Clinical Examination Self Assessment

Caries
 TrueFalse
Pulpal inflammation starts only after the bacteria enter the pulp
Antigens alone cannot initiate inflammation of the pulp
Att., abbr., erosions
 TrueFalse
Attrition, abrasion and erosion immediately affect the dentin/pulp complex
Fractures
 TrueFalse
Pulp may become rapidly irritated by a fracture not extending to the pulp
Microfractures
 TrueFalse
Microfractures often cause sharp pain upon occlusal activity
Microfractures are best diagnosed by a radiograph
Microfractures are best diagnosed by fiber optics
Hypersens. dentine
 TrueFalse
Hypersensitive dentine can only be treated by a root canal treatment
Hypersensitive dentine is often caused by exposed dentine at the cervical area of the tooth
Blocking/fixing (fixation) of dentinal tubules by Desensitizer, e.g., often helps in hypersensitive dentine
Swelling & abcesses
 TrueFalse
Swelling & abscesses always localize exactly by the affected tooth
Swelling & abscesses are mainly caused by extruded endodontic materials
Swelling & abscesses are mainly caused by micro-organisms
The main components in pus are bacteria
The main components in pus are tissue remnants
Sinus tract
 TrueFalse
Open sinus tract is usually observed together with severe pain
A closed sinus tract is always a sign of a complete eradication of infection
Tooth discoloration
 TrueFalse
Tooth discoloration is never caused by pulpal necrosis
Tooth discoloration is always caused by pulpal necrosis
Silver-containing root canal-sealers may cause discoloration of the teeth
Percussion
 TrueFalse
Sensitivity to vertical percussion is a sign of possible apical inflammation
The tooth is always necrotic if it is sensitive to vertical percussion.
A tooth with vertical root fracture will never respond with pain upon percussion.
Palpation
 TrueFalse
Palpation is done with the index finger
Increased sensitivity to palpation at the tooth apex is a sign of apical inflammation
Tooth mobility
 TrueFalse
Increased mobility can be a sign of advanced marginal periodontitis
Increased mobility can be a sign of apical periodontitis
Increased mobility can be a sign of vertical root fracture
Occl. interferences
 TrueFalse
Elimination of occlusal interferences is sometimes enough to relieve the patient from their symptoms (sensitivity to percussion)
Sens. to cold
 TrueFalse
The ice stick is the only way to perform a cold test
Cold test cannot be done with teeth with a crown
A negative response to cold test indicates pulpal necrosis
A positive response to cold test indicates always healthy pulp
Sens. to heat
 TrueFalse
Sensitivity to heat can be tested with warm gutta-percha
Sens. to el.stim.
 TrueFalse
For EPT, the tooth should be isolated from neighboring teeth and air-dried
In teeth with calcified canals the EPT tip should be placed at the cervical area of the tooth
The electrical pulp test always give you a detailed analysis of the pulpal status
EPT may give a false negative result
Period. inf.
 TrueFalse
Marginal periodontitis is always easy to diagnose from apical periodontitis
Mucosal lesions
 TrueFalse
Mucosal lesions (herpes, afta) can be confused with odontogenic pain
In primary herpes the pain can begin before any clinical signs of a mucosal lesion

Radiographic examination

Radiographic techniques
 TrueFalse
Parallel technique is preferred to taking endodontic radiographs
Digital radiography: CCD sensors are faster than phosphor plates
CCD-sensors should preferably be used with bisecting technique
Digital radiographs can be edited to enhance viewing
Radiography in endodontics
 TrueFalse
A preoperative radiograph must always be available before endodontic treatment
A fistulograph can give valuable information of the source of the infection
Use of two different types of files (K, H, e.g.) is recommended for WL radiograph when two canals is present in one root
Rubber dam should be removed when taking a radiograph

Diagnosis

Pulpitis
 TrueFalse
Ca 20% of teeth with irreversible pulpitis are symptomatic
Pulpitis is always easily diagnosed.
Canal obliteration may be a sign of chronic pulpitis
Large apical lesion may be a sign of pulpitis
Apical periodontitis
 TrueFalse
The pulp is usually vital
A lesion in bone will usually be observed apically in the radiograph
Ca. 80% of apical periodontitis cases are symptomatic
The lesion can locate only laterally in some cases
Radicular cyst
 TrueFalse
A radicular cyst can be reliably diagnosed by a radiograph
A radicular cyst can be reliably diagnosed histologically
Radicular cyst is typically pear-shaped
A tooth with a radicular cyst always has apical periodontitis
A tooth with apical periodontitis always has a radicular cyst
Craze line
 TrueFalse
Craze line usually requires invasive treatment
Crack tooth
 TrueFalse
Crack tooth has separated fragments
Crack tooth cannot occur in canines
Crack tooth: fracture line starts in the crown area
Crack tooth: fracture line is bucco-lingual
Split tooth
 TrueFalse
Split tooth has separated fragments
Split tooth can usually be save by endodontic treatment
Vertical root fracture
 TrueFalse
Typical radiographic shape of the lesion in vertical root fracture is round
Typical radiographic shape of the lesion in vertical root fracture is pear shaped
Vertical root fracture can occur in canines
Vertical root fracture is bucco-lingual
There is always a pocket with vertical root fracture
Cervical
 TrueFalse
Cervical resorption starts in the root canal
Cervical resorption starts cervically
Internal inflammatory
 TrueFalse
Internal inflammatory root resorption is common
Part of the pulp is vital in active internal inflammatory root resorption
External inflammatory
 TrueFalse
The pulp is necrotic in external inflammatory root resorption
Replacement
 TrueFalse
There is typically a bony lesion in advancing replacement resorption

Diff. Diagnosis

Pulpitis
 TrueFalse
Differential diagnosis of pulpitis can be herpes
Differential diagnosis of pulpitis can be neuropathic pain
The origin of pain in the oral cavity is always easy to find.
Necrosis
 TrueFalse
Necrosis can be verified by EPT
It is usually enough to test only the suspected tooth
Apical periodontitis
 TrueFalse
Some anatomical structures may be misdiagnosed as apical periodontitis
Periapical cement dysplasia needs treatment.
Radicular cyst
 TrueFalse
The pulp is always necrotic in radicular cyst
The tooth is necrotic in traumatic bone cyst
Cervical resorption
 TrueFalse
Cervical resorption begins apical to the junctional epithelium
Int. infl. resorption
 TrueFalse
Canal boundaries always disappear in internal inflammatory root resorption
Ext. infl. rootres.
 TrueFalse
External inflamm. root resorption typically starts 3d - 2 weeks after trauma
Replacem. res.
 TrueFalse
Replacement resorption proceeds rapidly
Inflammatory changes in the bone adjacent to the replacement resorption are usually detected in the radiograph