Endodontics · patient case question
What is the diagnosis for tooth #4?
Patient case: Full-Mouth Pulpal Diagnosis
demo: 46-year-old female
chief: “Several of my teeth on the upper right have been bothering me in different ways.”
history: Non-contributory. No medications.
meds: None
findings: Tooth #2: no response to cold, painful to percussion and palpation, periapical radiolucency. Tooth #3: sharp pain to cold that lingers more than 20 seconds. Tooth #4: exaggerated but non-lingering response to cold, deep restoration. Tooth #5: pain on biting, tender to percussion, widened PDL at the apex.
Show answer and explanation
Correct answer: B. Reversible pulpitis
- A. Asymptomatic irreversible pulpitis is diagnosed when there are no symptoms but the pulp is judged incapable of healing, often after caries excavation exposes the pulp.
- B. Correct. An exaggerated response that resolves promptly once the stimulus is removed is the definition of reversible pulpitis. Removing the irritant — here the deep restoration and any caries — should resolve it.
- C. A normal pulp gives a response proportional to the stimulus, not an exaggerated one.
- D. The absence of lingering is what separates this from irreversible pulpitis.