A tooth very painful to percussion, doesn’t respond to heat, cold or the electric pulp tester. The most probable diagnosis is:
- a. Reversible pulpitis.
- b. Irreversible pulpitis.
- c. Acute apical periodontitis.***
What does it mean when a tooth doesn't respond to cold?
No response — if a patient doesn't respond to cold, then the nerve supply to that tooth is diminished. This may be a sign of pulpal necrosis or in previously root-treated canals.
What if there is no response to Endo Ice test?
Endo Ice is so cold it will actually penetrate a casting. If there is no response from the cold test, you must assume that the tooth is necrotic (nonvital). You can, however, test adjacent teeth to get a general sense of the patient's response to cold.
Why is my tooth not tender to percussion?
The fact that the tooth is not sensitive to percussion only tells us that the inflammation has yet to spread to the periapical tissues. It must be remembered that pulps die in a coronal to apical direction.
What causes a tooth to be tender to percussion?
Percussion pain or tenderness is generally interpreted as a sign of apical inflammation. Since this is usually caused by bacterial infection of necrotic pulp tissue, percussion tenderness may indirectly indicate a non-vital pulp.