A 11-year-old child complains of pain during eating food, especially hot, in the lower right lateral tooth. On the masticatory surface of the 46 tooth there is a large carious cavity filled with softened light-brown dentin. The cavity is located within parapulpar dentin. In the projection of mesiobuccal pulp horn the carious cavity communicates with the pulp chamber. Deep probing is painful. Electric pulp test — 60 microamperes. Make the diagnosis:

Answer options

1. Acute focal pulpitis
2. Acute diffuse pulpitis
3. Chronic gangrenous pulpitis
4. Chronic hypertrophic pulpitis
5. Chronic fibrous pulpitis

Explanation

There are no typical symptoms of acute pulpitis. (complaints spontaneous pain is typical for all acute pulpitis, the pulp chamber is closed).Chronic pulpitis (pain during eating food, communication with the pulp chamber).Chronic gangrenous pulpitis Deep probing is painful, electric pulp test – 60 microamperes (because is characterized by complete or partial necro-utilization of the coronal pulp and localization of the chronic inflammation process in the root pulp). Chronic hypertrophic pulpitis is characterized by the growth of granulating and young connective tissues in it. Children complain of bleeding «from the tooth» and, very rarely, of pain during eating and toothbrushing. Chronic fibrous pulpitis. pain in case of mechanical irritants or pain caused by temperature changes. However, children may progress asymptomatically, and may only be detected at the regular oral cavity sanitation. Objective examination: a deep carious cavity connected with the pulp chamber; the pulp is dark - red, bleeding, and painful from probing.