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PULPAL TESTING

PULPAL TESTING. TERMINOLOGY. Dental pulp – Tissue within each tooth that contains the nerves, blood vessels, and cells that make the tooth a living organ Pulpitis – A range of conditions from inflammation all the way to pulpal necrosis. TERMINOLOGY CON’T.

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PULPAL TESTING

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  1. PULPAL TESTING

  2. TERMINOLOGY • Dental pulp – Tissue within each tooth that contains the nerves, blood vessels, and cells that make the tooth a living organ • Pulpitis – A range of conditions from inflammation all the way to pulpal necrosis

  3. TERMINOLOGY CON’T • Vitality – response of the pulpal tissue to a stimulus(healthy to nonresponsive) • Reversible/irreversible pulpitis – Reactions of a vital pulp to stimuli • Necrotic – death of the pulp • Periapical Tissue chronic periodontitis acute periodontitis

  4. WHY PULPAL TESTING? Pulp testing is done to determine the treatment need of the tooth

  5. TOOTH STATUS Healthy -------------------- Nonrestorable Tooth Tooth

  6. When do we need to pulp test? • Patient history/complaint • Clinical Exam

  7. Patient History • Pain • Swelling • Sensitivity (temperature, biting)

  8. CLINICAL EXAM • Radiographic • Decay • Soft tissue findings

  9. CLINICAL DECAY

  10. Where do we begin with pulpal testing? PATIENT INTERVIEW!!!

  11. Patient History • Has the tooth ever hurt(scale of 1-10) • Does cold or hot bother the tooth • Does it hurt when you bite • Has the tooth been traumatized • Is your pain spontaneous • How long have the symptoms been present • Does the pain wake you up at night • What makes the pain better or worse

  12. CATEGORIES OF PUPAL PATHOLOGY • Vital Reversible Irreversible • Necrotic Acute apical periodontitis Chronic apical periodontitis

  13. VITAL PULPITIS

  14. Reversible pulpitis - clinical • No apparent radiograpic changes to periapical tissue • Not sensitive to percussion • Any sensitivity to thermal is of short duration • No reported spontaneous pain • Response to electrical stimulus • Treatment – Routine restorative

  15. Irreversible pulpitis • No apparent radiographic changes • Not sensitive to percussion • Prolonged sensitivity to thermal • Spontaneous pain • Response to electrical stimulus • Initiate endo treatment

  16. NECROTIC PULP

  17. Necrotic pulp with acute apical periodontitis • May or may not have radiographic changes • Sensitive to percussion • May or may not have thermal sensitivity • Spontaneous pain • Likely no response to electical stimulus • Treatment - endo

  18. Necrotic pulp with chronic periapical periodontitis • Likely to see radiographic changes • Sensitive to percussion • No thermal sensitivity • No response to electrical stimulus • May or may not have spontaneous pain • Treatment - endo

  19. CLINICAL TESTS USED TO DIAGNOSIS PULPAL PATHOLOGY

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