Conservative Dentistry and Endodontics
Conservative Dentistry and Endodontics tests caries management, pulp diagnosis, restorative principles, and root canal treatment. Questions focus on diagnosis and safe clinical sequencing.
Core rules
- Reversible pulpitis causes sharp pain to cold that disappears quickly after stimulus removal.
- Irreversible pulpitis causes spontaneous or lingering pain; pulp testing may be exaggerated.
- Necrotic pulp often gives no response to cold and may have apical periodontitis.
- Working length is determined with apex locator and confirmed radiographically; the apical constriction is the ideal endpoint.
- Sodium hypochlorite dissolves organic tissue; EDTA removes smear layer; irrigation must not extrude beyond the apex.
Worked example
A patient has severe spontaneous pain that lingers after cold drink and wakes them at night. The tooth is tender to percussion but has no swelling. The diagnosis is irreversible pulpitis. Spontaneous lingering pain indicates pulp inflammation that will not resolve, so root canal treatment is indicated. Reversible pulpitis would have sharp brief pain, and apical periodontitis alone would not explain the thermal lingering.
Traps
- A nonvital tooth can be asymptomatic; absence of pain does not mean no infection.
- Do not obturate without confirming working length; overextension can injure the inferior alveolar nerve.
- NaOCl extrusion causes severe pain and swelling; manage immediately.
- Composite bonding requires moisture control; contamination reduces bond strength.