Endodontic Diagnosis

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Endodontic diagnosis requires the following information:

  1. History
    • Pain onset:
      • When did it begin?
      • Is it spontaneous?
    • Duration: Short or lingering?
    • Character: Sharp or throbbing?
  2. Existing Conditions
    • EPT Test, Cold Test, Hot Test, Percussion Test, Palpation
    • Clinical Evaluation for parulus, PPD, mobility, swelling
    • Radiograph Evaluation


Collection of this data should allow diagnosis of the tooth:

Diagnostic Table

CLASSIFICATION OF PULPAL AND PERIRADICULAR DISEASES
PULPAL

Symptoms Provoked Pain Spontaneous Pain Swelling Percussion Palpation EPT Thermal Radiolucency
Vital Healthy Pulp NO NO NO NO NO NO WNL WNL NO
Reversible Pulpitis YES YES NO NO NO NO WNL HYPER-SENSITIVE TO COLD NO
Irreversible Pulpitis YES YES YES NO NO/yes NO + / - + / -
(heat)
NO
Pulp Necrosis NO
(pulpal sx)
NO NO NO NO NO NEGATIVE NEGATIVE YES/NO
PERIRADICULAR
(pulp is necrotic or previous root canal treatment)

Symptoms Provoked Pain Spontaneous Pain Swelling Percussion Palpation EPT Thermal Radiolucency
Acute Periradicular Periodontitis YES
YES
YES/NO
NO
YES
YES/NO
NEGATIVE
NEGATIVE
YES/NO
Chronic Periradicular Periodontitis NO
NO
NO
NO
NO
NO
NEGATIVE
NEGATIVE
YES
Subacute Periradicular Periodontitis
YES
YES
YES/NO
YES/NO
YES/NO
YES/NO
NEGATIVE
NEGATIVE
YES/NO
Acute Periradicular Abcess
YES
YES
YES
YES
YES
YES
NEGATIVE
NEGATIVE
YES/NO
Suppurative Periradicular Periodontitis
NO/yes
NO
NO
Parulus/ Sinus Tract
NO/yes
NO/yes
NEGATIVE
NEGATIVE
YES