Question

A patient complains of intermittent and spontaneous pain in a tooth that was previously pulp capped. Radiographs disclose no periapical pathology. The tooth is not sensitive to percussion. Both cold and heat stimulate a severe and lasting pain. The most probable diagnosis is

A. reversible pulpitis.
B. irreversible pulpitis.
C. cracked tooth syndrome.
D. acute apical periodontitis.
E. chronic apical periodontitis.

Answer 1

The most likely diagnosis for the described dental symptoms, including severe and lasting pain upon thermal stimulation without periapical pathology, is irreversible pulpitis.

Step-by-step explanation:

The diagnosis most probable for a patient experiencing intermittent and spontaneous pain in a tooth with a previous pulp cap, severe and lasting pain upon thermal stimulation, but no periapical pathology visible on radiographs and no sensitivity to percussion, is irreversible pulpitis. This condition is characterized by lingering pain due to thermal stress (such as eating ice cream or drinking hot beverages) and indicates that the dental pulp is inflamed and unable to heal on its own. In contrast, reversible pulpitis would not present with such severe or lasting pain, and periodontitis typically involves gum issues and would likely show periapical pathology on radiographs. Thus, the most fitting answer is B. irreversible pulpitis.