CTPS 512, 1ST Semester December 11 , 2016 my 1st case presentation

1. Comprehensive Case Presentation
CTPS 512, 1ST Semester
December 11 , 2016
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Presenting Case of File #171518
Prepared By: Asma’a Bo-sroor
ID: 43320449
Team D
Level 9
ASMA’A BOSROOR 43320449 CTPS 512 1

2.  Age : 24 YO
 Gender : Female
 Nationality : Saudi
 Occupation : Social worker
 Marital & Social Status : Single and middle higher social status
 Patient attitude : Uncooperative , afraid of the needle and the
sound of the headpiece
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 2

3. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
‫أسنان‬ ‫بين‬ ‫فتحة‬ ‫وسبب‬ ‫بالغلط‬ ‫سني‬ ‫برد‬ ‫الدكتور‬‫ي‬‫مو‬
‫عاجبتني‬‫وشكلها‬‫مو‬‫حلو‬
The doctor prepared my tooth by
mistake which create an opining
between my teeth , it is bothering my I
think it’s ugly
‫قب‬ ‫إيطاليا‬ ‫وسافر‬ ‫عصب‬ ‫الدكتور‬ ‫بدأه‬ ‫سن‬ ‫عندي‬‫ما‬ ‫ل‬
‫يكمله‬
Also my doctor start endo teeth but
he travel to Italia before he complete
the treatment
ASMA’A BOSROOR 43320449 CTPS 512 3

4. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
The diastema created 2 years ago
And the tooth treated endodontically 5 mouths ago
ASMA’A BOSROOR 43320449 CTPS 512 4

5. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
The patient is medically fit and not under any medication
There is no significant family medical history
Multiple restored and endodontically treated teeth
ASMA’A BOSROOR 43320449 CTPS 512 5

6. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
She brush 2 times daily using a circumferential scrub
technique for 3 minute with soft tooth brush and
whitening toothpaste
She floss her teeth one time every two days
ASMA’A BOSROOR 43320449 CTPS 512 6

7.  She eats 2 meals and 5 snacks daily (mainly fruits and
sweets)
 She drinks Arabic coffee with sweets as breakfast
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 7

8. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 8

9. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
16 21 25
44 41 36
1
1
1 1
1
1
1 1 2 2
1
1
1 1
1
1
2 1
1
1
1 1
1.12 Moderate Gingival Inflammation
ASMA’A BOSROOR 43320449 CTPS 512 9
1
1

10. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
16 21 25
44 41 36
1
1
2 1 1 1 1 1
1 1 1 1
1
1 2
0.7 Mild Plaque Accumulation
ASMA’A BOSROOR 43320449 CTPS 512 10

11. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Grade 2 : Slight (Calculus deposits 1mm or less)
Good
ASMA’A BOSROOR 43320449 CTPS 512 11

12. Generalized moderate plaque induced gingivitis
Plaque, calculus & caries
Good
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 12
Diastema

13. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 13

14. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
• Disease control (caries control)
• OHI instructions and plaque and caries control.
• Supra and sub gingival scaling and polishing.
• Reevaluation of treatment 4-6 weeks
• Maintenance every 6 months.
Generalized moderate
plaque induced gingivitis
Full
mouth
Overall case prognosis : Good
ASMA’A BOSROOR 43320449 CTPS 512 14

15. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
 Includes the demonstration of the right technique in brushing and
flossing : Brushing “Modified Bass” technique .
ASMA’A BOSROOR 43320449 CTPS 512 15

16. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
 Flossing:
ASMA’A BOSROOR 43320449 CTPS 512 16

17.  Mouth wash 0.12% Chlorohexidine
two times daily for one week .
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 17

18. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 18

19. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 19

20. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
All
are
WNL
Lip
Skin
Neck
Lymph
Nodes
TMJ
 Face: Symmetrical face &
straight profile
 TMJ : No clicking or pain
ASMA’A BOSROOR 43320449 CTPS 512 20

21. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 21

22. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 22
Patient finger

23. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
All
are
WNL
Vestibul
e
Gingiv
a
Floor of
the
mouth
Palate
Tongue
ASMA’A BOSROOR 43320449 CTPS 512 23

24. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 24

25. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 25

26. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 26

27. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 27

28. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 28

29. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 29

30. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 30

31. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 31

32. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 32

33. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 33

34. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 34

35. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 35

36. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 36

37. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 37

38. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 38
NormalNormal-ve+veNormal24control
NormalNormal-ve+veNormal25Suspected
Necrotic pulpitisNormal-ve-veNormal37
NormalNormal-ve+veNormal35

39. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 39

40. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Restored teeth Carious teeth
Endodontically treated tooth
Missing tooth
Impacted tooth
ASMA’A BOSROOR 43320449 CTPS 512 40

41. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 41

42.  Elimination of patient’s chief complain .
 Enhance oral hygiene.
 Caries/ disease control , and prevent recurrence.
 Restore the oral function , structure and esthetic.
 Maintain the results.
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 42

43. Follow upNot erupted yet18
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 43

44. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Finishing and polishingPreviously treated tooth with
composite restoration w/ no evidence
of overhang or gab
17
ASMA’A BOSROOR 43320449 CTPS 512 44

45. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Finishing and polishing
Occlusal
Slot Mesial composite
restoration
Previously treated tooth with composite
restoration w/ no evidence of overhang or
gab , Mesial pit caries
16
ASMA’A BOSROOR 43320449 CTPS 512 45

46. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Preventive resin restorationDeep groves
Occlusal caries
15 , 14
ASMA’A BOSROOR 43320449 CTPS 512 46

47. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Class I composite restorationPalatal pit caries13
ASMA’A BOSROOR 43320449 CTPS 512 47

48. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Class III composite restorationMesial carries12
ASMA’A BOSROOR 43320449 CTPS 512 48

49. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Class IV composite restoration,
close the diastema
Previously endodontically treated tooth
with class III composite restoration
palatally , insisal pit caries
11
ASMA’A BOSROOR 43320449 CTPS 512 49

50. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Class VI and class V
composite restoration
Previously treated tooth with composite
restoration , recurrent caries insisally and
labial gingival caries
21
ASMA’A BOSROOR 43320449 CTPS 512 50

51. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Prophylaxis & fluoride applicationSound22
ASMA’A BOSROOR 43320449 CTPS 512 51

52. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Class I composite restorationPalatal pit caries23
ASMA’A BOSROOR 43320449 CTPS 512 52

53. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Fissure sealantSound deep groove24
ASMA’A BOSROOR 43320449 CTPS 512 53

54. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Mesiooclosodistal composite restorationMesiooclosodistal
deep caries
25
ASMA’A BOSROOR 43320449 CTPS 512 54

55. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 55
Endodontic retreatment
followed by post & core and
crown if needed
Normal-veNormalSubstandard root canal
treatment
26

56. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Root canal treatment
followed by post & core and
crown if needed
Normal-veNormalPreviously initiated
endodontic treatment
27
ASMA’A BOSROOR 43320449 CTPS 512 56

57. Follow upNot erupted yet28
No need for replacementMissing38
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 57

58. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Root canal treatment
followed by post & core
and crown if needed
Normal-ve-veNormalPreviously treated
tooth with deep
composite restoration
37
ASMA’A BOSROOR 43320449 CTPS 512 58

59. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Finishing and polishing Occlusally
Distal box composite restoration
Previously treated tooth with
composite restoration w/ no
evidence of overhang or gap,
distal caries
36
ASMA’A BOSROOR 43320449 CTPS 512 59

60. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Oclusodistal composite
restoration
Previously treated tooth with
composite restoration with no evidence
of overhang or gab , distal caries
35
ASMA’A BOSROOR 43320449 CTPS 512 60

61. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Class I composite restorationOcclusal caries34
ASMA’A BOSROOR 43320449 CTPS 512 61

62. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Preventive resin restorationPalatal pit caries33
ASMA’A BOSROOR 43320449 CTPS 512 62

63. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Prophylaxis & fluoride applicationSound32 , 31 , 41
,42 ,43
ASMA’A BOSROOR 43320449 CTPS 512 63

64. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Fissure sealantDeep groves44
ASMA’A BOSROOR 43320449 CTPS 512 64

65. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Preventive resin restorationOcclusal caries45
ASMA’A BOSROOR 43320449 CTPS 512 65

66. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Endodontic retreatment
followed by
post & core and crown
-ve+vewidening in the
periodontal
ligament
Substandard root
canal treatment with
periapical lesion
46
ASMA’A BOSROOR 43320449 CTPS 512 66

67. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Class I composite restorationOcclusal caries47
ASMA’A BOSROOR 43320449 CTPS 512 67

68. Follow upNot erupted yet48
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 68

69. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 69

70. ASMA’A BOSROOR 43320449 CTPS 512 70
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
An orthodontic treatment is needed to :
 Correct the lower arch crowding and upper arch
spacing
 Gain a proper Occlusal relationship

71. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 71

72. ASMA’A BOSROOR 43320449 CTPS 512 72
Recall the patient every 6 months to :
 Do periodontal maintenance
 Emphasize on the oral hygiene
 Maintain good relationship with the patient
“treat the patient as a whole , not hole …”
 Do full mouth x-ray , check all restorations and crowns
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY

73.  Oral hygiene recommendations : Modified
bass technique with medium soft nylon bristle
toothbrush (2 times daily) for 3 minutes with
interdental flossing once daily , mouthwash,
Chlorohexidine (0.12%) for 1 week
 Fissure sealant for teeth #22 #44
 Preventive resin restoration (PRR) for teeth
#15 #14 #33 #45
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 73

74.  Composite restoration for teeth #16 #13 #12
#11 #21 #23 #25 #36 #35 #34 #47
 Endodontic for teeth #26 #27 #37 #46
followed by prosthodontics treatment if
needed
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 74

75. RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
ASMA’A BOSROOR 43320449 CTPS 512 75

76. ASMA’A BOSROOR 43320449 CTPS 512 76
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY
Crown
Post
RCT

77. ASMA’A BOSROOR 43320449 CTPS 512 77
RIYADH COLLEGES OF DENTISTRY AND
PHARMACY