A 25-year-old male has lingering pain on his upper right central incisor for more than 12 seconds with cold testing. The tooth is NOT tender to percussion and has NO periapical changes on radiograph. What is the pulpal diagnosis?

Correct answer: A. Symptomatic irreversible pulpitis

• A. Correct. Symptomatic irreversible pulpitis is characterized by lingering pain after stimulus (>5–12 seconds), possible spontaneous/nocturnal pain. No TTP and no periapical changes indicate the periodontium is not yet affected.
• B. Incorrect. A normal pulp may respond briefly to cold but NOT with a lingering response exceeding 12 seconds.
• C. Incorrect. Symptomatic apical periodontitis would show tenderness to percussion (TTP) and possibly periapical changes. This tooth has neither.
• D. Incorrect. Reversible pulpitis produces pain that subsides quickly (<1–2 seconds) after stimulus removal. Lingering pain >5 seconds indicates irreversible pulpitis.