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Diagnose

1 / 3

A patient presents with a chief complaint of pain in a lower left tooth, which began during biting approximately two weeks ago. Two days prior to examination, the patient reports that the tooth “cracked,” and the pain became unmanageable despite the use of analgesics. The dental history reveals multiple restorations were placed in the same region approximately five years ago. Over the past year, the patient occasionally experienced heightened sensitivity to cold and sweet stimuli. Clinical testing shows that tooth 36 has a negative response to cold sensibility and severe pain on vertical percussion. A periapical radiograph has been obtained. Based on the clinical and radiographic findings, provide your diagnosis.

We are using FDI World Dental Federation notation (also “FDI notation” or “ISO 3950 notation”).

2 / 3

A patient presents with pain in the lower right jaw, preventing her from eating on that side. She reports sensitivity and pain during brushing. Medical history indicates an overlay on tooth 46 placed 7 years ago and a lost filling in the same area 6–7 months ago. Clinically, tooth 46 has lost its crown structure and shows extensive caries. Tooth 47 has an occlusal amalgam with secondary caries, is responsive to cold, and non-tender to percussion. Tooth 46 is non-responsive to cold and painful on vertical percussion. Based on these findings, provide your diagnosis.

3 / 3

A patient reports pain in the third quadrant with heightened sensitivity, even to tap water. Symptoms began approximately one week ago and have worsened, with painkillers no longer effective over the past two days. The patient has experienced sleep disturbances due to the pain.

Clinical examination reveals tooth 37 has an OD amalgam filling with secondary caries and a prolonged response to sensibility testing (approximately 20 seconds), along with minimal sensitivity to vertical percussion. Tooth 36 shows intense pain to sensibility testing and clear tenderness on vertical percussion. It has an occlusal amalgam filling with secondary and distal caries. A periapical radiograph has been taken.

Based on the clinical and radiographic findings, provide your diagnosis.

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