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Diagnosis and clinical examination/ oral surgery courses  

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit 
www.indiandentalacademy.com

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Diagnosis and clinical examination/ oral surgery courses  

  1. 1. Clinical examination,Diagnosis and Treatment Plan for Complete Denture Patients INDIAN DENTAL ACADEMY Leader in continuing Dental Education www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. CONTENTS Introduction Definition Communicating with the patient History taking Examination Supplemental diagnostic aids Treatment plan Conclusion References www.indiandentalacademy.comwww.indiandentalacademy.com
  3. 3. INTRODUCTION The goal in clinical examination is to recognize normal anatomy and physiology, normal variations, and early signs and symptoms of any disease. A through, comprehensive examination also allows modification or possible deferment of treatment when indicated. www.indiandentalacademy.comwww.indiandentalacademy.com
  4. 4. Examination: Scrutiny or investigation for the purpose of making a diagnosis or assessment -GPT Diagnosis: The determination of the nature of the disease- GPT Treatment plan: The sequence of procedures planned for the treatment of a patient after diagnosis-GPT DefinitionDefinition www.indiandentalacademy.comwww.indiandentalacademy.com
  5. 5. Diagnosis is derived from a Greek word which means Diag - to know Osis – condition “To know a condition” www.indiandentalacademy.comwww.indiandentalacademy.com
  6. 6. History taking and examination www.indiandentalacademy.comwww.indiandentalacademy.com
  7. 7. Ask the patient to fill the medical history form www.indiandentalacademy.comwww.indiandentalacademy.com
  8. 8. HAND SHAKEHAND SHAKE www.indiandentalacademy.comwww.indiandentalacademy.com
  9. 9. DEAD FISH VICE LIKEDEAD FISH VICE LIKE www.indiandentalacademy.comwww.indiandentalacademy.com
  10. 10. www.indiandentalacademy.comwww.indiandentalacademy.com
  11. 11. Seat the patient in the dental chair www.indiandentalacademy.comwww.indiandentalacademy.com
  12. 12. “we should meet the mind of the patient before we meet the mouth of the patient” www.indiandentalacademy.comwww.indiandentalacademy.com
  13. 13. Let the patient talk--.the dentist listens www.indiandentalacademy.comwww.indiandentalacademy.com
  14. 14. www.indiandentalacademy.comwww.indiandentalacademy.com
  15. 15.  NameName  AgeAge below 40 yearsbelow 40 years above 40 yearsabove 40 years  SexSex malemale femalefemale www.indiandentalacademy.comwww.indiandentalacademy.com
  16. 16. OCCUPATIONOCCUPATION • socioeconomic statussocioeconomic status • estheticsesthetics • phoneticsphonetics • functionfunction www.indiandentalacademy.comwww.indiandentalacademy.com
  17. 17. www.indiandentalacademy.comwww.indiandentalacademy.com
  18. 18. www.indiandentalacademy.comwww.indiandentalacademy.com
  19. 19. RACERACE www.indiandentalacademy.comwww.indiandentalacademy.com
  20. 20. ADDRESS AND TELEPHONE NOADDRESS AND TELEPHONE NO www.indiandentalacademy.comwww.indiandentalacademy.com
  21. 21. Chief complaintChief complaint MasticationMastication EstheticsEsthetics PhoneticsPhonetics FunctionFunction www.indiandentalacademy.comwww.indiandentalacademy.com
  22. 22. Patient expectationsPatient expectations www.indiandentalacademy.comwww.indiandentalacademy.com
