT: (Previously Treated)

Question 19

–Tooth has been previously treated by partial endodontic therapy, i.e. pulp cap, pulpotomy/pulpectomy. RCT NOT completed

Answer 19

PIT (Previously Initiated Treatment)

Question 20

When doing pulp testing, should you test only the tooth in question?

Answer 20

No test teeth adjacent to establish a baseline

Question 21

If the tooth is sensitive and the pain linger for 10 secs or more, what is it?

Answer 21

SIP

Question 22

If the tooth is sensitive to cold but doesn’t linger, what is it?

Answer 22

RP

Question 23

If heat causes pain and the pain is spontaneous, what is it?

Answer 23

SIP

Question 24

Once a diagnosis occurs, can it change within a period of time?

Answer 24

Can change

Question 25

Both seriously Inflamed and Infected Pulpitis cases will ultimately lead to a _______ if left untreated long enough.

Answer 25

Necrotic pulp

Question 26

The Prime Objective of Clinical Testing is to objectively ______ the patient’s CC

Answer 26

REPRODUCE

Question 27

Always remember that we are not testing teeth, per se, as much as we are testing the patient’s _____ to a variety of stimuli over a variety of control teeth and suspected teeth

Answer 27

response

Question 28

What is the best method to test teeth for heat?

Answer 28

isolate individual teeth (1 @ a time)with rubber dam & drip warm (140 degree) water

Question 29

What is the best test to determine pulpal status?

Answer 29

Cold 90%

Question 30

If cold test for pulpal status is unclear, what should you go to next?

Answer 30

EPT

Question 31

Alternate method of vitality Testing if cold testing yields no results A source of variable amperage high frequency electrical stimulation is applied to the surface of several teeth to determine if a response occurs (1-80):Actual # means very little about the condition of the pulp. Response or none*

Answer 31

EPT

Question 32

SHould the gingiva be touch when using EPT?

Answer 32

No

Question 33

Can you use EPT on tooth with a crown?

Answer 33

No

Question 34

_____ EPT test Pulp undergoing liquefaction may still respond+ Teeth involved in bridges may transfer current Touching gingiva –not drying & isolating tooth Extremely apprehensive patient variability

Answer 34

False +

Question 35

``` ______ EPT test Dead (weak) batteries in EPT Poor contact with tooth (tooth paste) Extremely calcified teeth (old people) Teeth tested shortly after eruption (-) Ad fibers ```

Answer 35

False -

Question 36

What 3 types of teeth don't work well on?

Answer 36

Newly erupted teeth Recently traumatized Mature patients

Question 37

ENDODONTIC DIAGNOSIS Requires both _______ and _________ Diagnoses

Answer 37

PULPAL and a PERI-RADICULAR