MR. CAPUTOUNIT #2 LESSON #3

Endodontic Diagnosis

Today’s Class

Driving Question: What are the various test used for endodontic diagnosis?

Learning Intentions: We will be able to describe the various tests used for endodontic diagnosis.

Anchor: What is a periapical abscess?

Percussion Test

Gentle tapping on crown of tooth

Back end of mirror handle or any blunt instrument may be used to lightly tap on tooth

Teeth on each side of affected tooth should also be tapped for comparison Image courtesy Instructional Materials for the Dental Team,

Lex. KY

Palpation

Applying finger or fingers with light pressure to areas of the mouth

Done to detect swelling, pain, or abnormally firm tissues

Mobility

Handles of two instruments are placed between tooth and pressure is applied to both sides to assess tooth movement

Mobility of tooth indicates permanent loss of tooth-supporting bone structure

Image courtesy Instructional Materials for the Dental Team, Lex. KY

Cold Test

Tooth is driedSmall piece of ice

or ethyl chloride is applied onto gingival third of tooth crown

If pulp is inflamed the patient will experience a lingering sensation to cold

Heat Test

Tooth is driedMelting gutta percha

point is appliedTooth with pulpitis

will feel lingering pain

If there is intense pain, pulp is irreversible

Necrotic pulp will not feel any pain

Image courtesy Instructional Materials for the Dental Team, Lex. KY

Electric Pulp Tester

Sends small electric current through tooth to detect vitality of tooth

Tooth vitality tells clinician the condition of pulp and whether it is alive and vital, dying, or already dead and necrotic

Transillumination

Fiber-optic light is used to diagnose a fractured crown

Done most effectively on anterior teeth Light transmits through enamel and dentin,

permitting detection of fractured crown or even a carious lesion

What are some of the reasonsfor tooth fracture?

Anesthetic Test

Done if other tests are not giving a good diagnosis

Based on other test results and dentist’s judgment, local anesthetic is administered to tooth most likely infected

If patient’s discomfort is relieved by anesthesia, the accurate tooth has been identified

Anesthesia will not work on a persistent infection area

Endodontic Procedures

Begins with initial access into pulp chamberInfection and infected pulp is removedPulp chambers and pulp canals are

carefully cleaned, enlarged, and shapedIf reversible, pulpitis medications are

placedDirect and indirect capping may occurOne or more appointments may be required

Indirect and Direct Pulp Capping

Done in an attempt to protect pulp from additional injury and to stimulate pulpal regeneration

Protective biocompatible agent or medicated liner is applied

Direct pulp cap placing pulp cap directly over exposed pulp

Indirect pulp cap placing pulp cap over layer of remaining dentin

Indirect and Direct Pulp Capping