  23. 23. MEDICAL HISTORYMEDICAL HISTORY • Cardiovascular diseaseCardiovascular disease • DiabetesDiabetes • Respiratory disorderRespiratory disorder • Rheumatic heart diseaseRheumatic heart disease • Blood dyscrasiasBlood dyscrasias • Neurological diseaseNeurological disease • Skin disordersSkin disorders • Bone disorder / arthritisBone disorder / arthritis • Transmissable diseasesTransmissable diseases • Immune disordersImmune disorders www.indiandentalacademy.comwww.indiandentalacademy.com
  24. 24. Chair Side ExaminationChair Side Examination • Once the patient is seated on the chair the following conditionsOnce the patient is seated on the chair the following conditions are observed :are observed : • Mode of breathing (for respiratory disorders).Mode of breathing (for respiratory disorders). • Pallor (for anaemia).Pallor (for anaemia). • Edema (for heart disease or renal failure).Edema (for heart disease or renal failure). • Blood pressure, pulse (for hypertension).Blood pressure, pulse (for hypertension). • Wide pupils ( Glaucoma )Wide pupils ( Glaucoma ) www.indiandentalacademy.comwww.indiandentalacademy.com
  25. 25. DRUG HISTORYDRUG HISTORY • InsulinInsulin • Anti hypertensiveAnti hypertensive • Anti anxietyAnti anxiety • DiureticsDiuretics • AnticoagulantAnticoagulant • CorticosteroidsCorticosteroids www.indiandentalacademy.comwww.indiandentalacademy.com
  26. 26. • Nutritional statusNutritional status • HabitsHabits www.indiandentalacademy.comwww.indiandentalacademy.com
  27. 27. Patients psychologyPatients psychology • Philosphical • Exacting • Hysterical • Indifferent www.indiandentalacademy.comwww.indiandentalacademy.com
  28. 28. 2ndclassification (Freud)2ndclassification (Freud) 1.1. Philosophical ..-understandingPhilosophical ..-understanding 2.2. Indifferent ..no interestIndifferent ..no interest 3.3. Critical ..looking for faultsCritical ..looking for faults 4.4. Skeptical ..unwilling to believeSkeptical ..unwilling to believe www.indiandentalacademy.comwww.indiandentalacademy.com
  29. 29. 1.Co-operative 2.Apprehensive 3.Unco-operative Simplest classification-Simplest classification- www.indiandentalacademy.comwww.indiandentalacademy.com
  30. 30. DENTAL HISTORYDENTAL HISTORY • Reasons for loss of teethReasons for loss of teeth cariescaries periodontalperiodontal congenitalcongenital • Sequence of loss of teethSequence of loss of teeth anterioranterior posteriorposterior • Duration of complete edentulousnessDuration of complete edentulousness www.indiandentalacademy.comwww.indiandentalacademy.com
  31. 31. border extensions, stability, retention, esthetics, the vertical dimension of occlusion, inter occlusal distance, phonetics, Denture hygiene Para functional habits occlusion. If the patient has previous completeIf the patient has previous complete dentures,examine thedentures,examine the www.indiandentalacademy.comwww.indiandentalacademy.com
  32. 32. Previous extraction recordsPrevious extraction records www.indiandentalacademy.comwww.indiandentalacademy.com
  33. 33. Examination extra oral examination www.indiandentalacademy.comwww.indiandentalacademy.com
  34. 34. • GaitGait • Physical deformitiesPhysical deformities www.indiandentalacademy.comwww.indiandentalacademy.com
  35. 35. BODY BUILDBODY BUILD • AesthenicAesthenic-(thin physique)They possess narrow dental arches-(thin physique)They possess narrow dental arches • PletoricPletoric-(obese) = they possess large square dental arches-(obese) = they possess large square dental arches • AthleticAthletic -(normal built) = they have normal sized arches-(normal built) = they have normal sized arches www.indiandentalacademy.comwww.indiandentalacademy.com
