Diagnosis

Signs and Symptoms

Radiographic Appearance

Response to Pulp Testsi Response Response Response (may be extreme and/or lingering)

Response to Periapical Testsii

Pulpal Diagnosis
Normal Pulp (NP)iii Reversible Pulpitis (RP) Symptomatic Irreversible Pulpitis (SIP)5 None May have Sharp Pain Sharp Pain, but may have Deep, Dull, Gnawing Pain, Spontaneous Pain, Referred Pain, or a Past History of Pain None, but may have a Past History of Pain No Response No Response No Response

Asymptomatic Irreversible Pulpitis (AIP)iv Pulp Necrosis (PN) Previously Treated (PT)v Previously Initiated Therapy (PIT)6

Response No Response No Response With or Without Response

Periradicular (Periapical) Diagnosisvi

Normal Apical Tissues (NAT)vii Symptomatic Apical Periodontitis (SAP)ix None (WNL)viii Pain No Periapical Changes 1. No Significant Changes (may have widened pdl) or 2. Apical Radiolucency Apical Radiolucency With or Without Apical Radiolucency With or Without Apical Radiolucency Radiopacity, may be framing a coexistent radiolucency None (WNL) Painful Response

Asymptomatic Apical Periodontitis (AAP)x Acute Apical Abscess (AAA)xi Chronic Apical Abscess (CAA)xii Condensing Osteitis (CO)xiii

None (WNL) Swelling With or Without Pain Sinus Tract Without Pain (usually) With or Without Pain

None (WNL) With or Without Painful Response Usually No Response With or Without Response

Pulp Tests are sensitivity tests that include (+), Hyper-Responsive (++), or Not Applicable (NA). (++) or Severe (+++). iii Also referred to as Healthy Pulp (HP) UNC 2006. perplastic Pulpitis (Pulp Polyp) is a form of Irreversible Pulpitis. v More a finding or observation, but used as a diagnostic term. vi Radiolucencies and/or Radiopacities of Non-Endodontic Origin that normally respond to Pulp Tests are not included. Other terms include Non-Endodontic Pathosis or Lesions of Non-Endodontic Origin. vii Also referred to as Healthy Periodontium, Normal Periodontium. viii WNL = Within Normal Limits; usually includes none to mild signs, symptoms, or responses. ix Also referred to as Acute Apical Periodontitis, Acute Periradicular Periodontitis, Subacute Periradicular Periodontitis. When associated with an apical radiolucency, also termed Acute Exacerbation of Acute Apical Periodontitis (AECAP) UNC 2006. x Also referred to as Chronic Apical Periodontitis, Chronic Periradicular Periodontitis. xi Also referred to as Apical Periodontitis with Abscess, Acute Periradicula Abscess. Periodontitis. s.