Endodontics · single question
A patient with osteoporosis on denosumab is a Kennedy Class I partial-denture wearer with a precision attachment on tooth #21. The tooth has Class III mobility, is non-responsive to cold, is tender to percussion, and shows bone resorption to the middle third of the root with an inflamed (not infected) periodontal ligament. What is the pulpal diagnosis of tooth #21?
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Correct answer: A. Pulp necrosis with symptomatic apical periodontitis
No response to cold indicates pulp necrosis, and percussion tenderness indicates periradicular inflammation (symptomatic apical periodontitis).Other options: Reversible/irreversible pulpitis would still respond to cold; a normal pulp would not be percussion-tender.Key exam takeaway: No cold response + percussion tenderness = necrotic pulp with symptomatic apical periodontitis.