  36. 36. 2ndclassification (SHELDON)2ndclassification (SHELDON) 1.1. EndomorphicEndomorphic-(Tall and thin) : they posses large square dental-(Tall and thin) : they posses large square dental archesarches 2.2. Mesomophic-Mesomophic-(average physique) : they have normal sized(average physique) : they have normal sized archesarches 3.3. EctomorphicEctomorphic (short and obese)-They possess narrow dental(short and obese)-They possess narrow dental archesarches www.indiandentalacademy.comwww.indiandentalacademy.com
  37. 37. SYMMETRYSYMMETRY www.indiandentalacademy.comwww.indiandentalacademy.com
  38. 38. Face formFace form www.indiandentalacademy.comwww.indiandentalacademy.com
  39. 39. Williams classification www.indiandentalacademy.comwww.indiandentalacademy.com
  40. 40. Face profileFace profile www.indiandentalacademy.comwww.indiandentalacademy.com
  41. 41. COMPLEXIONCOMPLEXION www.indiandentalacademy.comwww.indiandentalacademy.com
  42. 42. Clinical examination,Diagnosis and Treatment Plan for Complete Denture Patients www.indiandentalacademy.comwww.indiandentalacademy.com
  43. 43. PERIORAL STRUCTURESPERIORAL STRUCTURES lip examination:lip examination: 1.1. Lip supportLip support 2.2. Lip thicknessLip thickness 3.3. Lip lengthLip length 4.4. Lip cracking orLip cracking or fissuringfissuring www.indiandentalacademy.comwww.indiandentalacademy.com
  44. 44. 1.1. Nasolabial foldNasolabial fold 2.2. PhiltrumPhiltrum 3.3. MuscleMuscle www.indiandentalacademy.comwww.indiandentalacademy.com
  45. 45. Examination of the TMJExamination of the TMJ TendernessTenderness CrepitusCrepitus Mandibular movementsMandibular movements www.indiandentalacademy.comwww.indiandentalacademy.com
  46. 46. SOFT TISSUES EXAMINATIONSSOFT TISSUES EXAMINATIONS MUCOSAMUCOSA ColourColour ConditionCondition Thickness of mucosaThickness of mucosa www.indiandentalacademy.comwww.indiandentalacademy.com
  47. 47. Thickness of mucosaThickness of mucosa Class I class I I class I I I www.indiandentalacademy.comwww.indiandentalacademy.com
  48. 48. Tongue positionTongue position Class I class I I class I I I www.indiandentalacademy.comwww.indiandentalacademy.com
  49. 49. Tongue sizeTongue size Class I class I I class I I I www.indiandentalacademy.comwww.indiandentalacademy.com
  50. 50. FLOOR OF MOUTHFLOOR OF MOUTH www.indiandentalacademy.comwww.indiandentalacademy.com
  51. 51. Genial tuberclesGenial tubercles www.indiandentalacademy.comwww.indiandentalacademy.com
  52. 52. SALIVASALIVA • serousserous • mucousmucous • xerostomiaxerostomia www.indiandentalacademy.comwww.indiandentalacademy.com
  53. 53. MUSCLE ATTACHMENTSMUSCLE ATTACHMENTS www.indiandentalacademy.comwww.indiandentalacademy.com
  54. 54. Frenal attachmentsFrenal attachments www.indiandentalacademy.comwww.indiandentalacademy.com
  55. 55. www.indiandentalacademy.comwww.indiandentalacademy.com
  56. 56. Arch formArch form Class I class I I class I I I www.indiandentalacademy.comwww.indiandentalacademy.com
  57. 57. Arch sizeArch size Class I class I I class I I I www.indiandentalacademy.comwww.indiandentalacademy.com
  58. 58. Ridge contourRidge contour www.indiandentalacademy.comwww.indiandentalacademy.com
  59. 59. www.indiandentalacademy.comwww.indiandentalacademy.com
  60. 60. Palatal vaultPalatal vault U shape V shape Flat www.indiandentalacademy.comwww.indiandentalacademy.com
  61. 61. SOFT PALATESOFT PALATE Class I class I I class I I I www.indiandentalacademy.comwww.indiandentalacademy.com
  62. 62. Gag reflexGag reflex www.indiandentalacademy.comwww.indiandentalacademy.com
