Diagnostic aids in endodontics /certified fixed orthodontic courses by Indian dental academy

Diagnostic aids in endodontics

INDIAN DENTAL ACADEMY
Leader in Continuing Dental Education
www.indiandentalacademy.com

Contents
Introduction
Case history
Clinical examination
Diagnostic tests
Visual and tactile inspection
Palpation
Percussion
Mobility and depressibility test
Electric pulp testing
Thermal test
Anesthetic test
Test cavity
Transillumination
Staining
Wedging
Radiographs

Advances

 Xeroradiography
 RVG
 Digital subtraction radiography
 TACT
 Pulse oximetry
 LDF
 Liquid cholesterol method
 Infrared thermography (Hughes Probeye camera)
 Computed tomography
 MRI

References
conclusion


INTRODUCTION


Diagnosis can be defined as :

“The translation of data gathered by clinical and
Radiographic examination in to an organized,
classified definition of the conditions present”.


Diagnostic sequence
 Demographic information with respect to name, age, sex etc
 Chief complaint and history of present illness
 Medical and dental history
 Clinical examination
 Radiographic findings
 Other tests, laboratory values or consultations if required
 Provisional diagnosis / diagnosis
 Treatment plan www.indiandentalacademy.com

 Presenting Symptoms;
Subjective symptoms
Objective symptoms

 Pathway to correct clinical diagnosis;
Case history
Clinical examination
Diagnostic tests investigations


 Dental history
PAIN:
Type of pain
Duration of pain
Localization of pain


 Clinical examination:
Extraoral examination
Intraoral examination

 DIAGNOSTIC TESTS :
 visual & tactile inspection:-
soft tissue: Hard tissue:
colour Colour
contour Contour
consistency consistency

 Palpation :-
 Percussion :-www.indiandentalacademy.com

Mobility and depressibility test:
as classified by:

 Grossman & Cohen
 Miller


Electric pulp testing (EPT)

Advantages
Comfortable for patients
Digital display

Disadvantages
Interferes with cardiac pacemakers
Teeth with immature apex
Recently traumatized teeth
No indication about vascular supply


 Pulp tester classification:
Monopolar
Bipolar

 False positive response

 False negative response


Commercially available pulp testers
 Digilog pulp tester
 Parkell pulp tester
 Analytic technique tester
 Pelton crane system
 Greenwood pulp tester
 Neosono ultima EZ-apex locator + pulp tester


Thermal tests
 Heat test-
Warm stick temporary stopping
Hot water bath
Hot air
Hot burnisher
 Cold test-
Ice sticks
Compressed gases
CO2 snow
Ethyl chloride


Anesthetic testing:

Test cavity

Transillumination:


Staining

Wedging

Radiography


Advances
 Xeroradiography -
Based on electrostatic process
Types:
Medical 125 system
Dental 110 system


 Radiovisiography
3 components of RVG

Advantages
Elimination of x-ray film
Reduction in exposure time
Instant image display

Digital subtraction radiography

Can detect 0.12 mm change in thickness of cortical bone

Useful in:
Evaluating osseous healing
Accurate detection of active disease


TACT

consists of:

 Standard radiographic unit
 Digital image acquisition device
 TACT software

Uses
visualization of canals
Detection of secondary caries
Diagnosis of external root resorption


Pulse oximetry
Probe sensor consists of:
Two LED
 red light ( 640 nm)
 infrared light (960 nm)
Photo detector

Avg value
 O2saturation 94% ( tooth )
 PR = 72 / min


Laser Doppler flowmetry

 Used to assess blood flow
 HeNe or diode lasers used


Liquid cholesteric crystal
method
 Introduced by Howell (1970)
 inference

Vital Non Vital

blue-green red

Red-green yellow

green yellow-red

Infrared Thermography
 (Hughes probeye camera)

Can detect temperature changes as
small as 0.10 C .
Consists of :
Thermal video system
Silicon close-up lens

Spiral CT


Micro CT


Magnetic resonance imaging


Advantages of MRI

• It offers the best resolution of tissues of
low inherent contrast.

• No ionizing radiation is involved with MRI

• Direct multiplanar image is possible without
reorienting the patient.

Disadvantages:
 Long imaging time.

 Potential hazard imposed by the presence of ferromagnetic
metals in the vicinity of the imaging magnet.


References
1. Pulse oximetry as a diagnostic tool of pulp vitality .JOE,1991
vol 17 ,488-90
2. Pulpal blood flow assessed by laser Doppler flowmetry in a tooth
with horizontal root fracture. Oral surgery oral med oral path,feb
1996,vol 81, 229-33
3. Three dimensional quantization of periradicular bone destruction
by micro-computed tomography. JOE,2003 vol 29 , 252-56


Conclusion


Diagnostic aids in endodontics /certified fixed orthodontic courses by Indian dental academy

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