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LOGO        RIYADH COLLEGE OF DENTISTRY AND
                      PHARMACY



Comprehensive Case
  Presentation

         ...
Age : 25

           Gender : Male

           Nationality : Yamani

       Occupation : receptionist

Marital & Social St...
In the ‫• ﺗﺼﺒﻐﺎت ﻓﻲ‬
          ‫ﻲ‬      ‫ﺒ‬
patient’s
   i ’      ‫اﻷﺳﻨﺎن‬
  own
 words:
     d      ‫اﻷﻣﺎﻣﻴﺔ‬

•History o...
Medical History

Within Normal •

Family Medical History
Within Normal •

Past Dental History
Just for check up •
        ...
No habits       He use tooth
                brush twice a
                day




            5
6
I. Extra – Oral Examination



  Swelling


    Skin       NAD


    TMJ




                          7
II. Intra – Oral Examination
II.




                 NAD




                           8
III . Oral Hygiene

   Gingival Index ► 1 mild inflammation

    18   17   16   15   14   13   12   11   21   22   23   24...
PRE-TREATMENT PHOTOGRAPHS



             10
Frontal view




               11
Maxillary Occlusal view




                     12
Mandibular Occlusal view




                       13
Right lateral view




                     14
Left lateral view




                    15
16
Panoramic
Pa o amic




            17
Bitwing Radiograph




                     18
Diagnostic Casts




         19
20
1                2              3
generalized
        li d        Carious teeth   Extraction
sever enamel
fluorosis with
s...
Caries




         22
Caries




         23
Diagnosis




 Periodontium:   Generalized mild gingivitis
                 G     li d ild i i iti




                   ...
25
26
Phase I
Ph             Perio treatment



    Condition:
    Generalized mild gingivitis


    Recommendation :
    Polish...
28
Phase II   Operative t
           Op   ti treatment
                       tm nt




                    Condition:
      ...
Condition:
# 17 , O Caries
       O. C ries


Recommendation :
Class I composite restoration


       30
Condition:
# 16 , Dist l , Palatal Caries
       Distal P l t l C ries


Recommendation :
P.R.R


        31
Condition:
# 27 , O. Caries


Recommendation :
Class I composite restoration


                           32
Condition:
# 37 , O. Caries


Recommendation :
P.R.R


                   33
Condition:
# 4 , O. Caries
  48


Recommendation :
Class I composite restoration




       34
Condition:
# 4 , O. Caries
  47


Recommendation :
P.R.R




       35
36
Condition:
# 38 , impacted teeth


Recommendation :
Extraction




                        37
Phase III Surgical Treatment
Condition:
# 28 , traumatize and No opposing
after extraction tooth # 38


Recommendation :
E...
39
Upper anterior teeth
U       t i t th

Condition:
Sever dental fluorosis of
TFI = 6-9 with yellow/brown
       6 9
discolo...
41
preparation ( 0.5 – 0.8 ) mm
midfacially , ( 0 3 – 0 5 )mm along
                0.3 0.5
       the gingival margin




42
p    y    p
Temporary composite restoration

                                  43
After veneer cementation



44
45
Lower anterior teeth
L       t i t th

Condition:
Sever dental fluorosis of
TFI = 6-9 with yellow/brown
       6 9
discolo...
Microabrasion



                              Conservative treatment
 Bleaching

                Veneer




             ...
Microabrasion
Mi    b i

        ( No any Effect )




                 48
Bleaching ( ZOOM2)
                49
Bleaching ( ZOOM2)
  eac g OO )




    isolation




                     50
Bleaching ( ZOOM2)
  eac g OO )




                          Whitening Gel




                     51
Bleaching ( ZOOM2)
  eac g OO )




                          ZOOM light
                                   g
            ...
After Bleaching


                  53
After 1 month


                54
Veneer


After 1 month , patient come back to evaluate the lower
anterior shade color . The CC In the patient s own words
...
56
57
Temporary composite restoration
                                  58
Return        After veneer cementation
         59
POST-TREATMENT PHOTOGRAPHS



             60
Frontal view




               61
Maxillary Occlusal view




                     62
Mandibular Occlusal view




                       63
Right lateral view




                     64
Left lateral view




                    65
1   restore esthetic and function



2         improve his OHI
                                         Treatment
        ...
LOGO




       67
office bleaching with 35% hydrogen
peroxide does not significantly affect the
color and luminosity of fluorotic teeth

   ...
Conservative treatment options such as tooth whitening
                          p                           g
and microab...
A chronic endemic form of hypoplasia of the dental
 e a e
 enamel caused by d   drinking water with a high
               ...
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Comprehensive Case Presentation Sultan Alshammery

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Comprehensive Case Presentation Sultan Alshammery

