Endodontics

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Endodontics

  1. 1. APPENDIX I ENDODONTICS SPECIALTY BOARD CASE PRESENTATION REPORTCase Number: Candidate Number:Patient Age: Date Started:Patient Sex*: Male/ Female Date Finished:Procedure Category *: Date of Recall:Diag / Emer / Med Comp / NS RCT / RETX / S-RCT / Others* Delete where applicable A. Tooth # (FDI notation): B. CHIEF COMPLAINT: C. MEDICAL HISTORY: D. DENTAL HISTORY: E. CLINICAL EVALUATION 1. EXAMINATION 2. DIAGNOSTIC TESTS
  2. 2. 3. RADIOGRAPHIC FINDINGSF. PRE-TREATMENT DIAGNOSIS: Pulpal: Periradicular: Others:G. TREATMENT PLAN: Recommended: Emergency: Definitive: Alternative: Other Treatment Needs:
  3. 3. H. PROGNOSIS I. CLINICAL PROCEDURES: Treatment Record CANAL WORKING MASTER OBTURATION TECHNIQUES(M, D, B, L etc) LENGTH APICAL MATERIALS FILE SIZE (MAF) J. POST-TREATMENT DIAGNOSIS (If different) Pulpal: Periradicular: K. HISTOPATHOLOGIC DIAGNOSIS (If biopsied)
  4. 4. L. RECALLS (Last recall recorded must be a minimum of 1 year) Date: Date: Date:M. DISCUSSION

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