El-Maestro-Arreglado.pdf

2015/2014 RQ – blue
2016 RQ – green (Highlighted )
2017 RQ- purple pink



ENDODONTIC DIAGNOSIS
KNOW THIS!




QUESTION: Which teeth do you perform pulp evaluation on?
a. tooth only
b. tooth and neighboring tooth
c. tooth, neighboring teeth, contralateral tooth

d. tooth, neighboring teeth, opposing tooth

QUESTION: When testing tooth for cold: test adjacent teeth, opposing teeth & contralateral teeth.

QUESTION: If an apical radiolucency is present for a long time with no symptoms and no sinus tract associated with necrotic pulp,
asymptomatic apical periodontitis, Asymp chronic periodontitis


QUESTION: You have a tooth, no pulp, but periapical radiolucency, you do access and find no canal, what do you do? - I said don’t try to be a
hero, refer to an endodontist

QUESTION: A molar is super-erupted, but has irreversible pulpitis, what do you do? – RCT & Crown (other choices were EXT, just do crown –
this was tricky because to answer the question, you have to look at the patient dental chart and findings)

,QUESTION: Case: Patient with tooth that has sensitivity that lingers with thermal test, sinus tract, and positive to percussion, what does the
patient have? Irreversible pulpitis with acute periapical abscess (other choices were Irreversible pulpitis with no acute periapical abscess, and
2 other choices with reversible pulpitis in them).

QUESTION: Prolonged, unstimulated night pain suggests which of the following conditions of the pulp?
A. Pulp necrosis
B. Mild hyperemia
C. Reversible pulpitis
D. No specific condition

QUESTION: Pulpal pain that only occur at night with no stimulation: pulpal necrosis

QUESTION: Chronic periradicular abscess indicates: necrotic pulp


ENDO TESTS
Percussion- presence of inflammation in PDL or not
Palpation- spread of inflammation to periodontium from PDL or not
EPT- Pulp vitality, responsiveness (necrosis or not)
Thermal test (hot & cold)- pulp vitality. Hot (irrev), cold (rev)
QUESTION: Which is incorrect? Do EPT for traumatic tooth

QUESTION: If you have pain, what would be the hardest to anesthetize?
a. Irreversible pulpitis and maxillary
b. Irreversible pulpitis and mandibular
c. Necrotic pulp and maxillary
d. Necrotic pulp and mandibular
- With irreversible pulpitis, the teeth that are most difficult to anesthetize are the mandibular molars, followed by the mandibular
premolars, the maxillary molars and premolars, and the mandibular anterior teeth. The fewest problems are in the maxillary anterior
teeth.

QUESTION: When heat is applied to the tooth, lingering pain for several minutes indicates: irreversible pulpitis

QUESTION: What is diagnosis for lingering pain to cold and sensitivity to percussion? Irreversible pulpitis & acute periapical abscess
- Usually periodontal abscess is sensitive to percussion, irreversible is usually positive to percussion

QUESTION: A tooth is not responsive to cold, not to percussion, and palpation is tender: necrotic pulp and chronic apical periodontitis. –
irreversible pulpitis and normal apex, there was not an item saying necrotic pulp and normal apex)

QUESTION: What is test to diagnose chronic periradicular periodontitis? Percussion

QUESTION: EPT test for pulpal: responsiveness (not health)
- EPT tests whether the tooth is responsive or nonresponsive that’s it (not pulpal necrosis or how vital the tooth is, etc.): Nerve
- Doesn’t tell you about vascularity of the pulp (pulpal diagnosis)

QUESTION: EPT does NOT indicate health of the pulp

QUESTION: How does a tooth covered with crown react to pulp testing? Cold is a better test (thermal)

QUESTION: How do you differentiate between an endo/perio lesion? EPT

QUESTION: Differential diagnosis of periodontal abcess & periradiculal abscess? Vitality

QUESTION: Best way to diagnose irreversible pulpitis? Cold/ thermal test

QUESTION: What is untrue about EPT?
It is more reliable than cold testing for necrotic teeth (false!!!)
It gives relative health status of pulp (true)
Tells if there are vital nerve fibers (true)

,QUESTION: Tooth did not respond to thermal & EPT but response to palpation and percussion? Necrotic pulp

QUESTION: Most reliable way to test vitality of a tooth? Thermal test
- Mosby’s states that thermal tests must be done before a final diagnosis, because EPT can have may false readings

QUESTION: Which of the following is the least important factor in referring an endo case to specialist?
Dilacerations
Calcifications
Inability to obtain adequate anesthesia
Mesial inclination of a molar

QUESTION: Chronic endodontic lesion has what type of bacteria? Anaerobes

QUESTION: How do you test a tooth to differentiate between chronic perio and supperative perio?
a. Cold test
b. Percussion
c. EPT


