Dental Diagnostics: Periodontal Probing & Pulp Tests

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Questions and Answers

What does periodontal probing provide information about?

Possible etiology and prognosis.

Which of the following thermal tests can be performed for pulp testing? (Select all that apply)

Cold test using air blasts (correct)

Hot test using heated gutta-percha (correct)

Electrical pulp test with EPT (correct)

None of the above

What does EPT stand for in dental testing?

Electrical pulp test.

A response to thermal tests that indicates necrotic pulp is _____ to thermal tests.

no response Signup and view all the answers

What is typically indicated by a response of severe, momentary pain lasting 1–2 seconds after the removal of the stimulus?

Reversible pulpitis Signup and view all the answers

Match the pulpal diagnoses with their response to thermal testing:

Normal pulp = Mild to moderate pain lasting 1–2 sec after removal of stimulus Reversible pulpitis = Severe, momentary pain lasting 1–2 sec after removal of stimulus Irreversible pulpitis = Moderate to severe pain that lingers Necrotic = No response to thermal tests Signup and view all the answers

Which sign indicates acute apical periodontitis?

Painful response to biting and percussion Signup and view all the answers

What might a crack in a tooth indicate?

Cracked tooth syndrome, such as pulp canal obliteration or immature tooth. Signup and view all the answers

What is the most common cause of a split tooth?

Long-term progression of a cracked tooth Signup and view all the answers

Endodontically treated teeth are not susceptible to vertical root fractures.

False Signup and view all the answers

What characterizes a vertical root fracture?

A crack that begins in the root and extends toward the occlusal surface. Signup and view all the answers

Which diagnostic test can visually verify cracks in teeth?

Visual verification Signup and view all the answers

What symptoms may a patient report in case of a vertical root fracture?

History of abscess or sinus tract formation, and pain upon biting or palpation. Signup and view all the answers

What appearance may be observed on radiographs for a vertical root fracture?

A diffuse radiolucency along the length of the root with an elliptical or J-shaped appearance. Signup and view all the answers

A sinus tract often traces to the apex of the root.

False Signup and view all the answers

Study Notes

Periodontal Probing

Provides insights into potential dental etiologies and prognoses.
Narrow pockets may indicate root fractures or pathologies of pulpal origin.

Pulp Tests

Thermal Tests:
- Cold Test: Can be conducted using air blasts, ice sticks, ethyl chloride, "Endo Ice" (difluorodichloromethane), or CO2 sticks.
- Hot Test: Carried out with heated gutta-percha or hot water.
Electrical Pulp Test (EPT):
- Requires teeth to be dry before testing.
- A conductive medium such as toothpaste is applied to the tester's tip.
- The patient holds the handle of the tester, releasing it when feeling the current.
- EPT indicates whether a tooth is vital (reading 1–79) or necrotic (reading 80), but does not confirm pulp diagnosis.
- High rates of false-positive and false-negative results necessitate additional tests.

Pulpal Diagnosis

Primarily achieved through thermal tests, assessing the vitality of pulp.
Responses to thermal testing indicate:
- Normal Pulp: Mild to moderate pain lasting 1-2 seconds post-stimulus.
- Reversible Pulpitis: Severe, momentary pain lasting 1-2 seconds after stimulus removal.
- Irreversible Pulpitis: Moderate to severe pain that lingers.
- Necrotic Pulp: No response to thermal tests.

Periapical Diagnosis

Should be assessed alongside pulpal diagnosis for teeth requiring endodontic intervention.
Signs and symptoms for diagnostic categories include:
- Normal Periodontium: No radiolucency and normal responses to percussion and palpation.
- Acute Apical Periodontitis: Painful response to biting and percussion.
- Chronic Apical Periodontitis: Periradicular radiolucency present without symptoms.
- Acute Exacerbation of Chronic Apical Periodontitis: Painful response to biting and percussion with radiolucency.
- Acute Apical Abscess: Rapid onset of spontaneous pain, tenderness to percussion, and pus formation.

Tooth Cracks

Cracks commonly observed in minimally restored posterior teeth, especially mandibular molars.
Cracks extend primarily from mesial to distal direction and may indicate issues such as pulp canal obliteration, immature teeth, or previous trauma.

Split Tooth

A split tooth is completely divided into two segments.
It typically arises from the progressive deterioration of a previously cracked tooth.

Vertical Root Fracture

Defined as a crack starting in the root, extending toward the occlusal surface in a buccal-lingual direction.
Commonly occurs in teeth that have undergone endodontic treatment.
Symptoms include a history of abscess or sinus tract formation, plus pain when biting or palpating the area.

Diagnostic Tests for Vertical Root Fracture

Visual inspection can reveal visible cracks.
Periodontal probing may indicate a narrow periodontal pocket.
Radiographs display:
- A diffuse radiolucency along the root's length, possibly shaped like an ellipse or a J.
- Fracture lines may be identified by taking radiographs from various angles.
- Sinus tracts may not necessarily point to the root's apex.

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Description

This quiz covers key concepts in dental diagnostics, focusing on periodontal probing and various pulp tests, including thermal and electrical tests. Understand the implications of probing depths and how different tests help determine tooth vitality and diagnosis. Perfect for students and professionals in dentistry.