Differential and diagnostic criteria of acute forms of pulpitis

Diagnostic criteria

Diagnosis

Pulp hyperemia

Acute localised pulpitis

Acute diffuse pulpitis

Acute purulent pulpitis

Traumatic pulpitis

Anamnesis; complaints

1

Acute spontaneous pain in affected tooth that lasts 1 – 2 min; “light periods” – 6 – 24 hrs.

Pain attacks are increased at night. Pain arises from all kinds of stimuli, lasts for 1 – 2 min. after their removal. There is no irradiation of pain.

Acute spontaneous attack-like pain, lasts 5 – 10 min.; “light-periods” from 2 hrs. and more. Pain attacks are increased at night. Pain arises from all kinds of stimuli, slowly disappears after their removal. Sometimes could irradiate in adjacent teeth.

Acute spontaneous attack-like pain, from 2 hrs. and more; “light-periods” 10 – 30 min. Pain attacks are increased at night; arises from all types of stimuli in laying position. Irradiation of pain.

Spontaneous, pulsate (throbbing), continuous pain, could be weaken for a few minutes. There is an irradiation of pain. Pain is exacerbating at night and from hot stimulus; relieving factor is cold water. Any of the irritants lead to sharp attack of pain.

Accidental pulp exposure –short-termed acute pain.

During crown fracture – acute pain that irradiates following branches of n. trigeminal. Pain due to all irritants even when breathing air though mouth.

Deepness of carious cavity

2

Carious cavity is medium or deep. Amount of decayed dentine is in correspondence to the course of caries.

Deep carious cavity with great amount of decayed dentine.

Deep carious cavity with great amount of decayed dentine.

Deep carious cavity with great amount of decayed dentine.

In the case of accidental pulp exposure – pink pulp is visible in one point and drop of blood comes out. In the case of traumatic fracture of tooth crown – red pulp is clearly visible.

Probing of carious cavity bottom

3

Painful in a limited part of carious cavity bottom. Pain in a few minutes disappears.

Sharply painful in one point. Pain is preserved for some time after probing is stopped.

All bottom of carious cavity is painful; pain is preserved after stopping of probing.

Sharply painful probing of all carious cavity bottom; roof of the pulp chamber could be easily perforated and drop of pus could come out.

Extremely painful

Vertical percussion

4

Painless

Painless

Painful when there is pulp exposure

Temperature test

5

Pain from cold water that lasts for 1 – 2 min.

Pain from cold or hot water that lasts for some time after irritant removal.

Pain due to cold or hot water; pain irradiates following branches of V cranial nerve.

Cold water relieve pain for few min.

Extremely painful reaction from cold or hot water.

EPT

6

8-12 mcA

15-25 mcA

20-35 mcА

35 — 45 mcА

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