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Symptomatic irreversible pulpitis — NDEB AFK MCQ

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HardEndodonticsSymptomatic irreversible pulpitisNDEB AFK

A 35-year-old has spontaneous lingering pain from tooth 4.7. Cold testing causes pain lasting over 60 seconds, percussion is normal, and a periapical radiograph shows a deep restoration close to the pulp without apical change. What is the most appropriate treatment?

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Correct answer: B — Root canal treatment or pulpectomy

Spontaneous lingering cold pain with a deep restoration and no apical signs is most consistent with symptomatic irreversible pulpitis, for which pulpal treatment is required. Antibiotics do not treat confined pulpal inflammation without spreading infection. The pearl is that lingering thermal pain localizes pulpal disease before periapical radiographic changes are visible.

Reference: Canadian endodontic teaching standards; NDEB KSAs 2024