| PULPAL DIAGNOSIS |
CLINICAL FINDINGS |
RADIOGRAPHIC FINDINGS |
ENDODONTIC TREATEMENT ASSUMING TOOTH IS RESTORABLE |
| Normal pulp |
- Pulp is vital
- Patient is asymptomatic
- Gingival retraction: may cause symptoms due to fluid movement inside dentinal tubules
|
|
- No endodontic treatment
- Non-surgical root canal treatment for prosthetic or periodontal reasons
|
| Reversible pulpitis |
- Pulp is vital with some degree of inflammation
- Symptoms: from none to intense
- Pain: Mainly to cold
- Pain subsides after stimulus is removed
- No carious pulp exposure
|
|
- Removal of the etiologic factor, normally caries, and placement of restoration or sedative filling
- Non-surgical root canal treatment for prosthetic or periodontal reasons
- Emergency treatment may be required
|
| Irreversible pulpitis |
- Pulp is vital with severe degree of inflammation
- Symptoms: from none to intense
- Pain: may be spontaneous, poorly localized
- Pain to hot and/or to cold
- In some cases, cold relives pain
- Pain lingers for several seconds after stimulus is removed
- May present with pain to percussion
- May present with carious pulp exposure
|
- Normal PDL space
- Some cases may present with “thickened” PDL space
|
- Non-surgical root canal treatment
- Emergency treatment is required
|
| Necrotic pulp |
- Pulp is non-vital
- Symptoms: from none to intense
- Pain: Present when inducing periradicular disease
|
- May or may not present with periradicular lesion
|
- Non-surgical root canal treatment
- Emergency treatment may be required
|
| Previously treated |
- Previous endodontic treatment detectable radiographically
- Symptoms: from none to intense
- Normally, no sensitivity to thermal stimuli
- Pain: present when inducing periradicular disease
|
- May or may not present with bone resorption
|
- Non-surgical root canal retreatment
- Surgical root canal treatment
- Emergency treatment may be required
|
