In order to render proper treatment, a complete endodontic diagnosis must include both a pulpal and periapical diagnosis for each tooth evaluated. Coupled with this are the limitations associated with current pulp testing modalities, as well as clinical and radiographic examination techniques. Clinicians must recognize, however, that diseases of the pulp and periapical tissues are dynamic and progressive as such, signs and symptoms will vary, depending on the stage of the disease and patient status. This article will define each diagnostic term and describe each condition’s typical clinical and radiographic characteristics in addition, representative case examples will be provided, when appropriate. Both the AAE and American Board of Endodontics have accepted these terms and recommend their use across all dental disciplines and health care professions.
Attendees also sought to resolve concerns about testing and interpretation of results, and determine the radiographic criteria, objective test results, and clinical criteria needed to validate the diagnostic terms established at the conference. 1 The goals were to propose universal recommendations regarding endodontic diagnoses, and develop standardized definitions of key diagnostic terms that will be generally accepted by endodontists, educators, test construction experts, third parties, generalists, specialists and students. In 2008, the American Association of Endodontists (AAE) held a consensus conference to standardize diagnostic terms used in endodontics. A simple and practical system that uses terms related to clinical findings is essential, and will help clinicians understand the progressive nature of pulpal and periapical disease, directing them to the most appropriate treatment approach for each condition. This could include performing endodontic therapy when it is not needed, or providing no treatment or some other therapy when a root canal procedure is truly indicated.Īnother important purpose of establishing a universal classification system is to allow for effective communication between educators, clinicians, students and researchers. 3,4 For example, incorrect assessment may lead to improper management. 2 A key purpose of establishing a proper pulpal and periapical diagnosis is to determine appropriate clinical treatment. 1 Unfortunately, the majority of them have been based upon histopathological findings, rather than clinical findings - often leading to confusion, misleading terminology and incorrect diagnoses.
Historically, there have been a variety of diagnostic classification systems advocated for determining endodontic disease. Establishing a proper pulpal and periapical diagnosis is key to determining appropriate clinical treatment
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