Pulp Sensitivity Testing

Question 1

what is the most accurate determination of pulp vitality

Answer 1

vascular supply is the most accurate

not pulpal innervation

Question 2

types of fibres that innervate the pulp

Answer 2

• myelinated A delta and A beta fibres
• unmyelinated C fibres

Question 3

key uses for pulp testing

Answer 3

• prior to procedures - pulp degeneration can occur without symptoms
• diagnosis of pain
• investigation of radiolucent areas: usually due to periapical pathology
• post-trauma assessment

Question 4

types of pulp sensibility testing

Answer 4

• thermal testing
• electric pulp testing
• test cavity preparation
• local anaesthetic test

Question 5

what is a normal response to sensitibility testing sugestive of

Answer 5

vital tooth or reversible pulpitis

Question 6

what is a intense, prolonged response to sensibility testing suggestive of

Answer 6

irrversible pulpitis

Question 7

what is no response to sensibility testing suggestive of

Answer 7

necrotic pulp

false negative (calcified canal, immature apex or recent trauma)

Question 8

what does a response to cold indicate

Answer 8

vital pulp

Question 9

what does an increased response to heat indicate

Answer 9

pulpal/ peri-apical pathology that may require endodontic intervention

Question 10

how does the cold test lead to a sharp sensation

Answer 10

causes contraction of the dentinal fluid within the tubules, resulting in rapid outward flow which results in hydrodynamic forces acting on A fibres leading to sharp sensation

Question 11

what can cold tests be used to differentiate

Answer 11

reversible - pain subsides on removal of stimulus

irreversible pulpitis - pain lingers after removal of stimulus

Question 12

temperature of Endofrost

Answer 12

-50 degress celsius

Question 13

what does heat activate

Answer 13

activation of c fibres - dull pain of longer duration

Question 14

how can you apply heat to a tooth

Answer 14

hot water

gutta percha stick in a heated flame

Question 15

how does the EPT work

Answer 15

Question 16

EPT - electric pulp test technique

Answer 16

Question 17

False postive examples with the EPT

Answer 17

Question 18

false negatives - EPT examples

Answer 18

Question 19

what is test cavity preparation

Answer 19

direct dentine stimulation

a last resort in testing pulpal vitality

only when other results are inconcsluive

Question 20

technique for test cavity preparation

Answer 20

Question 21

local anaesthetic test technique

Answer 21

Question 22

what is sensitivity

Answer 22

Question 23

what is specificity

Answer 23

Question 24

what is laser doppler flowmetry

Answer 24

an optical measuring method that enables the number and velocity of particles covenyed by a fluid to be measured

Question 25

indications for using laser doppler flowmetry

Answer 25

- pulp testing in children - traumatised teeth - monitor revascularisation of replanted teeth - differential diagnosis of peri-apical radiolucencies