DH 23Periodontal Case Study By: Kelli Robinson
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.
Patient Profile • Sally Smiles Age: 16 Sex: F Ethnicity: Caucasian Occupation: Student
Chief Complaint • Patients states she wants her teeth cleaned.
Medical and Dental History • Pt states she wears reading glasses • Pt states she’s 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
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.
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
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
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
Goals • Arrest patients areas of recession • Using a automatic toothbrush or bass technique • Flossing four times a week, especially lingual arch wires
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
Radiographs Pano- Taken @ RCC 3/08
Oral Pictures Pre-treatment Supragingival Plaque and calculus on mandibular incisors Recession Buccal #28-30
Oral Pictures Post-treatment Manibular incisors-Post Tx