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Endodontics · single question

A patient has lingering pain to cold stimuli and positive percussion on tooth #X. The correct diagnosis is:

  1. Pulp necrosis with symptomatic apical periodontitis
  2. Asymptomatic irreversible pulpitis with symptomatic apical periodontitis
  3. Symptomatic irreversible pulpitis with symptomatic apical periodontitis
  4. Reversible pulpitis with normal apical tissues
Show answer and explanation

Correct answer: C. Symptomatic irreversible pulpitis with symptomatic apical periodontitis

  • A. Pulp necrosis produces no response to cold (the pulp is dead); this patient has a pain response to cold.
  • B. ASYMPTOMATIC irreversible pulpitis has no spontaneous pain; this patient has lingering pain (symptomatic).
  • C. Correct. Lingering pain to cold indicates IRREVERSIBLE pulpitis (hyperemic/inflamed pulp that cannot recover). Positive percussion indicates apical inflammation (symptomatic apical periodontitis). Together: Symptomatic Irreversible Pulpitis + Symptomatic Apical Periodontitis.
  • D. Reversible pulpitis produces transient pain that resolves quickly with removal of stimulus; lingering pain rules this out.

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