Periodontic and Restorative Case

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PeriodontalandRestorativeCaseTreatmentplanning-Dr.NeilWilsonTreatment-VictoriaRichards-Carter

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Thisgentleman,inhislatefortieswasreferredtothe

centrebyhisGDPfortreatmentofGeneralisedChronic

Periodontitis.

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Periodontal&RestorativeCaseNeilWilson&VictoriaRichards-Carter

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ThepatientwasreferredbyhisGDPforassistancewithtreatinghisperiodontaldisease.TheOPGradiographshowsgeneralisedsevereboneloss.

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Onexamination,thepatientwassufferingfromgeneralisedchronicperiodontitisandtoothsurfacelosslocalisedtotheanteriorteeth.Bothuppercentralincisorswere6mminlength.

BPE’srecordedwere4*/4/4*4*/4/4*

Largeamountsofsupraandsubgingivalcalculuswaspresent.ThepatienthadahistoryofseeingGDPforscalingandpolishingofhisteeth,buthadneverseenahygienist.

Theissuesofperiodontitisaswellastoothsurfacelosswerediscussedwiththepatient.

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Priortoundertakinganycomplexrestorativedentaltreatment,itwasexplainedtothepatientthatgingivalhealthneededtoimprovesignificantly.ItwasdecidedthatthepatientwastogothroughacourseofFullMouthDisinfectionunderthecoverofantibiotics,duetothechronicnatureoftheperiodontitis.Thenatureofthetreatmentwasexplainedtothepatient,along

withtheexpectedoutcomes.

Aninitialhygieneappointmentwasundertaken.Adetailedpocketchart(inc.recession,mobility&furcationcharting)identifieddeeppocketing,especiallyinmolarregions.Thebleedingscorewas36.1%.

ThroughoralhygienetechniquesweredemonstratedtothepatienttoimproveplaquecontrolpriortoFullMouthDisinfection.

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Followingtheinitialhygieneappointment,thepatientunderwent2x90minappointmentswithin24hours.A7daycourseofantibiotics(amoxicillin500mg&Metronidazole200mg)werestartedatthefirstofthese

appointments.LAwasusedinordertocarryoutRSDatthe2x90minappointments.

Thepatientwasgivenchlorhexidenebasedproductstousefollowinghisappointments,theseincluded;mouthwash,gel&spray.

6weekslater,thepatientwasseenforareviewandstainremoval.At12weekspostFullMouthDisinfection,anewdetailedpocketchartwascarriedout,identifyingsignificant

reductioninpocketing.Bleedingscorewasnowat6.5%

Hygienerecallsweresetat3months.

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