L.11 njood h. al yousef

Njood AlYousef – 42820071 .

Level – 11 .

COMPREHENSIVE CASE PRESENTATION

NJOOD ALYOUSEF 42820071 1

PERSONAL DATA

• Age : 31 years old.

• Gender : Male.

• Nationality : Pilipino.

• Social Status : Married.

• Occupation : Driver.

• Patient’s Attitude : Co-operative.

• File Number : 43925


CHIEF COMPLAINS

“ Regular Check up.”


MEDICAL HISTORY

• No significant history.

• No significant history.

FAMILY MEDICAL HISTORY


PAST DENTAL HISTORY

• Multiple extractions done within the past seven years without

any complications .

• All dental visits were for extractions.

• Trauma 6 months ago.

Last dental visit was a couple of years ago for an extraction.


CLINICAL DIAGNOSIS


I. EXTRA-ORAL EXAMINATION

• Skin.

• TMJ.

• Lymph Nodes.

• Neck.

All within normal limits.


II. INTRA-ORAL EXAMINATION

• Floor of the mouth: Torus mandibularis.

• Palate.

• Oral Mucosa.

• Lips.


All within normal limits.

CONT II. INTRA-ORAL EXAMINATION

Maxillary Arch

Caries


Abrasion

CONT II. INTRA-ORAL EXAMINATION

Mandibular Arch


Caries Abrasion

HABITS & ORAL HYGIENE ACTIVITY

• He brushes his teeth twice a day (Hard brush).

• Doesn’t floss neither uses mouth wash.

• He visits the dentist periodically.


PRE-TREATMENT PHOTOGRAPHS


FRONTAL VIEW


MAXILLARY OCCLUSAL VIEW


MANDIBULAR OCCLUSAL VIEW


RIGHT LATERAL VIEW


LEFT LATERAL VIEW


1. Radiographs.

2. Diagnostic Cast.

DIAGNOSTIC TOOLS


PANORAMIC


BITEWINGS


RIGHT SIDE PA


ANTERIOR PA


LEFT SIDE PA


MOUNTED DIAGNOSTIC CAST (FRONTAL)


MOUNTED DIAGNOSTIC CAST (RIGHT & LEFT)

RIGHT LEFT


Molar Relationship: Not applicable Canine Relationship: Class I

DIAGNOSTIC CAST (MAX. & MAND.)

MAXILLARY OCCLUSAL MANDIBULAR OCCLUSAL


PERIODONTAL CHARTING


GINGIVAL EXAMINATION (GINGIVAL INDEX)

• Silness & Loe, 1967

1622 25

44 41 36

• Score: 0.08 Mild gingival Inflammation.

• redness, edema , and glazing.


0

0

0

0

0

0

0

0

0

0

0 0 0

0

0

00

1

00

0

0 01

ORAL HYGIENE (PLAQUE INDEX)

• Silness & Loe, 1967

1622 25

44 41 36

1 0

0

01

11

1

0 1

0

11

1

00

• Score: 0.4 – Mild plaque accumulation.

• Mild accumulation of soft deposits in the free gingival margin seen by using the probe or disclosing

solution.


0

0 0

0

00

0

1

ORAL HYGIENE (CALCULUS INDEX)

• Procter & Gamble, 1987

• Moderate accumulation.

• Supra and Subgingival Generalized calculus accumulation.


28272625242322211112131415161718

010010M-CEJ

133334312222322121222121332M-PD

223344CAL

+++Bleeding

Bleeding

010M-CEJ

444313112213222112212212212M-PD

232CAL

28272625242322211112131415161718


38373635343332314142434445464748

010210M-CEJ

222232223223311111211222211222222M-PD

233430CAL

+++Bleeding

+Bleeding

M-CEJ

223111111111212111211222211111111M-PD

CAL

38373635343332314142434445464748


PSR

2 1 3

2 2 2


ETIOLOGIC & RISK FACTORS

• Plaque.

• Caries.

• Calculus.


PERIODONTAL DIAGNOSIS

• Generalized Mild to Moderate Chronic Periodontitis.

• Over all prognosis:

Good


VITALITY TEST


PULP TEST

• Application of Endo Frost (-50° C) on suspected teeth.

• History of tooth: Trauma.

Tooth

#

Cold

Test

V

.Percussio

n

H.

Percussion

Pulp

Diagnosis

Periapical

Diagnosis

12 +ve -ve -ve Normal NormalNJOOD ALYOUSEF 42820071 37

PULP TEST



Tooth

#

Cold

Test

V

.Percussio

n

H.

Percussion

Pulp

Diagnosis

Periapical

Diagnosis


PULP TEST



Tooth

#

Cold

Test

V

.Percussio

n

H.

Percussion

Pulp

Diagnosis

Periapical

Diagnosis


PULP TEST



Tooth

#

Cold

Test

V

.Percussio

n

H.

Percussion

Pulp

Diagnosis

Periapical

Diagnosis


PULP TEST



Tooth

#

Cold

Test

V

.Percussio

n

H.

Percussion

Pulp

Diagnosis

Periapical

Diagnosis


PULP TEST



Tooth

#

Cold

Test

V

.Percussio

n

H.

Percussion

Pulp

Diagnosis

Periapical

Diagnosis


PULP TEST



Tooth

#

Cold

Test

V

.Percussio

n

H.

