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Why do we need to classify pulpal and periradicular diseases?
- 1. To determine the treatment plan (RCT, surgery, antibiotics)
- 2. To assess the treatment outcome (diagnosis affects prognosis)
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What is Reversible pulpitis?
- A reactive inflammatory process
- radiographically normal
- pain with pressure and temperature
- self limiting inflammation with time and insult removal
- Monitor first before RCT
- EX: incipient caries, acute trauma, restorative procedure
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Visual example of reversible pulpitis
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What is irreversible pulpitis?
- Irreperable pulpal injury
- Spontaneous sharp pains
- sensitive to cold/hot (lingering sensitivity)
- Can progress to necrosis if untreated
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Image of irreversible pulpitis
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What is pulpal necrosis?
- Complete loss of vitality
- Mostly asymptomatic
- Can be partially necrotic in multi-rooted teeth
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What is hyperplastic pulpitis?
- Pulp polyps
- prevalent in young patients
- usually asymptomatic
- highly vascularized
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Acute periradicular periodontitis
- Main issues are with pressure. Cannot chew
- always linked with pulpal diseaseNo PARL, but thickened PDL
- Needs RCT
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Chronic periradicular periodontitis
- Occasional 'acting up'. No major symptoms
- Always linked with infected pulp necrosisDistinct PARL radiographically
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Acute periradicular abscess
- Facial swelling and extreme pain
- ALWAYS linked with pulp necrosisDistinct PARL
- Needs incision and drainage with antibiotics
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Chronic periradicular abscess
- No major symptoms
- Always linked with pulp necrosis
- radiographically distinct PARL
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Chronic periradicular Abscess
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Condensing osteitis
- Variant form of CPP
- Increase in bone density
- Little or no pain
- Linkd with necrotic pulp in mandibular molars
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Endodontic diagnosis chart
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Characteristics of pulpal diseases
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