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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 | 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 | 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 | 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 | Painless | Painless | Painful when there is pulp exposure | |||
| Temperature test | 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 | 8-12 mcA | 15-25 mcA | 20-35 mcА | 35 — 45 mcА | – |
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