  63. 63. PALATAL THROAT FORMPALATAL THROAT FORM Class I class I I class I I I www.indiandentalacademy.comwww.indiandentalacademy.com
  64. 64. LATERAL THROAT FORMLATERAL THROAT FORM Class I class I I class I I I www.indiandentalacademy.comwww.indiandentalacademy.com
  65. 65. RIDGE PARALLELISMRIDGE PARALLELISM Class I class I I class I I I www.indiandentalacademy.comwww.indiandentalacademy.com
  66. 66. RIDGE RELATIONSHIPRIDGE RELATIONSHIP Class I class I I class I I I www.indiandentalacademy.comwww.indiandentalacademy.com
  67. 67. INTERRIDGE DISTANCEINTERRIDGE DISTANCE Class I class I I class I I I www.indiandentalacademy.comwww.indiandentalacademy.com
  68. 68. INTER ARCH SPACEINTER ARCH SPACE www.indiandentalacademy.comwww.indiandentalacademy.com
  69. 69. www.indiandentalacademy.comwww.indiandentalacademy.com
  70. 70. TORITORI www.indiandentalacademy.comwww.indiandentalacademy.com
  71. 71. www.indiandentalacademy.comwww.indiandentalacademy.com
  72. 72. www.indiandentalacademy.comwww.indiandentalacademy.com
  73. 73. www.indiandentalacademy.comwww.indiandentalacademy.com
  74. 74. www.indiandentalacademy.comwww.indiandentalacademy.com
  75. 75. RADIOGRAPHSRADIOGRAPHS www.indiandentalacademy.comwww.indiandentalacademy.com
  76. 76. Treatment planTreatment plan • Elimination of infectionElimination of infection • Elimination of pathologyElimination of pathology • Pre-prosthetic surgeryPre-prosthetic surgery • Tissue conditioningTissue conditioning www.indiandentalacademy.comwww.indiandentalacademy.com
  77. 77. Review of literatureReview of literature Thomas j mc garry n etal gave classification system forThomas j mc garry n etal gave classification system for complete edentulism. J PROSTHODONT 1999; 8; 1; 27-39complete edentulism. J PROSTHODONT 1999; 8; 1; 27-39 www.indiandentalacademy.comwww.indiandentalacademy.com
  78. 78. Classification System for the Completely Edentulous PatientClass I Class II Class III Class IV Diagnostic Criteria 1. Bone height--mandibular 2. Maxillomandibular relationship 3. Residual ridge morphology- maxilla 4. Muscle attachments Ideal or minimally compromised Moderately compromised Substantially compromised Severely compromised www.indiandentalacademy.comwww.indiandentalacademy.com
  79. 79. conclusionconclusion ““the most important thing you can do for your patient isthe most important thing you can do for your patient is to make the correct diagnosis.it is the foundation for success .to make the correct diagnosis.it is the foundation for success . nothing is more critical to success than beginning with anothing is more critical to success than beginning with a necessary data”necessary data” www.indiandentalacademy.comwww.indiandentalacademy.com
  80. 80. REFERENCESREFERENCES 1.1. Complete Denture Prosthetics – John P. SharryComplete Denture Prosthetics – John P. Sharry 2.2. Essentials of complete denture – Sheldon winklerEssentials of complete denture – Sheldon winkler 3.3. Syllabus for Complete Dentures – Charles HeartwellSyllabus for Complete Dentures – Charles Heartwell 4.4. Treatment Planning for Edentulous Patients – BoucherTreatment Planning for Edentulous Patients – Boucher 5.5. Dental clinical of north America vol 40 ; no 1 ; janDental clinical of north America vol 40 ; no 1 ; jan 1996.1996. 6.6. Classification system for complete edentulism.Classification system for complete edentulism. J PROSTHODONT 1999; 8; 1; 27-39J PROSTHODONT 1999; 8; 1; 27-39 www.indiandentalacademy.comwww.indiandentalacademy.com

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