PERIODONTAL CASE STUDY PROJECT Dental Hygiene Clinical Practice

EXTRA ORAL & INTRA ORAL FINDINGS v Bilateral linea alba v Sl pronounced rugae

ASSESSMENT FINDINGS v Class I furcations on the buccal aspect of #18 & 31

GINGIVAL DESCRIPTION v Generalized slight cyanotic, recessed, rounded, firm stippled tissue with localized bleeding

CONTRIBUTORY FACTORS v Calculus v Faulty restorations v Root morphology v Root resorption v

PERIODONTAL RISK FACTORS v Stress v Nutritional deficiencies v Obesity

RADIOGRAPHS v See hard copy (scanner not working)

PERIODONTAL DIAGNOSIS v Generalized moderate inactive chronic periodontitis with localized severe inactive chronic periodontitis

PROCEDURES v v First & second visit completed assessments Third visit v Medical history,

PROCEDURES v Fifth visit Medical history, IOE, EOE, vital signs Biofilm index Still doing

SUMMARY v Although this case had many challenges I learned a lot from it.

Slides: 21

Download presentation

PERIODONTAL CASE STUDY PROJECT Dental Hygiene Clinical Practice II Shannon Kelleher

PATIENT PROFILE v 59 year old Caucasian male v Health history reveals: Job related stress High blood pressure controlled with medication Vitals WNL ASA Class II v Dental history reveals: Brushes with electric toothbrush 1 x daily Flosses occasionally Clenches 3 month recall

EXTRA ORAL & INTRA ORAL FINDINGS v Bilateral linea alba v Sl pronounced rugae v Sl scalloped & coated tongue v Sl maxillary right resorption of alveolar ridge v Moderate generalized attrition v Torso version #8, 9, 10, 21, 23, 28 & 29 v Linguoversion #4, 5 & 12 v Labioversion #6, 10, 11, 23 & 25 v Angles Class I molar & canine left v Angles Class I tend to II canine right v 20% overbite v Maxillary frena tag v 4 mm over jet v Amalgam stain #12 & 27 v Abfraction #4, 6, 11, 27 & 28

INTRA ORAL PHOTOS

DENTAL CHART

PERIODONTAL CHARTING

PE RIOD ONTAL EVALUAT ION

ASSESSMENT FINDINGS v Class I furcations on the buccal aspect of #18 & 31 v Class I furcations on the lingual aspect of #2, 17, 18 & 30 v Class II furcations on the buccal aspect of #2, 14, 15 & 17 v No mobility v Mucogingival involvement #17 v Sl BOP #13, 14, 15, 17 & 23 v Generalized spicules of subgingival calculus v Sl localized spicules of supragingival calculus on mandibular anteriors v Generalized moderate interproximal biofilm v Biofilm index 52%

GINGIVAL DESCRIPTION v Generalized slight cyanotic, recessed, rounded, firm stippled tissue with localized bleeding on probing.

CONTRIBUTORY FACTORS v Calculus v Faulty restorations v Root morphology v Root resorption v Mouth breathing v Food impaction v Malocclusion v Occlusal discrepancies v Un-replaced teeth v Clenching

PERIODONTAL RISK FACTORS v Stress v Nutritional deficiencies v Obesity

RADIOGRAPHS v See hard copy (scanner not working)

PERIODONTAL DIAGNOSIS v Generalized moderate inactive chronic periodontitis with localized severe inactive chronic periodontitis on teeth #2, 5, 18, 21, 29 & 31 with localized severe active chronic periodontitis on teeth #14, 15, & 17 v AAP IV

TREATMENT PLAN

PROCEDURES v v First & second visit completed assessments Third visit v Medical history, EOE, IOE, vital signs Biofilm index & homecare Review electric TB technique, floss technique & how to use proxi-brush Debridement on UR with cavitron slim insert & hand instrumentation Fourth visit Medical history, EOE, IOE, vital signs Biofilm index Reinforce good job done at home & improved biofilm index Re-assess UR Debridement of LR with cavitron slim insert & hand instrumentation

PROCEDURES v Fifth visit Medical history, IOE, EOE, vital signs Biofilm index Still doing a great job with homecare Re-assess UR & LR Debridement of UL with cavitron slim insert & hand instrumentation v Sixth visit Medical history, IOE, EOE, vital signs Biofilm index slightly more interproximal biofilm reinforced importance of flossing & technique Re-assess UR, LR & UL Debridement of LL with cavitron slim insert & hand instrumentation Selective motor polishing of mandibular anteriors Fluoride treatment with Na. Fl gel trays

SUMMARY v Although this case had many challenges I learned a lot from it. There were many things from text books and class that I got to see first hand with this patient. He had furcations, mucogingival involvement and extensive restorations among other issues. I was proud of myself for doing as well as I did with this case with the little experience that I had. There were a few areas around furcations that I had left some tenacious calculus but I don’t feel as though I had the experience level to remove it and in the future I expect to learn techniques to deal with that type of situation. v I would love to have this patient in for a follow up to see how his condition progresses now that I have a base line. Being able to see if removing calculus or the homecare education made a difference in the patient would be a valuable experience. I look forward to implementing the things I learned with this patient in the future.