Endodontics · single question
A patient has pain on percussion but NO response to cold testing. What is the PULPAL diagnosis?
Show answer and explanation
Correct answer: B. Pulp necrosis
No cold response + pain on percussion = pulp necrosis (dead pulp) with periapical inflammation (symptomatic apical periodontitis).
- A. Symptomatic irreversible pulpitis has a POSITIVE, lingering cold response (>10 seconds) with spontaneous pain. No cold response rules this out.
- B. CORRECT. Pulp necrosis = no response to cold (necrotic pulp cannot transmit thermal stimuli). Pain on percussion indicates periapical inflammation (symptomatic apical periodontitis) from bacterial by-products irritating the PDL.
- C. Reversible pulpitis has a brief positive cold response that resolves quickly. No cold response rules this out.
- D. Normal pulp has a brief, normal cold response with no percussion sensitivity.