Sensibility Testing Before RCT — ORE Part 1 MCQ

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EasyEndodonticsSensibility Testing Before RCTORE Part 1

A mandibular premolar has a periapical radiolucency on a periapical radiograph. The patient has no history of trauma. Before deciding whether root canal treatment is indicated, which additional test is essential?

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Correct answer: C — Pulp sensibility testing with cold and/or electric pulp testing

The correct answer is C. A periapical radiolucency supports an apical diagnosis but does not, by itself, establish the pulpal diagnosis or justify root canal treatment. Pulp sensibility testing, using cold and/or electric pulp testing and interpreted with the history, examination and radiograph, is needed to assess the pulp before irreversible treatment. Percussion and palpation assess periradicular inflammation, not pulp sensibility. Bite testing is useful when a crack is suspected, while visual examination may identify caries, restorations or fractures, but neither determines pulpal status. The UK British Endodontic Society guidance also recognises that apical signs may occur with non-endodontic causes such as trauma or occlusal overload; radiographic or periapical signs must therefore not be treated as proof of pulp necrosis.

Reference: British Endodontic Society. The British Endodontic Society Guide to Good Endodontic Practice, 2021. https://www.rcseng.ac.uk/-/media/FDS/The-British-Endodontic-Society-guide-to-Good-Endodontic-Practice.pdf