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Diagnosis and treatment_planning


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Diagnosis and treatment_planning

  1. 1. Diagnosis and Treatment Planning 52 yr old male who has had perio eval after seeing his general dentist. The periodontist want to know if #18 can be retreated or should it be extracted? Courtesy Dr. Randy Hedrick and ROOTS
  2. 2. Radiographs
  3. 3. Examination and Testing <ul><li>Fluctuant, boggy swelling on #18-19 buccal area for several months that usually drains in the morning, no pain, some soreness until after it drains. </li></ul><ul><li>Cold: #20 no response, #21-23 normal response </li></ul><ul><li>Perio: #18 8+mm, with purulence </li></ul><ul><li> #20 8-10mm, with purulence </li></ul><ul><li> #21-23 < 3mm </li></ul><ul><li>No percussion or bite sensitivity </li></ul><ul><li>Bridge #18-20 has CL I mobility </li></ul><ul><li>#18 previous endo tx with multiple posts/pins </li></ul>
  4. 4. More Radiographs
  5. 5. Diagnosis <ul><li>Malignant Lymphoma, </li></ul><ul><li>diffuse large B-cell type </li></ul>
  6. 6. Comments <ul><li>#17-22 were extracted, Chemo and radiation therapy </li></ul><ul><li>Wife 2yrs later “You would never think that a dentist could save your life but you did it for us.” </li></ul><ul><li>5/2/06 No recurrence, annual checks with oncologist </li></ul><ul><li>“ Please continue to show my case others so they can learn from it. I think that is just awesome for you to continue to show it!” </li></ul>