ENDO/PERIO ABSCESSES & LESIONS
ENDO – PERIO LESIONS
st
Evaluate tooth: If tx is warranted, initiate endo therapy 1 . Perio treatment may be combined with periapical surgery, if needed. Prognosis is
poorest with perio lesions.
- If Endo lesion is draining through periodontal ligament space, complete RCT & wait several months to evaluate healing of periodontal
lesion.
o Endo-perio: Pulpal necrosis leading to a perio problem as pus drains from PDL.
- If Perio Lesion has spread to the periapical region, evaluate vitality of the pulp, institute periodontal treatment alone if vital (treatment
may devitalize pulp).
o Perio-endo: infection from pocket spreads to pulp causing pulpal necrosis.

QUESTION: What is initial treatment of a combination perio and endo lesion? Perform endo with RCT first, then perio Sc/RP

QUESTION: Periapical abscess, what do you do? DO NOT DO RCT FIRST, YOU ARE SUPPOSE TO INCISE AND DRAIN (incise & drain lesion first)
PRESCRIBE ANTIOBIOTCS AND WAIT TO DO RCT AT A LATER DATE
- Use gutta percha to find it
- Most important thing for acute apical abscess is drainage & cleaning the canal
QUESTION: Acute perio abscesses that require drainage are usual firm, localized lesion, fluctuant, local lesion; generalized firm lesion)

QUESTION: Difference between perio and endo periapical lesions, which one has the best prognosis? Perio started from endo or endo started
from perio?

QUESTION: Test performed to differentiate endo vs. perio lesions: Percussion
- Perio lesion are sensitive to lateral percussion.

QUESTION: Indications of perio lesion vs endo lesion: apical radiolucency and pain upon lateral pain pressure (not apical)

QUESTION: Which of following is not endodontic in origin: tooth with wide sulcular pocket not extending to apex

QUESTION: Which of the following conditions indicates that a periodontal, rather than an endodontic problem, exists?
A. Acute pain to percussion with no swelling
B. Pain to lateral percussion with a wide sulcular pocket
C. A deep narrow sulcular pocket to the apex with exudate
D. Pain to palpation of the buccal mucosa near the tooth ape

QUESTION: Endo abscess w/ no sinus tract can pus drain through the PDL: True
- Do RCT and leave the sinus tract alone, will heal

QUESTION: What treatment is required with a tooth that has a draining sinus tract has been treated via RCT? No further treatment

QUESTION: Lateral periodontal abscess is best differentiated from the acute apical abscess by?
a. pulp testing (vitality tests)

, b. radiographic appearance
c. probing patterns
d. percussion
e. palpation

QUESTION: Best way to diagnose acute periradicular periodontitis? – sensitive to percussion, cold

QUESTION: Radiographically, the acute apical abscess
a. is generally of larger size than other lesions
b. may not be evident
c. has more diffuse margins than another lesion

QUESTION: When do you puncture an abscess?
Localized chronic fluctuant in palpation
Localized chronic hard in palpation (if hard there is no pus)

QUESTION: A patient has a non-vital tooth & a fistula that is draining around the gingival sulcus. What kind of abcess is it?
endo and perio at same time
perio and then endo
only endo
only perio

QUESTION: There usually is no lesion apparent radiographically in acute apical periodontitis. However, histologically bone destruction has been
noted.
a. Both statements are true
b. Both statements are false.
c. First statement is true, second is false.
d. First statement is false, second is true.

QUESTION: Based solely on the sharp transient response of pulp to hot stimuli, what is the periradicular diagnosis?
a. Acute apical periodontitis
b. Cannot diagnose based on information provided.
c. Acute Apical abscess
d. Irreversible pulpitis

QUESTION: What is the clinical ‘hallmark’ of a chronic periradicular abscess?
a. Large periradicular lesion
b. Sinus tract drainage
c. Granulation tissue in the periapex.
d. Cyst formation.

QUESTION: A periradicular radiolucent lesion of endodontic origin on the radiograph may be any of these histological diagnoses except one.
Mark this exception.
a. A cyst
b. A granuloma
c. An abscess
d. Dentigerous cyst

QUESTION: What complete endodontic diagnosis could be completely asymptomatic but should require endodontic therapy?
a. Pulpal necrosis and acute periradicular periodontitis
b. Normal pulp and acute periradicular periodontitis.
c. Pulpal necrosis and chronic periradicular periodontitis.
d. Normal pulp and normal periapex

QUESTION: A lesion of non-endodontic origin remains at the apex of the suspected tooth regardless of X-ray cone angulations.
a. True
b. False

QUESTION: After an RCT in maxillary molar, what Tx would you for sinus track? No treatment