Zusammenfassung der Ressource
Pulpal and Periapical Diagnoses
- Pulpal Diagnosis
- Normal Pulp
- Asymptomtic
- Mild to moderate
transient response to
stimuli
- Thermal
- Endo Ice (-30º)
Anmerkungen:
- Chilled pellet immediately to tooth for 5 seconds
DRY TEETH
- Intensity
- Duration
- Electrical
- Least reliable
pulp vitality
testing
- False positives &
negatives
- Presence of vital sensory fibers
- Contraindicated
- Reversible
Pulpitis
- Symptomatic
- Cold stimuli response
Anmerkungen:
- Important to test healthy teeth to compare and have a baseline response (contralateral teeth, adjacent teeth, oposing, etc.)
- sharp
hypersensitve
- Transient
- No complaints of
spontaneous pain
- Caused by irritant
that affects the pulp
Anmerkungen:
- - Deep restorations without a proper liner of base
- Deep cleaning
- Caries
- when removed,
reversion to normal
pulp status
- Irreversible
Pulpitis
- Symptomatic
- Spontaneous pain
- Continuous or
intermittent pain
- Cold stimuli
response
- lingering pain
Anmerkungen:
- The pain remains when withdrawing the pellet for 10, 15, 20 or more seconds
- Bending over or laying down
exacerbates the pain
- Asymptomatic
- No clinical
response
- Irreversible
damage
beyond
repair
- Pulp Necrosis
- Usually
asymptomatic
- Partial or total
- Anterior teeth may be
discolored
- Toxins can spread beyond
the apical foramen
- Tenderness to percussion (PDL)
- Thickening of the PDL
Anmerkungen:
- PDL: periodontal ligament
- Apical
disease
- Periapical Diagnosis
- Normal apical
tissues
- Asymptomatic
- Tactile stimulation
- No pain on percussion or palpation
Anmerkungen:
- - Percussion: tapping on teeth with a mirror handle
- Palpation: feeling on gums around apex of the root
- Symptomatic apical
periodontitis
- Painful inflammation
around the apex
- Tactile stimulation
- Painful percussion
- Intense, throbbing pain
- Localized inflammatory
infiltrate within the PDL
- Treatment
- Sometimes
occlusal
adjustment is
enough
- If the tooth is necrotic,
endodontic treatment is
necessary to prevent
progression
- Asymptomatic
apical periodontitis
- Apical
radiolucency
- Radicular cyst or periapical
granuloma
- Confirmation
of pulpal
necrosis
- Acute apical
abscess
- Rapid swelling
- Severe pain
- Purulent exudate (liquefaction
necrosis) around apex
- Chronic apical
abscess
- Draining sinus tract
usually without
discomfort
- Sometimes you can insert a
guttapercha through the sinus
tract and expose a periapical
radiograph and find the path and
source