Pulpal Disease

Question 1

Why “Clinical” pulpal diagnosis?

Answer 1

We won’t be gaining a histological diagnosis without destruction of the tooth to create the slides

Question 2

How must we obtain a clinical diagnosis?

Answer 2

Through non-invasive means, and from this, develop a plan of action to alleviate the chief complaint

Question 3

Where is MOST facial pain originated from?

Answer 3

Odontogenic origin

Question 4

One benefit of clinical testing is to prove whether or not the patient’s pain is, in fact…?

Answer 4

tooth related

Question 5

Each tooth needs 2 diagnoses. What are they?

Answer 5

Pulpal and peri-radicular

Question 6

What is the first question to ask the patient in pain?

Answer 6

“What is your chief complaint?”

Question 7

T or F:

If purely pulpal, the patient can point to the tooth that hurts and localize the source of pain.

Answer 7

False.

If purely pulpal, their is diffuse pain

Question 8

The objective of clinical testing is to find an confirm…?

Answer 8

the etiology of the patient’s chief complaint

Question 9

Clinical testing is performed based on?

Answer 9

the patient’s chief complaint

Question 10

Thermal tests?

Answer 10

Cold, heat (pulp vitality)

Question 11

Electric Pulpal Testing (EPT)

Answer 11

This test is done ONLY if pulpal status is in doubt. It is not done routinely.

Question 12

Percussion test

Answer 12

tapping with mirror to test periodontal ligament (PDL) sensitivity

Question 13

Palpation test

Answer 13

digital touching of gingival inflammation, redness, swelling, and tenderness

Question 14

Which radiographs are used for the suspect areas for endo?

Answer 14

1. Straight-on PA
2. PA Shift Shot (20 degree change in horizontal angulation mesially or distally)
3. Bite-Wing (used to determine restorability and bone level)

Question 15

Answering the question of “___?” usually leads to an ____ diagnosis and a more successful treatment outcome.

Answer 15

1- WHY

2- accurate

Question 16

Pulp exists in only 3 basic conditions:

Answer 16

1. Normal
2. Inflamed
   a. reversible
   b. irreversible
3. Necrotic

Question 17

Description of normal pulp?

Answer 17

should remain normal and healthy

Question 18

Description of inflamed pulp? Reversible vs. Irreversible?

Answer 18

Could recover or deteriorate.

Reversible= no treatment or symptomatic treatment

Irreversible= pain lingering and often spontaneous

a) symptomatic
b) asymptomatic (rare)

Question 19

Description of necrotic pulpal status?

Answer 19

Dead pulp

Question 20

WNL

Answer 20

Within normal limits (normal pulp)

Pulp is symptom free with normal response to pulp tests

Question 21

RP

Answer 21

Reversible pulpitis

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

Question 22

SIP

Answer 22

Symptomatic irreversible pulpitis

Vital inflamed pulp that is incapable of healing

For example: lingering pain to cold, sensitivity to heat, spontaneous pain

Question 23

AIP

Answer 23

Asymptomatic irreversible pulpitis

Vital inflamed pulp incapable of healing. No clinical symptoms.

Inflamed due to caries, caries excavation, trauma

Question 24

NP

Answer 24

Necrotic pulp

Death of the dental pulp
no response to pulp tests

Question 25

PT

Answer 25

Previously Treated

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

Question 26

PIT

Answer 26

Previously Initiated Treatment

Tooth has been previously treated by partial endodontic therapy (pulpotomy/pulpectomy), the root canal treatment has not been completed