3. Introduction
• Patient’s name : Ms. Amatulrahman
S. Abulqumsan
• Religion : Muslim
• Date of birth : 12 October, 2000
• Age : 15 Y/O
• Occupation : Secondary school
student
Personal data
4. Reason for Attendance n
Chief Complaint
• I have a pain in lower right and left
teeth , presented before one month.
Medical History
• She is not suffering from any disease
• No allergies nor medication
5. • Past Dental History
The last dental visit before 3
months.
• Previous Dental Treatment
Multiple composite restorations
of #16, #22, #47 & #46 .
Endodonticaly treated of #14
Extractions #36
• No allergies or complications
occurred in the dental clinic
before.
DentalHistory
• Brush once daily with
vertical and horizontal
motion
• Does not use auxiliary aids
• No oral habits
Oral Hygiene
& Habits
7. Extra Oral Examination
• Face :Asymmetrical, swelling in left side
• Skin :No abnormalities detected ( NAD )
• Lips :Competent
• TMJ :No clicking, no deviation during
opening & closing mouth & not tender
to palpation
• SMLN:Not palpable and not tender to
palpation
8. Intra Oral Examination
Lips NAD
Labial / Buccal mucosa NAD in upper ,
but there is swelling & inflammation in
lower buccal mucosa
Hard / Soft palate NAD
Tongue NAD
Saliva NAD
Labial / Buccal / lingual Vestibule NAD
Gingiva NAD
Floor of the Mouth NAD
14. Mounted Diagnostic Cast
• Mounted Diagnostic
Cast:
• Molar relationship
Rt : Class I
Lt : Indeterminable
• Canine Relationship
Rt: Class I
Lt : Class I
23. Objectives of treatment
• Address the patient chief complaint.
• Maintain good oral hygiene. ( scaling & root
planning)
• To replace the missing teeth
• To improve the patient comfort and masticatory
ability
• To maintain the health and integrity of dental
arches
• Educate and motivate the patient. (OHI)
• To restore to full function and rehabilitation of
entire occlusion
24. Treatment Options for Missing
Teeth
Orthodontic
Implants
Crowns and bridges
RPD
25. Treatment Plan
• Phase I Oral hygiene instructions,
scalling and root planning,
caries excavation of #12, #15, #17, #21, #26, #35 & #37
Remove old restorations #16, #22 & #47
Recalling the patient after 3 weeks
• Phase II Root canal treatment of #27, #34, & #46
• Phase III Permanent restoration for #12, #15, #16, #17, #21, #22,
#26, #35, #37& #47
Post & core #14
Fixed crown #14
Refer the pt. to orthodontic to treat the space.
• Phase IV Follow up & Maintenance
46. Endodontic Treatment
Clinical Scenario 1
• A 15 years old female, came to the clinic with
complaint of sever spontaneous pain in #34, lead
to wake her from the sleep; this pain started after
going to the dental clinic to endodontic treatment
of the same tooth before one year and a half. She
does not go back again to complete the treatment,
and still with TF and pain. The pain relief by the
analgesic (Brufen 400mg). And no swelling
detected intra& extra oral.
52. • The same patient came to the clinic with
complaint of sever spontaneous pain in lower
right teeth. Due to the pain, she cannot sleep
for one month before she came to the clinic.
The pain relief by the analgesic (Brufen
400mg). And there is intra oral swelling and
pus formation.
Endodontic Treatment
Clinical Scenario 2
53. Examination
Clinical Examination
Large composite restoration (Occluso-Buccal) in #46
RadiographicFindings
• Radiolucency under the restoration
• Mesial radiolucency close to the pulp
• Periapical radiolucency
Pulpalvitality Test
Percussion +ve
Palpation +ve
Cold test +ve