Percussion

Pulp

Diagnosis

Periapical

Diagnosis


PULP TEST



Tooth

#

Cold

Test

V

.Percussio

n

H.

Percussion

Pulp

Diagnosis

Periapical

Diagnosis


PULP TEST



Tooth

#

Cold

Test

V

.Percussio

n

H.

Percussion

Pulp

Diagnosis

Periapical

Diagnosis


FINDING & DIAGNOSIS

• Plaque accumulation.

• Calculus.

• Carious teeth : #18, #16, #14, #13, #12, #11, #22, #25, #27,

#28, #37, #35, #34, #44, #45.

• Missing teeth : #17, #15, #21, #24, #26, #38, #36, #46, #47,

#48.

• Cross-bite : #11, #25


TREATMENT PLAN


TREATMENT OBJECTIVES

• Improve oral hygiene.

• Caries control.

• Restore function and esthetics.

• Maintain the results.


PREVENTIVE TREATMENT

• Periodontal diagnosis :

Generalized Mild to Moderate Chronic Periodontitis.

• Treatment plan:

• OHI and plaque control.

• Supragingival scaling / subgingival scaling.

• Polishing.

Re-evaluation after 4-6 weeks.

Maintenance every 3 months.


# 18


Finding Treatment

- Occlusal

Caries with

Buccal

Extension.

- Over eruption.

Extraction.

Finding Treatment

Occlusal caries

with Palatal

Extension.

- Class I

Restoration

with Palatal

extension

Restoration.

# 16


Finding Treatment

- Occlusal Caries.

- Buccal abrasion.

- Class I

Restoration.

- Class V

Restoration.


# 14

Finding Treatment

Cingulum Caries. Class I

restoration.

# 13


Finding Treatment

Mesial Caries. Class III

Composite

Restoration.


# 12

Finding Treatment

Distal Caries. Class III Composite

Restoration.


# 11

Finding Treatment

Cingulum Caries. Class I Restoration.

# 22


Finding Treatment

Occlusal Caries. Class I

Restoration.

# 25


Finding Treatment

Occlusal Caries

with Palatal

Extension.

Class I

Restoration with

Palatal

Extension

Restoration.

# 27


Finding Treatment

- Occlusal

Caries With

Palatal

Extension.

- Over

Eruption.

- Extraction

# 28


Finding Treatment

Occlusal Caries

with Buccal

Extension.

Class I

Restoration with

Buccal

Extension

Restoration.

# 37



- Extraction

- RPD

Finding Treatment

- Occlusal Caries.

- Buccal abrasion.

- Class I

Restoration.

- Class V

Restoration.

# 35


Finding Treatment

- Pit Caries.

- Buccal abrasion.

- Preventive Resin

Restoration.

(PRR)

- Class V

Restoration.

# 34


Finding Treatment

- Pit Caries.

- Buccal abrasion.

- Preventive Resin

Restoration.

(PRR)

- Class V

Restoration.

# 44

# 45


Finding Treatment

- Pit Caries.

- Cervical Caries.

- Preventive Resin

Restoration.

(PRR)

- Class V

Restoration.


ORTHODONTIC AND PROSTHETIC

TREATMENT OPTIONS


• Canine relationship: Class I

• Molar relationship: Not applicable


Anterior cross-bite in tooth #11

Posterior cross-bite in tooth #25

ORTHODONTIC TREATMENT OF CROSS-BITE


5 mm

11 mm

6 mm

5.5 mm

- Rotation correction for teeth #16, #27

- Mesialization and correction of the

cross bite for #25*Space gained 8-9 mm for #26*

ORTHODONTIC TREATMENT



5 mm

2 mm available

- Rotation correction for tooth #37

- Mesialization for teeth #35, #34*Space gained for #36 is 8-9 mm*


6 mm


No need for intrusion.

(enough space for teeth replacement).


- #15

- #11

- #24

- #26

- #36

- #46

REPLACEMENT WITH ORTHODONTIC

TREATMENT

Implant :


Fixed Partial Denture:

- #15 (16-14).

- #21 (11-22 ).

- #24 (23-25)

- #26 ( 25-27)

- #36 (37-35)

REPLACEMENT WITH ORTHODONTIC

TREATMENT

PIER ABUTMENT


PIER ABUTMENT

BY DR. DEVENDRA CHOPRA,


REPLACEMENT WITHOUT ORTHODONTIC

TREATMENT

Implant :

- #15

- #11

- #24

- #46


Fixed Partial Denture:

- #15 (16-14).

- #21 (11-22 ).( #21 may need elective RCT to

adjust the cross-bite).

- #24 (23-25)( #25 may need elective RCT to

adjust the cross-bite).

No enough space to replace #26 &

#36

REPLACEMENT WITHOUT ORTHODONTIC

TREATMENT


REPLACEMENT WITH OR WITHOUT


Removable Partial Denture.

TREATMENT PHASES

• Phase I : Emergency/Preventive Treatment.

• Phase II : Operative Treatment.

• Phase III : Endodontic Treatment.

• Phase IV : Pre-prosthodontics/Surgical Treatment.

• Phase V : Prosthodontics Treatment.

• Phase VI : Recall & Maintenance.


THANK YOU


Date post:	08-Jul-2015
Category:	Education
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L.11 njood h. al yousef

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