pulp & vitality testing

Question 1

What is used to conduct the cold stimulus testing?

Answer 1

Ethyl Chloride

Question 2

What is used to carry out the hot stimulus test?

Answer 2

Gutta Percha

Question 3

How to carry out the Ethyl Chloride test.

Answer 3

1. Spray the Ethyl Chloride on a cotton pellet.
2. Hold against the tooth in question.
3. Compare to adjacent teeth which act as a control.

Question 4

How to carry out the Gutta Percha Test.

Answer 4

1. Dry the tooth.
2. Apply vaseline to stop the gutta from sticking.
3. Heat the gutta percha and apply to teeth.

Question 5

How does the electric pulp test test for vitality?

Answer 5

Stimulates the nerve endings with a low current and a high potential difference voltage.

Question 6

How to check normal/baseline values.

Answer 6

Conduct the vitality testing on the teeth adjacent to the one in question.

Question 7

Which pulpal clinical disease is indicated by a EPT response at a higher current than normal?

Answer 7

Chronic pulpitis.

Question 8

Which pulpal clinical disease has no response at any current.

Answer 8

Pulp Necrosis and Periodontal Apical Abscess

Question 9

Examples of when the EPT may not be reliable.

Answer 9

1. Pus-filled canal.
2. Nervous Patient
3. Recent Dental Trauma
4. An insulating restoration
5. Moisture contamination.

Question 10

In what situations would sensibility testing result in a false positive?

Answer 10

1. Pus filled canal.
2. A nervous patient.
3. Multiple root canals containing vital and non-vital pulp.

Question 11

In what situations would sensibility testing record a false negative?

Answer 11

1. If the patient was taking analgesics.
2. Weak batteries in the EPT.
3. Improper application of the test.

Question 12

What are the symptoms of irreversible pulpitis?

Answer 12

1. spontaneous pain which is usually throbbing.
2. pain which radiates to the face or jaw.
3. poorly localised to 1 tooth
4. persistent pain lasting minutes-hours after hot/cold/sweet stimuli.

Question 13

What are the symptoms of reversible pulpitis?

Answer 13

1. transient pain from stimuli (lasts seconds)
2. Poorly localised to 1 tooth.

Question 14

Describe a Class I pulp exposure.

Answer 14

• Caused by Iatrogenic Damage or Trauma *
• no pre-op presence of a deep carious lesion.
• clinically judged to be sound dentine with healthy underlying pulp tissue.

Question 15

Describe a Class II pulp exposure.

Answer 15

• Pre-op existence of a deep carious lesion with pulp exposure *
• occurs due to bacterial invasion and causes inflamed pulp tissue.

Question 16

What are 3 examples of pulpal protection for deep carious lesions?

Answer 16

1. Dycal (CaOH)
2. Biodentine (Calcium Silicate)
3. Vitrebond (Resin Glass Ionomer)

Question 17

When would Dycal be indicated?

Answer 17

• DIRECT and INDIRECT pulp capping
• root fractures
• root resorption

Question 18

When should Dycal NOT be used?

Answer 18

Under amalgam restorations -
dycal can crack under pressure, doesn’t bond to dentine or amalgam so can cause microleakage and is soluble so may cause voids under amalgam.

Question 19

When is Biodentine indicated?

Answer 19

• Direct and indirect pulp capping.
• Pulpotomies.
• Furcation repair.
• Can be used under amalgam.

Question 20

What are 2 disadvantages of biodentine?

Answer 20

High cost and long setting time.

Question 21

When is the use of Vitrebond indicated?

Answer 21

• INDIRECT pulp capping only!!
• as a base under COMPOSITE AND AMALGAM.

Question 22

When placing vitrebond, which part of the tooth structure will it bond to?

Answer 22

Only the dentine, not the pulp.