Transcript DH 23 Periodontal Case Study

DH 23
Periodontal Case Study
By: Kelli Robinson
Rationale for case selection
Because of patients age I was under
the impression that she would be a
light, ADA I case that I could complete
in two appointments max.
My preconceptions were false, this case
proved to me that all patients, all ages,
male or female can be periodontally
involved.
Patient Profile
Sally Smiles
Age: 16
Sex: F
Ethnicity: Caucasian
Occupation: Student
Chief Complaint
Patients states she wants her teeth
cleaned.
Medical and Dental History
Pt states she wears reading glasses
Pt states she’s current on her childhood and Hep B
vaccinations
Pt states she menstruates regularly
Pt states she takes a One-A-Day Multivitamin
Pt denied any other past or present medical info
Last cleaning and dental exam: 06/2007
Previous radiographs: FMX 06/2007 (existing) and
Pano 03/08 (RCC)
Orthodontic Tx: 2004 for 1.5 yrs
Clinical Findings
E & I: Freckles, mole below nose, fibrous lingual
frenum, and mandibluar tori.
Restorations: #2-O comp, #3-seal, #14-OB comp,
#15-O comp, #18-O comp, #19-O comp, #20-O
comp, #30-O comp, #31-O comp.
Pt has lingual arch wires behind #8-9 and #22-27.
MBI: 0%, BOP: 1.8%, Probing gen. 1-3mm
Mobility: Slight #8, 24-26
Fremetus: #8
Calculus: Pt had no subgingival calculus, only
supragingival on the buccal of maxillary molars and
on the lingual of mand. incisors.
Clinical Findings
Perio Exam: Patient presented with localized
recession- 2mm on #2-B, 12-B, 19-B, 30-B, 1mm on
#20-B, 28-B, 29-B
The recession brought the A.L. on #3, 12, 19, & 30
to 4mm.
Radiographic Exam: Trabecular pattern was
consistent throughout, lamina dura was present
throughout, alveolar crest was gen. 1-2mm from CEJ
with local. 3-4mm in the posterior regions, there was
no widening of the PDL space.
ADA II and generalized slight chronic periodontitis
due to plaque and calculus
Dental Health Education
Went over what recession is and why she
might be having sensitivity associated with
the areas of recession
OHI on Automatic tooth brushing technique
OHI on Bass brushing technique
Flossing especially between both arch wires
Tepe brush (Pink) for arch wires
Rationale for case selection
Because of patients age I was under
the impression that she would be a
light, ADA I that I could complete in
two appointments max.
Thought case was interesting and felt
the need to share with the class
Goals
Arrest patients areas of recession
Using a automatic toothbrush or bass
technique
Flossing four times a week, especially
lingual arch wires
Treatment Plan
Apt 1:
RMH
Pano & 1PAX
Assessments
Apt 2:
DDS Exam
2nd Check in
PI & OHI
Scaled UR
Apt 3:
OHI
Scaled LR
Scaled UL
Scaled LL
4mrc
Implementation of Tx Plan
Referred patient to primary DDS for
examination of 3rd molars
Treatment Plan went as scheduled
OHI was given at every appointment
Radiographs
Pano- Taken @ RCC 3/08
Oral Pictures
Pre-treatment
Supragingival Plaque and
calculus on mandibular
incisors
Recession Buccal #28-30
Oral Pictures
Post-treatment
Manibular incisors-Post Tx
Questions?