MR. CAPUTO UNIT #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 dried Small 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 dried Melting gutta percha point is applied Tooth 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 reasons for 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 chamber Infection and infected pulp is removed Pulp chambers and pulp canals are carefully cleaned, enlarged, and shaped If reversible, pulpitis medications are placed Direct and indirect capping may occur One 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