Comprehensive clinical case copy - copy
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Comprehensive clinical care case presentation
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Comprehensive clinical case copy - copy
- 1. 2016
- 2. About the case: 2 Khulood Khaled Alzhrani 1102012014 2 Number of visits ⢠17 visits in 10 weeks Number of canceled visits ⢠12 visits Socioeconomic status ⢠Low Patient education level ⢠Primary Patient attitude ⢠Exacting mind
- 3. Patient Biographic Data Khulood Khaled Alzhrani 1102012014 Nationality: Syrian Gender: female Age: 47 years Marital status: Married Occupation: housewife Chief complaint: ⢠⢠âI have pain in left side increased during eatingâ 3
- 4. Medication ⢠Free Allergic reaction ⢠Free Medical history ⢠Insignificant Family history ⢠Insignificant â˘Social history ⢠Insignificant Dental history ⢠Extractions ⢠Restorations ⢠Scaling Khulood Khaled Alzhrani 1102012014 4
- 5. Examination Extraoral ⢠Head and neck. ⢠Lymph nodes. ⢠Facial profile ALL ARE WITHINE NORMAL LIMIT (soft tissue) ⢠Buccal mucosa ⢠Flour of the mouth ⢠Tongue ⢠Hard/soft palat ALL ARE WITHINE NORMAL LIMIT (hard tissue) #28 Extracted #27 Extracted #26 RCT, post, metal crown #24 Overhang restoration #18 Extracted #17 Palatal pit #38 Extracted #37 Occlusal caries #36 Extracted #35 Extracted #34 Deep caries #48 Remaining root #47 Occlusal caries #46 Remaining root #45 Proximal caries Khulood Khaled Alzhrani 1102012014 5 Intraoral
- 6. Intraoral examination (hard tissue) #25 Overhang restoration #26 RCT, post, metal crown #27 Extracted #28 Extracted #18 Extracted #17 Palatal pit #38 Extracted #37 Occlusal caries #36 Extracted #35 Extracted #34 Deep caries #45 Proximal caries #46 Remaining root #47 Occlusal caries with lingual extension #48 Remaining root Khulood Khaled Alzhrani 1102012014 6
- 7. Khulood Khaled Alzhrani 1102012014 Intraoral photographs 7
- 9. Primary impression & Diagnostic cast Khulood Khaled Alzhrani 1102012014 9
- 10. ⢠Diagnosis: Generalized mild chronic periodontitis ⢠Mean Probing depth = 2.05 mm ⢠Plaque index = 63 % ⢠BOP = 21 % ⢠Prognosis: fair Periodontal examination Khulood Khaled Alzhrani 1102012014 2016/10/10 10
- 11. Teeth #46 and #48 Khulood Khaled Alzhrani 1102012014 11
- 12. Tooth #17 palatal pit Khulood Khaled Alzhrani 1102012014 12 Affected dentine
- 13. Tooth #25 Overhang class II restoration Khulood Khaled Alzhrani 1102012014 13
- 14. Tooth #34 +ve response to ethyl chloride test Irreversible pulpitis ⢠RCT ⢠Post and core Khulood Khaled Alzhrani 1102012014 14
- 15. Tooth #34 ⢠Deep caries extend to the pulp ⢠Widening of PDL ⢠Apical 1/3 slightly curved distally Preoperative Khulood Khaled Alzhrani 1102012014 15
- 16. Tooth #34 Working Length: 21 mm Reference Point: Cusp tip Initial file Khulood Khaled Alzhrani 1102012014 16 Master cone Master Cone: #45 Length: 21 mm Spreader Size: #35, #30 Auxiliary Gutta Percha: #35, #30, #25 obturation
- 17. Tooth #34 post & core Postoperative Khulood Khaled Alzhrani 1102012014 17
- 18. Tooth #45 Class II Khulood Khaled Alzhrani 1102012014 Final Rx 18 Affected dentine
- 19. Tooth #47 Class I compound Khulood Khaled Alzhrani 1102012014 19
- 20. Lower left side (Missing: #35, #36) Lower right side (Missing: #46) 4 units bridge Abutment: #34, #37 3 units bridge Abutment: #45, #47 Fixed prosthodontics Outline of the areas to be restored: Khulood Khaled Alzhrani 1102012014 20
- 21. 1st Abutment: #45 Periodontal pocket: No Mobility: WNL Restorations: ⢠Class II Khulood Khaled Alzhrani 1102012014 2nd Abutment: #47 Periodontal pocket: No Mobility: WNL Restorations: ⢠class I compound Posterior bridge (lower right side) 21
- 22. Khulood Khaled Alzhrani 1102012014 Tooth preparation #45 Complain: ⢠sharp pain start when the preparation start in distal surface ⢠And she said: âSometimes I feel throbbing pain in the same tooth specially at night relieved only by pain killerâ Vitality test: ⢠+ve response to ethyl chloride test treatment: ⢠RCT 22
- 23. Khulood Khaled Alzhrani 1102012014 Tooth preparation #47 Complain: ⢠Aching pain in all the teeth in lower jaw relieved only by pain killer Vitality test: ⢠normal response to ethyl chloride test Diagnosis: ⢠Not clear (pain either due to endo./perio. origin) periodontal management and follow up 23
- 24. 1st Abutment: #34 Periodontal pocket: No Mobility: WNL Restorations: ⢠RCT ⢠Post & core Khulood Khaled Alzhrani 1102012014 2nd Abutment: #37 Periodontal pocket: No Mobility: WNL Restorations: ⢠simple class I Posterior bridge (lower left side) 28
- 25. Axial wall reduction: 1.2 mm Occlusal reduction: Functional cusp: 2 mm Nonfunctional cusp: 1 mm Finish line: Deep shamfer Khulood Khaled Alzhrani 1102012014 Posterior bridge (lower left side) Teeth preparation #34 & #37 29
- 26. Khulood Khaled Alzhrani 1102012014 Posterior bridge (lower left side) 2ry impression & provisional crowns Impression by putty to fabricate temporary crowns by protemp⢠shade A3 30
- 27. Khulood Khaled Alzhrani 1102012014 Posterior bridge (lower left side) Metal try-in 32
- 28. Khulood Khaled Alzhrani 1102012014 33 As a result of closing the training clinics due to end of this semester.. The patient file referred to internship clinics to complete the treatment plan! Patient didnât came for the next appointment!
Hinweis der Redaktion
- Generally about the case Exacting Mind pt. Require extreme care, effort, and patience. he is very compulsive, precise, and accurate ****Every step should be explained in detail. If he is intelligent & understanding can be the best type If he lack intelligence extra hours spent , prior to ttt. In pt. education
- Frontal view shows Upper anteriors cover more than 1/3 of lower anteriors Slight constriction of maxilla
- overjet= Deep bite =
- The Pt doesn't complaint with oral hygiene practice although she had have an appointment for scaling just 2 weeks before she referred to me but she still have a high plaque index
- Extraction done without any complication
- This X-ray was taking at the next appointment after I removed the inflamed pulpal tissue and put metapex (calcium hydroxide + iodoform)âŚ
- Half of the post length impeded under bone level ((whichâs the minimum required to avoid ^lever arm effect)) Post type: Fiber Post length: 15 mm
- Outline of the areas to be restored: 2 bounded edentulous area in lower arch
- Pain character: continuous Pressure in the gum Canât localized pain site
- I give the post operative instruction to pt and we decided the date of the follow up appointment
- some obstacles that I faced