牙体牙髓病诊断学

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1、DIAGNOSISINENDODONTICSPRIYACHAND,M.S.DDEPT.OFENDODONTICSDIAGNOSISDiagnosisisanart.Itinvolveslearningskillsofevaluationandknowinghowtointerprettheresponsesthattheclinicianreceivesfromthepatient.Evenforthefinestclinician,therewillbetimeswhenthediagnosi

2、sisindoubt.Inthoseinstances,itisbesttopostponeinitiatingtreatment.Symptomswillusuallylocalize.OBJECTIVESOFADIAGNOSISTodetermineneedforappropriatetreatment(doesthisrequireendo,periointerventionetc.)Todeterminethosecasesdeemedtobetoocomplexforthelevelo

3、ftraining,experienceandexpertiseofthepractitionerTodetermineifitisnecessarytoconsultorrefertootherhealthprofessionalsDIAGNOSTICTESTSThermaltestElectricPulpTestSinusTractTracingRadiographsSelectiveanesthesiaPercussionPalpationPeriodontalprobingSYSTEMO

4、FDIAGNOSISRadiographicexaminationperiapicalchangesperiodontaladjacentteethCariesDeterminepathosisandpotentialetiologyREVIEWONESTRUCTUREATATIMEDIAGNOSISRADIOGRAPHICEVALUATIONKnownormalstructuresIfpulptestsvital,PAlesioncouldbenormallandmarkorothertyp

5、eofpathologyMultiplefilmsfromdifferentanglesPAlesionshouldremainatapexregardlessofangleDIAGNOSISRADIOGRAPHSBrynolf,SwedDentJ,1970Correctdiagnosisfromsinglex-ray:74%ofcasesCorrectdiagnosisfrom3x-raysatdifferentangles:90%ofcasesAgoodqualityradiographic

6、imageisessentialRADIOGRAPHSBender,Seltzer,JADA,1961Lesionsincancellousbonecannotbedetectedradiographically.ThelesioncanbedetectedwhenthereiserosionorperforationofinnercorticalbonePulpcanbenecroticwithnoPAlesionEarlystagesCorticalbonemustbeinvolvedtob

7、evisibleRADIOGRAPHICEVALUATIONKnownormalstructuresIfpulptestsvital,PAlesioncouldbenormallandmarkorothertypeofpathologyMultiplefilmsfromdifferentanglesPAlesionshouldremainatapexregardlessofanglePulpcanbenecroticwithnoPAlesionInnerCorticalbonemustbeinv

8、olvedforalesiontobevisiblePULPVITALITYTESTSThermaltestsColdTestHeatTestELECTRICPULPTESTINGDoesnotmeasuredegreeofhealthordiseaseinpulpYesorNoresponseResultsmustbecomparedtootherteethFalsepositive--Largemetalrestoration,wettooth,touchinggingivaFalseNeg