Root end anatomy of apical constriction is referred to as what?
Apical foramen
(Cemento-dentinal junction)
What does the S in SOAP mean?
Subjective
What is not an example of Subjective? (List the examples of subjectives)
- History of Pain
- Stimulus of Pain
- Frequency of Pain
- Severity of Pain
- Duration of Pain
- Spontaneity of Pain
- Location of Pain
- Character of Pain
What is not an example of Objective?
- Visual Exam
- Palpation
- Percussion
- Presence of Sinus Tract
- Caries/Tooth Fractures
- Fractured Restorations
- Extensive Restorations
- Periodontal Disease/Probing
- Mobility
- Exposed Dentin/Wear Facets
Which of the following is not a sign of irreversible pulpitis?
- Symptomatic IRREVERSIBLE PULPITIS: lingering thermal pain, Spontaneous pain, Referred pain
- ASYMPTOMATIC: no clinical symptoms, inflammation produced by caries, caries excavation , trauma
What is not indicative of a chronic periapical abscess?
Chronic periapical abscess: Inflammatory reaction to pulpal infection and necrosis characterized by gradual onset, little or no discomfort intermittent discharge of pus through a sinus tract.
Which is not a sign of acute apical periodontitis?
Acute periapical periodontitis:
- Symptomatic periapical periodontitis: Inflammation, usually of the apical periodontium, producing clinical symptoms including a painful response to biting and/or percussion or palpation. It might or might not be associated with an apical radiolucent area.
- Asymptomatic periapical periodontitis: Inflammation and destruction of apical periodontium that is of pulpal origin, appears as an apical radiolucent area, and does not produce clinical symptoms.
What are the signs of a necrotic pulp?
- Death of dental pulp.
- Nonresponsive to pulp testing. May response to HOT ONLY and relieved by COLD.
- Electric pulp test negative.
- Asymptomatic to intense
- May or may not have periradicular lesion
- Can be percussive sensitive with onset of periradicular inflammation.
Periapical or periradicular pathosis is a consequence of … (or can have or maybe)?
Pulp necrosis
Internal resorption is always symptomatic (T/F)
False, internal root resorption is usually asymptomatic and is first recognized clinically through routine radiographs.
Teeth with internal resorption may respond normally to pulp tests (T/F)
True -
Internal root resorption usually occurs in teeth with vital pulps and responses to sensitivity testing. However, it is common to register a no-response to sensitivity testing, since often the coronal pulp has been removed or is necrotic, and the active resorbing cells are more apical in the canal. Also, the pulp might have become necrotic after active resorption took place (Hargreaves 645).
If you discover a resorption, you should treat it as fast as possible?
IMMEDIATELY! OR IT WILL DIE FOREVER
Teeth with intracanal resorptive lesions usually respond within normal limits to pulpal and periapical tests. Radiographs reveal presence of radiolucency with irregular enlargement of the root canal compartment
Immediate removal of the inflamed tissue and completion of root canal treatment are recommended; these lesions tend to be progressive and eventually perforate to the lateral periodontium. When this occurs, pulp necrosis ensues and treatment of the tooth becomes more difficult.(Torabinejad 56)
Non-odontogenic pain can result from…?
- Heterotropic pain - pain felt in an area other than its true source
- Referred pain
- Central pain - CNS
- Projected pain - peripheral of same nerve (shingles)
- Myofascial sources (most common)
- Masseter, temporalis, medial & lateral pterygoid, anterior digastric muscles
- Sinus/nasal mucosal sources
- Neurovascular sources
- Neuropathic pain disorders
- Neuralgia
- Neuroma
- Neuritis
- Neuropathy
- Cardiac sources
- Psychogenic pain
Which of the following statements regarding internal resorption is accurate?
- Initiated within the root canal system
- Etiology - caries, trauma, crown prep, cracked tooth, abrasion, erosion, idiopathic
- Can occur at any location
- Usually asymptomatic often found on routine exam
- Tooth usually tests positive or vital
- Prompt endo treatment necessary
Perforating a tooth during endodontics is always below the standard of care.
True
If you separate a file, bypass it, and seal it in a canal you don’t need to tell the patient (T/F)
False
Which of the following is the closest percentage of maxillary molars that have four canals?
90-95%
What is the closest percentage of mandibular anteriors that have two canals?
40% (Lower central laterals)
Max first bicuspids commonly have how many canals?
2 roots & 2 canals
Max second bicuspid commonly have how many canals?
1 root & 1 canal
Which tooth has most varied morphology?
Max 1st molar
Mand first premolar freq have two canals (T/F)?
False, 1 canal. 20-30% have 2 canals
Which tooth frequently presents with C shaped root canal system?
mandibular second molar
Which of the following most frequently likely indicates pain that is not of pulpal origin?
There are several indicators that a toothache may be non-odontogenic in origin.
- Red flags for non-odontogenic pain include:
- toothaches that have no apparent etiology for pulpal or periradicular pathosis;
- pain that is spontaneous, poorly localized, or migratory;
- pain that is constant and non-variable.
- pain that is described as burning, pricking, or “shocklike” is less likely to be pulpal or periradicular in origin.
- If pain of suspected periradicular origin is non-responsive to local anesthetic, it is a strong indication that the pain may be non-odontogenic in origin.
- Referred pain from a tooth is usually provoked by an intense stimulation of pulpal C fibers, the slow conducting nerves that when stimulated cause an intense, slow, dull pain.
