Pulpal Diagnosis Flashcards
What is the main reason a patient comes to see you that is the most important in the diagnosis?
Chief complaint
We must obtain a______ through non-invasive means and,from this, develop a plan of action to alleviate the presenting problem
Clinical DX
Most head and neck pain is of ____ orgin
Odontogenic
If the pain is purely pulpal, is it easy or hard to localize?
Hard to localize
____ is used to test teeth for cold sensitivity
Endo ice
Can endo ice be used on teeth with crowns?
Yes
____ is performed (based on Chief complaint)
Clinical Testing
What are the 3 radiographs needed to diagnose pulpal issues?
PA
PA Shift Shot
Bitewing
Should you do an endodontic diagnosis when the patient has taken Ibuprofen?
No; wait until it wears off
If percussion will cause pain in inflammation, it is ________
Necrotic pulp
T/F: Answering the question of “WHY?”usually leads to an accurate diagnosis and a more successful treatment outcome
True
What are the 3 pulp statuses that can exist?
Normal
Inflamed (Symptomatic and Asymptomatic)
Necrotic
–Pulp is symptom free with normal response to pulp tests
WNL: (Normal Pulp)
–Inflammation of the pulp based on subjective and objective findings that should revolve and return the pulp to normal.
RP : (Reversible Pulpitis)
-Vital inflamed pulp that is incapable of healing.i.e. lingering pain to cold, sensitivity to heat, spontaneous pain.
SIP (Symptomatic Irreversible Pulpitis)
–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)
AAP (Asymptomatic Irreversible Pulpitis)
–Death of the dental pulp (No Response to pulp tests)
Pulpal Necrosis (Necrosis)
–Tooth has been endodontically treated with canals obturated with final root canal filling materials other than medicaments..
PT: (Previously Treated)
–Tooth has been previously treated by partial endodontic therapy, i.e. pulp cap, pulpotomy/pulpectomy. RCT NOT completed
PIT (Previously Initiated Treatment)
When doing pulp testing, should you test only the tooth in question?
No test teeth adjacent to establish a baseline
If the tooth is sensitive and the pain linger for 10 secs or more, what is it?
SIP
If the tooth is sensitive to cold but doesn’t linger, what is it?
RP
If heat causes pain and the pain is spontaneous, what is it?
SIP
Once a diagnosis occurs, can it change within a period of time?
Can change
Both seriously Inflamed and Infected Pulpitis cases will ultimately lead to a _______ if left untreated long enough.
Necrotic pulp
The Prime Objective of Clinical Testing is to objectively ______ the patient’s CC
REPRODUCE
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
response
What is the best method to test teeth for heat?
isolate individual teeth (1 @ a time)with rubber dam & drip warm (140 degree) water
What is the best test to determine pulpal status?
Cold 90%
If cold test for pulpal status is unclear, what should you go to next?
EPT
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*
EPT
SHould the gingiva be touch when using EPT?
No
Can you use EPT on tooth with a crown?
No
_____ 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
False +
\_\_\_\_\_\_ 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
False -
What 3 types of teeth don’t work well on?
Newly erupted teeth
Recently traumatized
Mature patients
ENDODONTIC DIAGNOSIS Requires both _______ and _________ Diagnoses
PULPAL and a PERI-RADICULAR
