Table 1.
Differential diagnosis between acute and chronic pulpitis | ||
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Criteria | Acute pulpitis | Chronic pulpitis |
Dental history | First dental pain in the causal tooth which goes to dental emergencies | More episodes of dental pain caused which did not lead the patient to go at dental emergencies |
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Painkiller | Pain does not respond to analgesics | Pain goes to analgesics |
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Pain type | Intense, sharp, progressive | Dull or annoying |
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Onset | Suddenly, fulminatory | Insidious |
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Duration/time frame of occurrence | From a few hours to 24–48 hours | From several minutes to several hours (up to 2 hours) |
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Pain location | Irradiance, diffuse | Located |
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Stimulus | Heat and cold | A painful embarrassment often felt during chewing |
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Percussion in the tooth | Positive response | Negative response |
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Pulp test | Hyperexcitability at a lower intensity of thermal stimulant | Hypoexcitability at a higher intensity of thermal stimulant |
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Causes | Primary acute deep tooth decay or fillings adjacent but with pulp chamber closed | Primary chronic dental caries or recurrent under fillings adjacent but with pulp chamber closed or open. Affected teeth with dental erosion or vital teeth prepared for fixed prosthetic crown. |
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Radiograph | Coronary radiolucent areas (caused by tooth decay or erosion) or radiolucent coronal dentin under a filling but very close to the celling of pulp chamber |