ENDODONTICS AND ESTHETIC DENTISTRY(6)

On 2010年12月15日 by 佚名 Resource：本站原创 Hits：

Bite Test

Every time that the patient's complaint is sensitivity to biting and/or chewing, it is important to investigate further which tooth and, more importantly, which part of it are sensitive to biting pressure. This is to distinguish between vertical crown/root fractures and periapical pathosis. A very convenient instrument for this investigation is the Tooth Slooth (Professional Results, Laguna Niguel, CA) (Figure 19-21). By design, this instrument has a slight depression in the biting surface, so the patient will only bite on individual cusps (Figures 19-22A, and 19-22B) without adjacent cusp interference when he or she bites down. If there is a fracture in the crown, the patient is likely to report normal sensation to biting on all but the area that is fracturing. It is advisable to start with having the patient bite on the Tooth Slooth on a tooth that is not suspected of being fractured so that the patient knows what to expect. Then it is moved from tooth to tooth around the mouth as the patient exerts pressure. The patient is asked to close slowly yet exert maximum pressure. Pain on bite release is indicative of an inflamed pulp/irreversible pulpitis requiring extirpation.

A plastic saliva ejector may be used as an alternative instrument for this test (Figure 19-23).

Figure 19-21: Tooth Slooths, two sizes.

Figure 19-22A: Bite test with Tooth Slooth (Professional Results) checking DB cusp of mandibular molar.

Figure 19-22B: Bite test with smaller-sized (blue) Tooth Slooth.

Figure 19-23: Plastic saliva ejector is useful in bite testing the entire tooth rather than an individual cusp.

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