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 SmilesAge: 16Sex: FEthnicity: CaucasianOccupation: Student

Chief Complaint

Patients states she wants her teeth cleaned.

Medical and Dental History

Pt states she wears reading glassesPt states she’s current on her childhood and Hep B vaccinationsPt states she menstruates regularlyPt states she takes a One-A-Day MultivitaminPt denied any other past or present medical infoLast cleaning and dental exam: 06/2007Previous radiographs: FMX 06/2007 (existing) and Pano 03/08 (RCC)Orthodontic Tx: 2004 for 1.5 yrs

Clinical FindingsE & 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. 1-3mmMobility: Slight #8, 24-26Fremetus: #8Calculus: 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-BThe 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 recessionOHI on Automatic tooth brushing techniqueOHI on Bass brushing techniqueFlossing especially between both arch wiresTepe 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 recessionUsing a automatic toothbrush or bass techniqueFlossing four times a week, especially lingual arch wires

Treatment PlanApt 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

Implementation of Tx Plan

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

Radiographs

Pano- Taken @ RCC 3/08

Oral Pictures

Pre-treatment

Recession Buccal #28-30

Supragingival Plaque and calculus on

mandibular incisors

Oral Pictures

Post-treatment

Manibular incisors-Post Tx

Questions?