Diagnostic criteria
ACUTE SEROUS APICAL PERIODONTITIS
ACUTE PURULENT APICAL PERIODONTITIS
ACUTE DIFFUSE PULPITIS
ACUTE PURULENT PULPITIS
Anamnesis
complaints
The patient feels heaviness and tension in
the tooth, which was like the big, longer
than others. Gradually there is quite a lot
of pain spontaneous nature. The pain is
constant, localized, not radiating, worse
at night and barely suppressed
conventional analgesics. Since the
process is constantly evolving, pain
intensity grows.Also, can occur
characteristic provoked pain. All that can
increase blood flow in the area of the
tooth and change its mobility, provokes
attacks of pain. Yes, there is pain during
eating. In the initial stage, however,
passive, slow, long-term pressing reduces
the pain that is associated with the
outflow of fluid from periodontal reducing
congestion and compression of nerve
endings.
Acute spontaneous continuous pain pulsation
character. Always points to the aching tooth,
he feels as "higher" very painful when
pressed or even if touched his tongue while
talking. Pain enhance existing by heat, while
cold, by contrast. Any physical effort leading
to increased pain.
Acute spontaneous attack-like pain, from 2
hrs. and more; “light-periods” 10 – 30 min.
Pain attacks are increased at night; arises
from all types of stimuli in laying position.
Irradiation of pain.
Spontaneous, pulsate (throbbing), continuous
pain, could be weaken for a few minutes. There is
an irradiation of pain. Pain is exacerbating at night
and from hot stimulus; relieving factor is cold
water. Any of the irritants lead to sharp attack of
pain.
Deepness of
carious cavity
Sick tooth may be intact, that does not
exclude injury (such as when you use
orthodontic appliances). Often, however,
it is caries, devital, with an open cavity of
a tooth filled or a great seal. Enamel loses
its characteristic luster, is gray. It is clear
in the area of apex often hiperemic and
swollen, sometimes existing congestion
and adjacent areas gums.
The patient's tooth may be intact, although its Deep carious cavity with great amount of
color is changed, sometimes significantly
decayed dentine.
carious defects or filling. Pulpova cavity in
most cases closed, but may be open.
Probing of carious
cavity bottom
Probing the bottom of tooth cavity is
painless.
Probing the bottom of tooth cavity is painless.
All bottom of carious cavity is painful; pain
is preserved after stopping of probing.
Sharply painful probing of all carious cavity
bottom; roof of the pulp chamber could be easily
perforated and drop of pus could come out.
Vertical
percussion
painful.
Very painful
Painless
Painless
Temperature test
There are no reactions to temperature
irritants.
There are no reactions to temperature irritants.
Pain due to cold or hot water; pain
irradiates following branches of V cranial
nerve.
Cold water relieve pain for few min.
EPT
Higher than 100 mA
120-150 mA
20-35 mcА
35 — 45 mcА
1
Deep carious cavity with great amount of decayed
dentine