FREE AGD Endodontic Diagnosis and Treatment Questions and Answers

Question 1

A 35-year-old patient presents with a chief complaint of a sharp, shooting pain on tooth #19 when biting down on hard foods, which disappears immediately upon release.
Cold testing elicits a brief, sharp response, but there is no lingering pain or spontaneity.
Percussion and palpation are within normal limits.
A periapical radiograph shows no abnormalities.
A focused bite test with a Tooth Slooth on the mesiolingual cusp reproduces the sharp pain upon release.
What is the most likely diagnosis?

Accepted Answer

Cracked Tooth Syndrome

Answer

Reversible Pulpitis with Symptomatic Apical Periodontitis

Answer

Symptomatic Irreversible Pulpitis

Answer

Dentin Hypersensitivity

Question 2

A patient presents for an emergency visit complaining of intense, spontaneous, throbbing pain in the lower right quadrant that has been waking them up at night. The pain lingers for several minutes after drinking cold water. Tooth #30 has a large carious lesion. It is severely tender to percussion. A periapical radiograph reveals a distinct widening of the periodontal ligament space around the apices. According to the American Association of Endodontists (AAE) diagnostic terminology, what is the correct pulpal and periapical diagnosis?

Accepted Answer

Symptomatic Irreversible Pulpitis and Symptomatic Apical Periodontitis

Answer

Pulp Necrosis and Asymptomatic Apical Periodontitis

Answer

Reversible Pulpitis and Normal Apical Tissues

Answer

Asymptomatic Irreversible Pulpitis and Chronic Apical Abscess

Question 3

Which of the following is the primary objective of pulp sensibility testing, such as cold tests or the electric pulp test (EPT)?

Accepted Answer

To assess the presence or absence of nerve response (sensibility) in the pulp.

Answer

To determine the vascular supply (vitality) of the pulp.

Answer

To definitively distinguish between a periapical cyst and a granuloma.

Answer

To measure the extent of bacterial invasion into the dentinal tubules.

Question 4

A patient has a non-vital maxillary central incisor with a large, well-defined periapical radiolucency. There is a history of trauma from 10 years prior. The tooth is asymptomatic and not tender to percussion or palpation. A sinus tract is present on the facial gingiva, which traces back to the apex of the incisor. What are the most likely pulpal and periapical diagnoses?

Accepted Answer

Pulp Necrosis and Chronic Apical Abscess

Answer

Previously Treated and Symptomatic Apical Periodontitis

Answer

Symptomatic Irreversible Pulpitis and Acute Apical Abscess

Answer

Normal Pulp and Asymptomatic Apical Periodontitis

Question 5

When diagnosing a primary endodontic lesion with secondary periodontal involvement, what is the typical initial treatment sequence that offers the best prognosis?

Accepted Answer

Initiate root canal therapy first, then re-evaluate the periodontal condition after a healing period.

Answer

Perform periodontal surgery first, followed by root canal therapy after 3 months.

Answer

Extract the tooth as combined lesions have a hopeless prognosis.

Answer

Prescribe systemic antibiotics for one week, followed by simultaneous endodontic and periodontal treatment.

Question 6

Radiographically, which feature is traditionally considered more suggestive of a periapical cyst rather than a periapical granuloma, although it is not a definitive diagnostic criterion?

Accepted Answer

A large (>1 cm), well-circumscribed radiolucency with a distinct corticated border.

Answer

A small, diffuse radiolucency with ill-defined borders.

Answer

A radiopacity surrounding the apex, consistent with condensing osteitis.

Answer

Evidence of external root resorption on the associated tooth.