Pulpal Diagnosis - University at Buffalo
Pulpal Diagnosis - University at Buffalo
Pulpal Diagnosis - University at Buffalo
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Eugene A. Pantera, Jr., DDS, MS<br />
Department of Periodontics and Endodontics<br />
Periapical <strong>Diagnosis</strong><br />
There IS a Need for Endodontic Tre<strong>at</strong>ment<br />
PULPAL DIAGNOSIS IS REQUIRED FOR DEFINITIVE DETERMINATION<br />
CLINICAL CLASSIFICATION SIGNS AND SYMPTOMS DIAGNOSTIC TEST RESULTS<br />
Chronic Suppur<strong>at</strong>ive Apical Periodontitis<br />
A periapical condition characterized by non<br />
pain on mastic<strong>at</strong>ion. A draining sinus tract or<br />
other evidence of suppur<strong>at</strong>ion is evident.<br />
Radiographs reveal periapical or l<strong>at</strong>eral<br />
radiolucencies.<br />
Acute Alveolar Abscess<br />
Syn: Acute apical abscess<br />
An acute alveolar abscess is a severe clinical<br />
manifest<strong>at</strong>ion of periapical infectious<br />
disease, characterized by severe pain and<br />
swelling.<br />
Pain<br />
History of pain.<br />
Usually no pain present.<br />
Etiology<br />
Irreversible pulpitis, traum<strong>at</strong>ic injuries,<br />
periodontal disease, orthodontic forces,<br />
restor<strong>at</strong>ion in hyperocclusion.<br />
Pain<br />
History of pain.<br />
Severe intensity.<br />
Constant and spontaneous pain.<br />
Pain is pulsing and throbbing.<br />
Pain can occur with mastic<strong>at</strong>ion.<br />
Etiology<br />
The result of coronal apical progression of pulpal<br />
necrosis with resultant release of antigens into<br />
the periapical tissues.<br />
Pulp Tests<br />
EPT and Thermal tests may be normal, or<br />
similar to irreversible pulpitis or pulpal<br />
necrosis. (Is this a lesion of endodontic origin)<br />
Percussion<br />
None to slight pain.<br />
Palp<strong>at</strong>ion<br />
Slightly tender.<br />
Radiology<br />
Periapical or l<strong>at</strong>eral radiolucency.<br />
Visual<br />
Sinus tract present.<br />
Pulp Tests<br />
No response.<br />
Percussion<br />
Moder<strong>at</strong>e to severe.<br />
Palp<strong>at</strong>ion<br />
Moder<strong>at</strong>e to severe. Swelling probable.<br />
Radiology<br />
PDL thickening, periapical or l<strong>at</strong>eral<br />
radiolucency.<br />
5