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20116080
Pulpal and Periapical Diagnoses
Descrição
Pulpal and Periapical Diagnoses
Sem etiquetas
diagnose
dentistry
endodontics
pain
odontología
dentistry
Mapa Mental por
TR AS
, atualizado more than 1 year ago
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Criado por
TR AS
mais de 4 anos atrás
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Resumo de Recurso
Pulpal and Periapical Diagnoses
Pulpal Diagnosis
Normal Pulp
Asymptomtic
Mild to moderate transient response to stimuli
Thermal
Endo Ice (-30º)
Anotações:
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
Anotações:
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
Anotações:
- 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
Anotações:
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
Anotações:
PDL: periodontal ligament
Apical disease
Periapical Diagnosis
Normal apical tissues
Asymptomatic
Tactile stimulation
No pain on percussion or palpation
Anotações:
- 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
Anexos de mídia
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