Reversible Pulpitis Diagnosis — ORE Part 1 MCQ

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EasyEndodonticsReversible Pulpitis DiagnosisORE Part 1

A 45-year-old patient presents with deep caries in the lower left first molar. The tooth responds sharply to cold testing, with pain resolving within 5 seconds of stimulus removal. There is no spontaneous pain and no tenderness to percussion. What is the pulp diagnosis?

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Correct answer: E — Reversible pulpitis

The correct answer is E: Reversible pulpitis. The clinical presentation is diagnostic: sharp pain to cold stimulus resolving within 5 seconds, absence of spontaneous pain, and absence of percussion tenderness are the hallmark findings of reversible pulpitis. The deep caries has caused mild, localised pulp inflammation that remains responsive to stimulation but resolves when the stimulus is removed, indicating the pulp retains its capacity for recovery if the carious stimulus (the deep caries) is removed. Option C is incorrect because normal pulp does not exhibit painful response to cold, only a normal sensation. Option B (symptomatic irreversible pulpitis) requires either spontaneous pain or lingering pain persisting after stimulus removal—neither is present here. Option D (pulp necrosis) would show no response to cold testing. Option A (asymptomatic irreversible pulpitis) would be asymptomatic to testing, contradicting the sharp cold response observed.

Reference: American Association of Endodontists (AAE) diagnostic classification and international endodontic diagnostic criteria as applied in clinical practice and endorsed by UK specialist training (FGDP, BDA Specialist Group in Endodontics). Gold-standard diagnostic framework adopted across UK dental education and practice. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769305/