DH 23 Periodontal Case Study

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DH 23Periodontal Case Study

• By Kelli Robinson

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Rationale for case selection

• Because of patients age I was under the
  impression that she would be a light, ADA I case
  that I could complete in two appointments max.
• My preconceptions were false, this case proved to
  me that all patients, all ages, male or female
  can be periodontally involved.

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Patient Profile

• Sally Smiles
• Age 16
• Sex F
• Ethnicity Caucasian
• Occupation Student

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Chief Complaint

• Patients states she wants her teeth cleaned.

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Medical and Dental History

• Pt states she wears reading glasses
• Pt states shes current on her childhood and Hep
  B vaccinations
• Pt states she menstruates regularly
• Pt states she takes a One-A-Day Multivitamin
• Pt denied any other past or present medical info
• Last cleaning and dental exam 06/2007
• Previous radiographs FMX 06/2007 (existing) and
  Pano 03/08 (RCC)
• Orthodontic Tx 2004 for 1.5 yrs

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Clinical Findings

• E I Freckles, mole below nose, fibrous lingual
  frenum, and mandibluar tori.
• Restorations 2-O comp, 3-seal, 14-OB comp,
  15-O comp, 18-O comp, 19-O comp, 20-O comp,
  30-O comp, 31-O comp.
• Pt has lingual arch wires behind 8-9 and 22-27.
• MBI 0, BOP 1.8, Probing gen. 1-3mm
• Mobility Slight 8, 24-26
• Fremetus 8
• Calculus Pt had no subgingival calculus, only
  supragingival on the buccal of maxillary molars
  and on the lingual of mand. incisors.

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Clinical Findings

• Perio Exam Patient presented with localized
  recession- 2mm on 2-B, 12-B, 19-B, 30-B, 1mm on
  20-B, 28-B, 29-B
• The recession brought the A.L. on 3, 12, 19,
  30 to 4mm.
• Radiographic Exam Trabecular pattern was
  consistent throughout, lamina dura was present
  throughout, alveolar crest was gen. 1-2mm from
  CEJ with local. 3-4mm in the posterior regions,
  there was no widening of the PDL space.
• ADA II and generalized slight chronic
  periodontitis due to plaque and calculus

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Dental Health Education

• Went over what recession is and why she might be
  having sensitivity associated with the areas of
  recession
• OHI on Automatic tooth brushing technique
• OHI on Bass brushing technique
• Flossing especially between both arch wires
• Tepe brush (Pink) for arch wires

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Rationale for case selection

• Because of patients age I was under the
  impression that she would be a light, ADA I that
  I could complete in two appointments max.
• Thought case was interesting and felt the need to
  share with the class

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Goals

• Arrest patients areas of recession
• Using a automatic toothbrush or bass technique
• Flossing four times a week, especially lingual
  arch wires

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Treatment Plan
Apt 1 Apt 3
RMH OHI
Pano 1PAX Scaled LR
Assessments Scaled UL
Scaled LL
Apt 2 4mrc
DDS Exam
2nd Check in
PI OHI
Scaled UR
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Implementation of Tx Plan

• Referred patient to primary DDS for examination
  of 3rd molars
• Treatment Plan went as scheduled
• OHI was given at every appointment

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Radiographs

• Pano- Taken _at_ RCC 3/08

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Oral Pictures

• Pre-treatment

Supragingival Plaque and calculus on mandibular
incisors
Recession Buccal 28-30
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Oral Pictures

• Post-treatment

Manibular incisors-Post Tx
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Questions?