Test #2 Diagnosis Flashcards
What is the key to effective treatment?
-Accurate diagnosis
What is the key to accurate diagnosis?
-Understanding of the pathological processes occuring in affected tissues
What are the 5 steps used for diagnosis?
- Chief complaint
- Medical and dental history
- Oral exam and tests
- Correlate findings to reach differential diagnosis
- Formulate definitive diagnosis and treatment plan
Which of the 5 steps in diagnosis is subjective?
-Medical and dental history
Which of the 5 steps in diagnosis is objective?
-Oral exams and tests
What are subjective tests?
- Localization
- Commencement
- Intensity
- Provocation and relief of symptoms
- Duration
- Previous RCT
What are cardiovascular conditions that warrant modification of dental care?
- Endocarditis
- Pathologic heart murmurs
- Hypertension
- Angina
- MI
- Arrhythmias
- CHF
What are pulmonary conditions that warrant modification of dental care?
- Obstructive pulmonary disease
- Asthma
- TB
What are common complaints with dental problems?
- Pain
- Swelling
- Trauma
- Tooth discoloration
- Bad Taste/Breath
What do you want to know in the dental history of a pt?
- Localization
- Commencement
- Intensity
- Provocation and Relief
- Duration
What is reversible pulpitis?
-Stimulation is uncomfortable but reverses quickly when stimulation is removed
What are the classifications of pulpal disease?
- Reversible pulpitis
- Irreversible pulpitis
- Pulpal necrosis
- Previously initiated pulpal therapy
- Normal
What can cause reversible pulpitis?
- Caries
- Exposed dentin (most)
- Recent dental treatment
- Defective restorations
- Trauma
T/F RCT is generally needed for reversible pulpitis
False
-Generally not needed
What cause dentin sensitivity?
-Dentin tubule fluid movement
What direction does dehydration cause the fluid to move in the dentinal tubule?
-Coronal
What direction does heat cause the fluid to move in the dentinal tubules?
-Apical
What direction does cold cause the fluid to move in the dentinal tubules?
-Coronal
What directions does hyper-osmotic solutions cause the the fluid to move in the dentinal tubules?
-Coronal
What is irreversible pulpitis?
- If Symptomatic means the pain is intermittent or spontaneous
- Pain stimulations is heightened and prolonged
- If Asymptomatic means the caries possibly into pulp space (best time to treat)
Do you see radiographic changes in irreversible pulpitis?
-Minimal or no radiographic changes
T/F with irreversible pulpitis the pulp will eventually become necrotic
True
Is RCT therapy needed for irreversible pulpitis?
Yes
What is the only classification describing histological status of pulp or lack there of?
-Pulpal necrosis
What is pulpal necrosis subsequent to?
-Irreversible pulpitis
Following complete pulpal necrosis symptoms usually subside until when?
-The disease extends into PA tissues
What type of response to the cold test do you get with Pulpal necrosis?
-No response
What can heat do in pulpal necrosis?
-Sometimes exacerbates pain due to expansion of gases or fluids
What are some endodontic diagnostic tests?
- Percussion
- Examination
- Palpation
- Thermal test
- Electric pulp testers
What are objective tests for endo?
- Palpation
- Percussion/bite
- Mobility
- Periodontal exam
- Pulp tests
What can you use for pulp vitality testing?
- Cold
- Heat
- Electric
- Test cavity
- Selective anesthesia
What do you use for a cold test in endo?
- CO2
- Ice
What do you use for a heat test in endo?
- Rubber prophy cup
- Gutta Percha stick
- Battery powered
What is an electric conductor and how do you use it?
- Test pulp vitality
- Conductor use toothpaste
- No gloves
- Can only detect vital tissue
Periapical lesions of endodontic origin, what do you see in a radiograph?
- Lamina Dura lost apically (widened)
- Lucency remains at apex despite angulation
- Lucency resembles hanging drop
- Tooth has necrotic pulp
Where does bone loss have to extend to, to be observed in an necrotic tooth?
-Junction of cortical and cancellous bone
T/F Bone loss in cancellous bone not detected
True
Are anterior and pre-molar teeth apices or molar roots apices located closer to the cortical/cancellous junction?
-Anterior and pre-molars
What is a reaction to pulp or periapical inflammation that results in density of bone?
-Condensing Osteitis
What occurs in an inflamed pulp with dentinoclastic activity?
-Internal resorption
What is Calcific Metamorphosis?
- Long-term low grade pulpal irritation
- Dentin formation obliterates canals (usually a history of trauma)
- Not always pathosis
What are pulp stones?
- Discrete calcified bodies
- No pathological significance
