Normal Pulp Reversible Pulpitis (Hyperaemia Of Pulp) Symptomatic Irreversible Pulpitis Total Necrosis Of Pulp Suppurative Pulpitis Apical Periodontitis Of Vital Teeth Apical Periodontitis Of Non Vital Teeth Acute Apical Abscess Relieved By Clenching Of Teeth Chronic Apical Abscess

1. ENDODONTIC DIAGNOSIS
DIAGNOSIS OF DIFFERENT
COMMON
ENDODONTIC CONDITIONS

2. CONTENTS
• Normal Pulp
• Reversible Pulpitis (Hyperaemia Of Pulp)
• Symptomatic Irreversible Pulpitis
• Total Necrosis Of Pulp
• Suppurative Pulpitis
• Apical Periodontitis Of Vital Teeth
• Apical Periodontitis Of Non Vital Teeth
• Acute Apical Abscess Relieved By Clenching Of
Teeth
• Chronic Apical Abscess

3. NORMAL PULP
• Normal pulp is basically asymptomatic, but if some
stimulus is applied then there is mild transient pain
(sensitivity) until the stimulus is there.
• Thermal test – mild transient response which
subsides when stimulus is removed, telling that the
pulp is vital.
• Electric test – mild transient response to tell the
vitality of the pulp or to tell the health of the nerve
fibers which are present.
• Percussion – no pain on percussion. (this test is done
for the health of the periapical periodontal
ligaments).

4. 1) REVERSIBLE PULPITIS
(HYPERAEMIA OF PULP)
• Pulpitis means hyperaemia i.e inflammation
of the pulp. When there is inflammation of
the pulp, since pulp is a closed cavity there
will be a build up of pressure & that will be
hurting the nerves present in the pulp & that
will elicit the pain.
• If it is reversible that means it can be reversed,
the injury can be healed. We can reverse it by
simply providing the restoration to the tooth.

5. • Type of pain – usually asymptomatic, vague
pain of short duration (usually 5 minutes) or
on application of cold.
• Thermal test – quick sharp hypersensitivity
that subsides when stimulus is removed.
• Electric test – response at lower currents
threshold level decreased.
• Percussion – percussion sensitive.

6. 2)SYMPTOMATIC IRREVERSIBLE
PULPITIS
• Type of pain – spontaneous unprovoked pain during
nights which is continuous in nature. When the patient is
in lying down condition, the total pressure in the pulp
increases leading to more venous return and more pain.
Aggravated by heat, relieved by cold as cold can lead to
vasoconstriction further relieving the pressure in the pulp
cavity & will relieve some symptoms.
• Thermal test – painful response to cold & heat stimulation
that lingers longer when stimulus is removed.
• Electric test – response required higher currents
compared to normal tooth.
• Percussion – sensitive.

7. 3) TOTAL NECROSIS OF PULP
• The whole pulp is dead, there is no nerve
fiber, no vascularity in that area. That means
there will be no response to anything.
• There will be a history of previous continuous
pains.
• Thermal test – no response
• Electric test – no response
• Percussion – no response/ no sensitivity.

8. 4) SUPPURATIVE PULPITIS
• Type of pain – there will be throbbing pain
aggravated by heat, relieved by cold.
• Thermal test – no response
• Electric test – no response
• Percussion – tender to percussion because the
inflammation has reached the periapical area
where the periodontal ligaments are there.

9. 5) APICAL PERIODONTITIS OF
VITAL TEETH
• This basically occurs due to occlusal trauma,
due to inflammation of periapical ligaments.
• Type of pain – pain on clenching of teeth &
localized mild, dull, constant pain.
• Thermal test – no response
• Electric test – no response
• Percussion – tenderness due to inflammation
of PDL.

10. 6) APICAL PERIODONTITIS OF
NON VITAL TEETH
• There will be a history of previous continuous
pains, mild dull & constant pains.
• Thermal test – no response
• Electric test – no response
• Percussion – tenderness due to inflammation
of PDL.

11. 7)ACUTE APICAL ABSCESS
RELIEVED BY CLENCHING OF
TEETH
• Type of pain – swelling with throbbing pain
• Thermal test – no response
• Electric pulp- no response
• Percussion – tenderness & mobility

12. 8) CHRONIC APICAL ABSCESS
• Acute apical abscess when treatment is not
given it becomes the chronic apical abscess.
• There will be absence of symptoms or history
of previous pain.
• Thermal test – no response
• Electric test – no response
• Percussion – occasional slight tenderness.