  1. 1. LOGO RIYADH COLLEGE OF DENTISTRY AND PHARMACY Comprehensive Case Presentation Prepared By: p y Sultan Rkeeb al-Shammery al- Level 12 1
  2. 2. Age : 25 Gender : Male Nationality : Yamani Occupation : receptionist Marital & Social Status : Single 2
  3. 3. In the ‫• ﺗﺼﺒﻐﺎت ﻓﻲ‬ ‫ﻲ‬ ‫ﺒ‬ patient’s i ’ ‫اﻷﺳﻨﺎن‬ own words: d ‫اﻷﻣﺎﻣﻴﺔ‬ •History of Chief Complaint Long time ago g g 3
  4. 4. Medical History Within Normal • Family Medical History Within Normal • Past Dental History Just for check up • p 4
  5. 5. No habits He use tooth brush twice a day 5
  6. 6. 6
  7. 7. I. Extra – Oral Examination Swelling Skin NAD TMJ 7
  8. 8. II. Intra – Oral Examination II. NAD 8
  9. 9. III . Oral Hygiene Gingival Index ► 1 mild inflammation 18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 1 1 1 1 0 1 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 Plaque Index ► 1 18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 1 0 1 1 0 1 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 9
  10. 10. PRE-TREATMENT PHOTOGRAPHS 10
  11. 11. Frontal view 11
  12. 12. Maxillary Occlusal view 12
  13. 13. Mandibular Occlusal view 13
  14. 14. Right lateral view 14
  15. 15. Left lateral view 15
  16. 16. 16
  17. 17. Panoramic Pa o amic 17
  18. 18. Bitwing Radiograph 18
  19. 19. Diagnostic Casts 19
  20. 20. 20
  21. 21. 1 2 3 generalized li d Carious teeth Extraction sever enamel fluorosis with stains 16 , 17 , 18 , 28 , 38 affecting all of 27, 37 , 47 , the permanent teeth 48 21
  22. 22. Caries 22
  23. 23. Caries 23
  24. 24. Diagnosis Periodontium: Generalized mild gingivitis G li d ild i i iti 24
  25. 25. 25
  26. 26. 26
  27. 27. Phase I Ph Perio treatment Condition: Generalized mild gingivitis Recommendation : Polishing , Oral hygiene instructions 27
  28. 28. 28
  29. 29. Phase II Operative t Op ti treatment tm nt Condition: # 18 , O Caries O. C ries Recommendation : Class I composite restoration 29
  30. 30. Condition: # 17 , O Caries O. C ries Recommendation : Class I composite restoration 30
  31. 31. Condition: # 16 , Dist l , Palatal Caries Distal P l t l C ries Recommendation : P.R.R 31
  32. 32. Condition: # 27 , O. Caries Recommendation : Class I composite restoration 32
  33. 33. Condition: # 37 , O. Caries Recommendation : P.R.R 33
  34. 34. Condition: # 4 , O. Caries 48 Recommendation : Class I composite restoration 34
  35. 35. Condition: # 4 , O. Caries 47 Recommendation : P.R.R 35
  36. 36. 36
  37. 37. Condition: # 38 , impacted teeth Recommendation : Extraction 37
  38. 38. Phase III Surgical Treatment Condition: # 28 , traumatize and No opposing after extraction tooth # 38 Recommendation : Extraction After discussing the Surgical treatment plan with the patient , The patient said (No need to go surgery at this time , Because No g y any symptoms or pain in this time 38
  39. 39. 39
  40. 40. Upper anterior teeth U t i t th Condition: Sever dental fluorosis of TFI = 6-9 with yellow/brown 6 9 discoloration, based on the 1978 dental flourosis classification scheme of Thylstrup and Fejerskov Recommendation options : - Bleaching ?? - Veneer 40
  41. 41. 41
  42. 42. preparation ( 0.5 – 0.8 ) mm midfacially , ( 0 3 – 0 5 )mm along 0.3 0.5 the gingival margin 42
  43. 43. p y p Temporary composite restoration 43
  44. 44. After veneer cementation 44
  45. 45. 45
  46. 46. Lower anterior teeth L t i t th Condition: Sever dental fluorosis of TFI = 6-9 with yellow/brown 6 9 discoloration, based on the 1978 dental flourosis classification scheme of Thylstrup and Fejerskov Recommendation options : - Bleaching or microabrasion ( coast?? Pt need ?? ) - Veneer 46
  47. 47. Microabrasion Conservative treatment Bleaching Veneer 47
  48. 48. Microabrasion Mi b i ( No any Effect ) 48
  49. 49. Bleaching ( ZOOM2) 49
  50. 50. Bleaching ( ZOOM2) eac g OO ) isolation 50
  51. 51. Bleaching ( ZOOM2) eac g OO ) Whitening Gel 51
  52. 52. Bleaching ( ZOOM2) eac g OO ) ZOOM light g ( 45 – mint ) 52
  53. 53. After Bleaching 53
  54. 54. After 1 month 54
  55. 55. Veneer After 1 month , patient come back to evaluate the lower anterior shade color . The CC In the patient s own words patient’s ‫ﻟﻮن اﻷﺳﻨﺎن ﻣﺎ ﻋﺠﺒﻨﻲ‬ ‫وارﻏﺐ ﻓﻲ ﻋﻤﻞ ﺗﺮآﻴﺒﺎت ﻟﻸﺳﻨﺎن اﻟﺴﻔﻠﻴﺔ‬ 55
  56. 56. 56
  57. 57. 57
  58. 58. Temporary composite restoration 58
  59. 59. Return After veneer cementation 59
  60. 60. POST-TREATMENT PHOTOGRAPHS 60
  61. 61. Frontal view 61
  62. 62. Maxillary Occlusal view 62
  63. 63. Mandibular Occlusal view 63
  64. 64. Right lateral view 64
  65. 65. Left lateral view 65
  66. 66. 1 restore esthetic and function 2 improve his OHI Treatment T Objectives j 3 control caries 66
  67. 67. LOGO 67
  68. 68. office bleaching with 35% hydrogen peroxide does not significantly affect the color and luminosity of fluorotic teeth Konsl 2007 , dental digest journal Return 68
  69. 69. Conservative treatment options such as tooth whitening p g and microabrasion can dramatically improve severely discoloured fluorosed teeth. This can provide a satisfactory interim outcome or minimize the removal of discoloured enamel and dentine prior to the provision of veneers Manton DJ , 2007 Australian dental journal return 69
  70. 70. A chronic endemic form of hypoplasia of the dental e a e enamel caused by d drinking water with a high g ate t g fluorine content during the time of tooth formation, and characterized by defective , y calcification that gives a white chalky appearance to the enamel, which g pp , graduallyy undergoes brown discoloration. Jablonski's Dictionary of Dentistry, 1992, p286 Return 70

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