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Perio Project

Perio Project. Luis Moreno & Gita Ansari. General information. Patient’s name: Grover Holland Sex: Male Age: 36 Ethnicity: Caucasian Profession: Registered Nurse Marital status: Partnered. Medical History. HIV positive since 1990. Suffers from depression Severe dental phobia

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Perio Project

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  1. Perio Project Luis Moreno & GitaAnsari

  2. General information • Patient’s name: Grover Holland • Sex: Male • Age: 36 • Ethnicity: Caucasian • Profession: Registered Nurse • Marital status: Partnered

  3. Medical History • HIV positive since 1990. • Suffers from depression • Severe dental phobia • Allergic to sulfa drugs

  4. Past history • All childhood immunizations • High fever as a child • Recurrent headaches • Recurrent backaches • Urinary infection • Other unspecified STDs.

  5. Medications and health status • Atripla: antiretroviral drug for HIV infection • PristiqDesvenlafaxin: NSRI drug for depression • Last medical exam: Jan/12/2010 • CD4 count: 540 • Viral load: undetectable

  6. Treatment plan • 4 quadrants of Root planings • Tooth #1 surgical extraction • Tooth #2 RCT, build up and PFM • Tooth #14 DO composite filling • Tooth #15 DO composite filling • Tooth # 19 B composite filling • Tooth # 30 MO composite filling • Perio consultation

  7. First appointmentAssessment only • BP: 130/90 • Pulse: 74 • Respiration: 14 • ASA: II • Alginate impressions • Intraoral photos • OHI

  8. Oral assessment • Extraoral: WNL • Intraoral: WNL • Salivary flow: adequate • PI: 26% • MBI: 90% • Calculus: Meduim-heavy • Periodontal probings: generalized 2-4 and localized 5-7. • AAP: Generalized moderate chronic perio.

  9. Gingival description • Color:generalized coral attached gingiva. Apparent red free gingival margin due to LGE. • Contour:generalized soft, spongy, hemorrhagic and edematous • Consistency: generalized bulbous, swollen • Texture:generalized glossy, smooth and shiny • Alveolar mucosa: WNL • Tongue: WNL

  10. Occlusalclasification • Mesognathic profile • End to end bite on right posterior teeth. • Edge to edge on anterior teeth. • Cross bite on tooth #10 and all left side posteriors. • No TMD present . • No deflexion or deviation. • No myalgia at the time of evaluation.

  11. Radiographs

  12. Study models

  13. Study models

  14. Treatment • Second appointment • BP: 124/78 • P: 80 • R: 14 • Sc/Rp LLQ &ULQ with anesthesia. • Third appointment • BP: 128/82 • P: 77 • R: 16 • Sc/Rp URQ &LRQ with anesthesia.

  15. Treatment • Fourth appointment • BP: 124/80 • P: 60 • R: 14 • MBI 48% • Plaque index 10% • Intraoral photographs • OHI • Nutritional counseling. • Research: • Highly active antiretroviral therapy.

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