TEKNIK DIAGNOSIS

TEKNIK DIAGNOSIS

Drg. Anastasia Elsa Prahasti, SpKG

DIAGNOSIS

DEFINISI

Suatu seni dan ilmu dalam mengenal penyakit

Ditetapkan dengan memadukan data-data hasil pemeriksaan yang dilakukan secara sistematis, berurutan mulai dari awal sampai dengan akhir pemeriksaan sesuai dengan prosedur.

Prognosis

Prediksi kemungkinan perjalanan penyakit, durasi dan hasil akhir penyakit berdasarkan pengetahuan ttg pathogenesis dan faktor resiko penyakit

PATIENT ASSESSMENT

Infection Control

Chief Complaint

Medical Review

Communicable Disease

Allergies or Medication

Systemic Diseases & Cardiac Abnormalities

Physiologic Changes Associated with Aging

Sociologic & Psychologic Review

Dental History

Risk Assessment

Caries risk indicators

FACTORS

NON ORAL

Age

Socioeconomic status

Medical condition

Medication

Fluoride history

Dietory habits

Genetic predisposition

General health

ORAL

Tooth anatomy and composition

Oral flora/plaque

Previous infection and restoration

Restoration

Oral hygiene (e.g., skills, knowledge, motivation

Categorization of adult according to caries risk indicators

CARIES RISK

LOW

NO carious lesion in last 3 years

Adequately restored surfaces

Good oral hygiene

Regular dental attender

Fluoride dentrifice use

MEDIUM

Presence of 2 of the following indicators

Current orthodontic treatment or removable appliance or

Several exposed root surfaces or

Poor oral hygiene or

Frequent fermentable carbohydrate intake

Or Inadequate exposure to topical fluoride

HIGH

Presence of 1 of the following indicators:

Any carious lesion in previous 2 yr or

Inadequate salivary flow or

Initial enamel interproximal radiolucencies or

Presence of >2 of the risk indicators shown in the medium risk category

EXAMINATION & DIAGNOSIS

General Consideration

Sterilization/disinfection of all instruments supplies & operatory surfaces

Barrier techniques: gloves, masks, protector eyewear, gowns

Standard Operating Procedures

CLINICAL EXAMINATION

GENERAL PHYSICAL HEALTH

ORAL CONDITION

COMMUNICABLE DISEASE

CHARTING & RECORDS

Identification data

Medical history

Dental history

Clinical examination

Diagnosis

Treatment planning

Documentation of informed consent

Progress notes

Completion notes

Tooth Denotation :

Universal

Preparation clinical examination

Proper Instrument:

Mirror, explorer, periodontal probe

Accurance Examination:

Scaling, flossing, toothbrushing prophylaxis

Cotton roll, dental floss

Magnification in operative dentistry

Dental loupes:

Single lens

Binocular loupes

Dental microscope

Interpretation & use of Diagnostic Test

Examination of orofacial Soft Tissue

EXAMINATION OF TEETH & RESTORATION

ClINICAL EXAMINATION FOR CARIES

Visual changes in teeth surface texture or color

Tactile sensation

Radiographs

Translumination

New Technology

Laser Induced Fluorescence

Digital Imaging fibreoptic Translumination

Quantitative light-induced fluorescence

Electrical Conductance

CLINICAL EXAMINATION OF AMALGAM RESTORATION

CLINICAL EXAMINATION OF CAST RESTORATION

CLINICAL EXAMINATION OF COMPOSITE & OTHER TOOTH COLORED REST

CLINICAL EXAMINATION FOR ADDITIONAL DEFECTS

RADIOGRAPHIC EXAMINATION OF TEETH AND RESTORATION

clinical situation for which radiographs may be indicated

Previous periodontal or root canal therapy

History of pain or trauma

Familial history of dental anomalities

Clinical evidence of periodontal disease

Large or deep restoration

Deep carious lessions

Malposed or clinical impacted teeth

Swelling

Mobility of teeth

Fistula or sinus tract infection

Growth abnormalities

Oral involvement in known or suspected systemic disease

Evidence of foreign objects

Abutment teeth for fixed or removable partial prosthesis

Unexplained bleeding

Unexplained sensitivity of teeth

Unusual tooth morphology, calcivication or color

Missing teeth with unknown reason

Guideline for prescribing dental radiographs for dentate adults

NEW PATIENT

All new patients to assess dental diseases

Individualized radiographic examination consisting of posterior bite-wings and selected periapicals; a full mouth intraoral radiographic examination is appropriate when the patient has clinical evidence of generalized dental disease or a history of extensive dental treatment

CLINICAL CARIES OR HIGH-RISK FACTORS FOR CARIES

POSTERIOR BITE-WING EXAMINATION AT 12 TO 18 MO INTERVALS

NO CLINICAL CARIES AND NO HIGH RISK FACTORS FOR CARIES

POSTERIOR BITE-WING EXAMINATION AT 24 TO 36 MO INTERVALS

PERIODONTAL DISEASE OR A HISTORY OF PERIODONTAL TREATMENT

INDIVIDUALIZED RADIOGRAPHIS EXAMINATION CONSISTING OF SELECTED PERIAPICAL AND BITE-WING RADIOGRAPHS FOR AREAS WHERE PERIODONTAL DISEASES (OTHER THAN NONSPECIFIC GINGIVITIS) CAN BE SHOWN CLINICALLY

RECALL PATIENTS

Adjunctive aids for Examining Teeth & Restoration

Percussion test

Palpation test

Thermal test

Electric pulp test

Test preparation

Review of periodontium

Gingival color & texture

The depth of gingival sulcus

Gingival recession

Area with minimum/lack of attached gingiva

Tooth mobility

Plaque, debris & inflamation

Radiographic Examination

Examination of occlusion

EXAMINATION OF PATIENT IN PAIN

Question asked of the patient

Can you point to the tooth or area that bothers you?

When did you first notice the pain or discomfort?

How long has it hurt?

Circle any of the following that describe(s) the character of your pain.

Pulsatingdullsuddenconstant

NaggingSharpOff and on

Is the pain spontaneous?

Does the pain wake you up at night?

What makes it hurt?

Heat/cold/sweets/chewing/biting/air/other

How long does the pain last?

What relieves the pain?

Clinical examination

Caries

Extensive restoration

Sensitive to percussion

Sensitive to palpation

Response to cold test

Response to heat test

Periodontal pocket depths

mobility

Wear facets or signs of occlusal trauma

Tooth sloth test

Craze lines emanation from developmental fissures

Exposed root surface

Presence of sinus tract

Tooth discoloration

other

Radiographic examination

Caries

Extensive restoration

Periapical pathology

Widened periodontal ligament

Radiolucent lesion

Root fracture

Bone levels

Furcation

Interproximally

TUGAS

Jelaskan tentang alat-alat baru untuk pemeriksaan karies.

Jelaskan bagaimana dan apa tujuan pemeriksaan :tes perkusi, tes palpasi dan tes termal.

Jelaskan apa yang dimaksud dengan Diagnostic test.

Jelaskan apa saja yang harus diamati dalam pemeriksaan oklusi.