Comprehensive case (graduation presentation)
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Comprehensive case (graduation presentation)
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Comprehensive case (graduation presentation)
- 1. Clinical Comprehensive Case Presentation Prepared By : Ghadah Sidqi Abulqumsan
- 2. Restorations RCT’s Post & Core & crown
- 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
- 10. Frontal View
- 13. DIAGNOSTIC TOOLS
- 14. Mounted Diagnostic Cast • Mounted Diagnostic Cast: • Molar relationship Rt : Class I Lt : Indeterminable • Canine Relationship Rt: Class I Lt : Class I
- 15. RADIOGRAPHS
- 16. * #36 Extracted * Mild generalized horizontal bone resorption * #14 Root canal treatment * #16, #22 & #46 treated by restorations * #34 & #46 periapical radiolucency * #27 Distal deep radiolucency of the crown
- 17. Periapical Films
- 20. DIAGNOSIS
- 21. Diagnosis Bad oral hygiene Destructed carious crown #27 Multiple carious teeth Partially edentulous of lower arch
- 22. TREATMENT PLANE
- 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
- 27. Control Oral Hygiene • Generalized mild gingivitis Condition • Scalling of lower lingual, • Polishing of all teeth, • Oral hygiene instructions Treatment
- 28. Restorative Treatment • Conditions #16 Recurrent caries #22 Mesial recurrent caries #25 Distal caries #26 Occlusal Caries #27 Distal caries #45 Distal caries #46 Recurrent caries #47 Occlusal caries #34 Opened cavity #35 Occlusal caries #37 occlusal & buccal caries UR UL LR UL
- 29. Maxillary Arch Condition • Caries and recurrent caries Treatment • Remove the caries and old resto then filled by composite #22
- 32. Treatment #25 & #26 Before After Cavity Preparation
- 36. Mandible Condition • Caries & recurrent caries Treatment • Remove the caries & old resto then filled the cavities by composite #34, #35, #37, #45, #46 & #47 caries of the tip of cusp
- 37. Treatment #34 & 35 Before After Cavity Preparation
- 43. Treatment #47
- 44. After Treatment Rt side Before After
- 45. After Treatment Lt Side Before After
- 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.
- 47. Examination Clinical Examination Large cavity (Occlusal) in #34 RadiographicFindings • Periapical radiolucency Pulpalvitality Test Percussion -ve Palpation -ve Cold test -ve
- 49. Root canal treatment #34 Measurement of Master File& Cone Canal Length Size #34 19 40 Treatment
- 51. After Treatment Before After After opturation
- 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
- 54. Diagnosis Chronic Apical Abscess
- 55. Root canal treatment #46 Measurement of Master File& Cone Canal Length Size Mesio-Buccal 18 40 Mesio-Lingual 18 40 Distal 19 50 Treatment
- 62. Right Lateral View Before After
Editor's Notes
- She want to installing braces ( ortho-treatment )