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Dentistry Today 2004-May

Endodontic diagnosis. Mystery or mastery?

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John D West

キーワード

概要

Review of 6 clinical distinctions: (1) Symptom: "anything under the sun."

METHODS

pulp exposure. Duplicate: clinical or radiographic pulp exposure evidence.

METHODS

endodontics or pulp cap under strict protocol conditions. (2) Symptom: "cold."

METHODS

hyperemia. Duplicate: ice.

METHODS

pulp protection or endodontics. (3) Symptom: "heat."

METHODS

pulpitis. Duplicate: heat.

METHODS

pulpotomy for multirooted teeth or pulpectomy for single-rooted teeth. Schedule endodontic completion. (4) Symptom: "I recently had a toothache and now it is gone."

METHODS

necrosis. Duplicate: Electric Pulp Test and ice are negative.

METHODS

endodontics. (5) Symptom: "I had a toothache awhile back and now it is gone."

METHODS

LEO. Duplicate: Electric Pulp Test, ice, and test cavity are negative.

METHODS

endodontics. (6) Symptom: "It really hurts to touch my tooth."

METHODS

percussion. Duplicate: may or may not have a LEO and may or may not have cellulitis.

METHODS

reduce occlusion, access cavity, water chew, and schedule to finish endodontics. If these tests are carefully performed, then they are objective and the doctor does not have to be in a subjective situation. A newfound sense of endodontic diagnostic mastery is experienced. Perhaps the best way to summarize the simplicity of this clinical diagnostic scheme is to quote Sherlock Holmes: "Nothing is more deceptive than the obvious."

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