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Endodontic NBDE part II
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Endodontic NBDE part II Endodontic NBDE part II Endodontic NBDE part II
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Endodontic NBDE part IIENDODONTIC DIAGNOSIS - ANS
- ANS
Which teeth do you perform pulp evaluation on?
a. tooth only
b. tooth and neighboring tooth
c. tooth, neighboring teeth, contralateral tooth
d. tooth, neighboring teeth, opposing tooth - ANS c. tooth, neighboring teeth, contra lateral tooth
When testing tooth for cold: test adjacent teeth, opposing teeth & contralateral teeth. - ANS -Test
adjacent teeth and contralateral teeth.
If an apical radiolucency is present for a long time with no symptoms and no sinus tract associated with
necrotic pulp is
-Asymptomatic apical periodontitis
-Asymp chronic periodontitis - ANS Asymp chronic periodontitis
You have a tooth, no pulp, but periapical radiolucency, you do access and find no canal, what do you do?
- ANS Refer to an endodontist
A molar is super-erupted, but has irreversible pulpitis, what do you do? - ANS - RCT & Crown (other
choices were EXT, just do crown - this was tricky because to answer the question, you have to look at
the patient dental chart and findings)
,Case: Patient with tooth that has sensitivity that lingers with thermal test, sinus tract, and positive to
percussion, what does the
patient have? - ANS Irreversible pulpitis with acute periapical abscess (other choices were Irreversible
pulpitis with no acute periapical abscess, and 2 other choices with reversible pulpitis in them).
Prolonged, unstimulated night pain suggests which of the following conditions of the pulp?
A. Pulp necrosis
B. Mild hyperemia
C. Reversible pulpitis
D. No specific condition - ANS A. Pulp necrosis
Pulpal pain that only occur at night with no stimulation: - ANS Pulpal necrosis
Chronic periradicular abscess indicates: - ANS Necrotic pulp
ENDO TESTS - ANS -Percussion: presence of inflammation in PDL or not
-Palpation:spread of inflammation to periodontium from PDL or not
-EPT: Pulp vitality, responsiveness (necrosis or not). Electric Pulp Testing (EPT) An electrical current can
be applied to the tooth in order to generate an action potential in the Type Aδ fibers within pulp,
eliciting a neurological response. Such tests are conducted by applying a conducting medium (e.g.
toothpaste) on a dried tooth and placing the probe tip of an electric pulp tester on the surface of the
tooth closest to the pulp horn(s). The patient is then directed to hold the end of the conducting probe to
complete the circuit and asked to let go of the probe when a 'tingling' sensation is felt. The use of
electric pulp testing has been questioned in patients with traditional cardiac pacemakers despite no
evidence of interferences in humans, particularly with more modern devices . Care must be taken if
using an electric pulp test on a tooth adjacent to metallic restorations, as these can create electrical
conduction and yield false negative results
,-Thermal test (hot & cold): pulp vitality. Hot (irrev), cold (rev)
Which is incorrect? - ANS Do EPT for traumatic tooth
If you have pain, what would be the hardest to anesthetize?
a. Irreversible pulpitis and maxillary
b. Irreversible pulpitis and mandibular
c. Necrotic pulp and maxillary
d. Necrotic pulp and mandibular - ANS b. Irreversible pulpitis and mandibular
- With irreversible pulpitis, the teeth that are most difficult to anesthetize are the mandibular molars,
followed by the mandibular
premolars, the maxillary molars and premolars, and the mandibular anterior teeth. The fewest problems
are in the maxillary anterior
teeth
When heat is applied to the tooth, lingering pain for several minutes indicates: - ANS Irreversible pulpitis
What is diagnosis for lingering pain to cold and sensitivity to percussion? - ANS Irreversible pulpitis &
acute periapical abscess
- Usually periodontal abscess is sensitive to percussion, irreversible is usually positive to percussion
A tooth is not responsive to cold, not to percussion, and palpation is tender:
-Necrotic pulp and chronic apical periodontitis.
-Irreversible pulpitis and normal apex
(there was not an item saying necrotic pulp and normal apex) - ANS Necrotic pulp and chronic apical
periodontitis
, What is test to diagnose chronic periradicular periodontitis? - ANS Percussion
EPT test for pulpal: - ANS Responsiveness (not health)
- EPT tests whether the tooth is responsive or nonresponsive that's it (not pulpal necrosis or how vital
the tooth is, etc.): Nerve
- Doesn't tell you about vascularity of the pulp (pulpal diagnosis)
EPT - ANS Does NOT indicate health of the pulp
How does a tooth covered with crown react to pulp testing? - ANS Cold is a better test (thermal)
How do you differentiate between an endo/perio lesion? - ANS EPT
Differential diagnosis of periodontal abcess & periradiculal abscess? - ANS Vitality
Best way to diagnose irreversible pulpitis? - ANS Cold/ thermal test
What is untrue about EPT?
-It is more reliable than cold testing for necrotic teeth
-It gives relative health status of pulp
-Tells if there are vital nerve fibers - ANS It is more reliable than cold testing for necrotic teeth
Tooth did not respond to thermal & EPT but response to palpation and percussion? - ANS Necrotic pulp
Most reliable way to test vitality of a tooth? - ANS Thermal test
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