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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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Presentation Transcript
terminology
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
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

why pulpal testing
WHY PULPAL TESTING?

Pulp testing is done to determine the treatment need of the tooth

tooth status
TOOTH STATUS

Healthy -------------------- Nonrestorable

Tooth Tooth

when do we need to pulp test
When do we need to pulp test?
  • Patient history/complaint
  • Clinical Exam
patient history
Patient History
  • Pain
  • Swelling
  • Sensitivity (temperature, biting)
clinical exam
CLINICAL EXAM
  • Radiographic
  • Decay
  • Soft tissue findings
patient history11
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
categories of pupal pathology
CATEGORIES OF PUPAL PATHOLOGY
  • Vital

Reversible

Irreversible

  • Necrotic

Acute apical periodontitis

Chronic apical periodontitis

reversible pulpitis clinical
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
irreversible pulpitis
Irreversible pulpitis
  • No apparent radiographic changes
  • Not sensitive to percussion
  • Prolonged sensitivity to thermal
  • Spontaneous pain
  • Response to electrical stimulus
  • Initiate endo treatment
necrotic pulp with acute apical periodontitis
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
necrotic pulp with chronic periapical periodontitis
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