Irreversible pulpitis with periapical pathosis
Irreversible pulpitis with periapical pathosis
A pulpal condition similar to above, but in which periapical or lateral radiographic changes are evident.
SIGNS AND SYMPTOMS
Pain
- May have acute or chronic symptoms. Sharp, exaggerated, painful response to thermal stimulus; pain lingers after stimulus is removed.
- Pain may be spontaneous; maybe past repeated episodes of pain, often continuous pain.
- Pain with mastication.
Etiology
- Deep caries and/or restorations, evidence of previous pulp cap.
- Exposed dentin (attrition, abrasion, and erosion).
- Traumatic injuries.
- Resorption (especially perforating).
- Orthodontic forces.
Radiology
- May be normal.
- Radiographic evidence may reveal normal pulp, calcifications, narrow pulp chamber, “calcified” canals, , or condensing osteitis.
- An enlarged PDL may also be present.
DIAGNOSTIC TEST RESULTS
EPT
Tooth may test within normal limits. Response may be markedly different from control, rapid/delayed onset, persistent, and may be of severe intensity.
Thermal Test
A key factor in making a diagnosis. May be abnormal, rapid/delayed onset, greater intensity and longer duration.
Percussion Test
May or may not be positive.
Palpation
May or may not be positive.
Endodontic Treatment IS Needed
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Category: Endodontics
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