Dentaltown March 2020 - 51

Yes! I remember reading that somewhere now! OK, so this condition doesn't happen very
frequently, and it's very distinct in its appearance. If there's not a name for it, I think we should
come up with one.
How about: acute gangrenous pulpitis (AGP)?
Basically this is like "partial necrosis" but would be associated with the specific pain and
symptoms we're talking about. The gangrenous part is the best way I could think of to describe
the pulpal death/pressure build-up sort of presentation. ■

palmers31
Member Since: 07/30/08
Post: 16 of 81

8/19/2019

Endo1234567, I'll go along with this. We've all entered what we are sure is a necrotic pulp,
only to discover acute vitality. Who cares which fibers survive? If any part of the pulp is alive, I
think this is the correct diagnosis. Pain is still relieved when the pulp is removed. ■

almunk
Member Since: 12/17/05
Post: 17 of 81

8/19/2019

For what it's worth, I remember endo faculty describing "partial necrosis" as often causing
severe pain that is only relieved by cold. It looks like it's one of those terms that not all endodontists agree on. ■

Adam W
Member Since: 08/04/11
Post: 18 of 81

8/19/2019

davidqcy

Liquefactive necrosis. ■
8/19/2019

Member Since: 05/16/01
Post: 20 of 81

palmers31

Yes! This is what I was thinking of! ■
8/19/2019

This I do know. That type of tooth must be seen immediately. Relieving pain for them with
an RCT will get a big "thank you" and a loyal-for-life patient. Phoning in abiotic and pain meds
doesn't cut it when they have to keep cold on it for relief.
Symptomatic irreversible pulpitis, or "hot tooth." ■

Member Since: 07/30/08
Post: 25 of 81

TuttleNumbNow
Member Since: 11/02/15
Post: 29 of 81

8/19/2019

I was taught that if a patient presents with ice water relieving their pain, by definition it
was acute suppurative pulpitis. My instructor described it as the worst possible tooth pain you
can get. In my office, this patient goes directly into a treatment chair and does not wait even a
minute in the waiting room. I do not care if the person has insurance or not, my job is to relieve
their intense pain ASAP. ■

Long Span Bridge
Member Since: 03/10/03
Post: 35 of 81

8/20/2019

Acute suppurative pulpitis. Those are the words I was trying to remember. I just call it a "hot
tooth" in my charting. Happily rare, but like you, it is one of those "got to do this right now"
type of emergencies. ■

raclro
Member Since: 08/17/05
Post: 36 of 81

8/20/2019

Wouldn't suppuration indicate pus? These teeth are usually dry when opened up. It's
funny that we can't all agree on what to call this condition! (Just another plug for acute
gangrenous pulpitis.) ■

palmers31
Member Since: 07/30/08
Post: 37 of 81

8/20/2019

dentaltown.com \\ MARCH 2020

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Dentaltown March 2020

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