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Medical Forum / General / Dentistry / July 2005Case Study (optimal treatment plan)
Hi everyone ... any help with this case study A healthy 36-year-old male patient presents requesting treatment for "broken back teeth". Examination shows a fully dentate mouth with extensive amalgams in a number of posterior teeth and composite restorations in most of anterior teeth. There is gingival bleeding on gentle probing in all quadrants and PPD of 3-5mm in posterior segments. There is plaque and supragingival calculus detected in lower anterior and upper posterior segments. Tooth 16 has been root filled and extensively restored with amalgam. Mesio-buccal cusp has fractured. A periapical radiograph shows well-defined periapical radiolucency apparently associated with the palatal root. Tooth 15 has been heavily restored with extensive MODPal pinned amalgam restoring palatal cusp. The buccal cusp has fractured below the level of the gingival attachment. Tooth 14 has minimal mesial and distal proximal composite restorations with early recurrent caries at the gingival margins. Discuss the case assessment, possible treatment options with advantages and disadvantages of every option. Discuss optimal treatment plan addressing this patient clinical problems. > Hi everyone ... > any help with this case study [quoted text clipped - 19 lines] > Discuss optimal treatment plan addressing this patient clinical > problems. Are you a dentist or a student doing their homework? Steve  SignatureCut the nonsense to reply >Hi everyone ... >any help with this case study [quoted text clipped - 19 lines] >Discuss optimal treatment plan addressing this patient clinical >problems. That man needs some dental treatment. Hope that helps. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com I would start with surgical extraction of teeth 1-28 Geez, leave 29-32 in? I think that's a bit radical. Take all 32. SignatureChristopher A. Young Learn more about Jesus www.lds.org www.mormons.com I would start with surgical extraction of teeth 1-28 >Hi everyone ... >any help with this case study [quoted text clipped - 19 lines] >Discuss optimal treatment plan addressing this patient clinical >problems. Where are you a student at? .. Stephen Troy, Michigan, USA I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. Hello again , Actually I am dentist graduated recently from the uni , not student any more but still I have dental council clinical examinations . I need to discuss some case studies with anyone who is interested to share ideas . I would suggest for this case : 1_ for the tooth 16 if symptoms of pathology present then RE do endo. therapy if no symptoms associated then either restore the fractured cusp with composite if the remaining amalgam satisfactory , or repeat the amalgam if it is not satisfactory . In both cases we have to keep the tooth under observation for 6-12 m for assesment with further raidograph. anfter cure we can restore the tooth with cast restoration 2_ for the tooth 15 we have to do crown lengthening procedure , if the remaining amalgam satisfactory then restore the fractured cusp with composite and cast restoration otherwise repeat it using amalgam and cast restoration. 3_ tooth 14 remove the composite and the caries then restore the tooth with composite or amalgam . 4_ supragingival scaling to remove the plaque and calculus with OHI Awaiting your Comments .... >Hello again , >Actually I am dentist graduated recently from the uni , not student any [quoted text clipped - 23 lines] > >Awaiting your Comments .... It is not proper to ask us to do your homework for you. .. Stephen Troy, Michigan, USA I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. >>4_ supragingival scaling to remove the plaque and calculus with OHI Why would anyone leave subgingival calculus ? >>Awaiting your Comments .... > >It is not proper to ask us to do your homework for you. >.. >Stephen >Troy Looks like humamhuda is going to have to keep on waiting....and waiting..... and waiting..... "Endeavor to persevere" -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE First, most of the regs of SMD are US. Second, we are familiar with the "international tooth numbering system" We don't like it, we don't use it. Check out ada.org; search for the "tooth chart" Thirdly >Hello again , >Actually I am dentist graduated recently from the uni , not student any >more but still I have dental council clinical examinations . What country ? What university ? >I need >to discuss some case studies with anyone who is interested to share [quoted text clipped - 21 lines] > >Awaiting your Comments .... -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE If Dr. Nani has an assignment to discuss a proposed hypothetical patient with other dentists to compare viewpoints, then I would not mind discussed it. If he needs the answers for a school assignment, I refuse to do his work for him. If he is casting for information to help in a law-suit, then I will simply block his postings from my machines. > First, most of the regs of SMD are US. >> [quoted text clipped - 44 lines] > wubbabubbazG@RBAGEyahoo.com > Take out the G'RBAGE >If Dr. Nani has an assignment to discuss a proposed hypothetical patient >with other dentists to compare viewpoints, then I would not mind discussed >it. If he needs the answers for a school assignment, I refuse to do his >work for him. If he is casting for information to help in a law-suit, then >I will simply block his postings from my machines. --or-- She Agreed. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > First, most of the regs of SMD are US. > > > Second, we are familiar with the > "international tooth numbering system" > > We don't like it, we don't use it. Why don't you like it WB? It's simpler to memorise and use and sometimes makes communication faster (eg patient has no 8s, please extract all 4s etc). It's the same with imperial and metric: you Yankees always choose the hard way to do something! :) George Even if we wanted to change, the insurance carriers al use the US system, so our notes have to be in that form. I was hoping we would have converted to the metric system back in 1970. I am still waiting for that one. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> First, most of the regs of SMD are US. [quoted text clipped - 10 lines] > > George Besides what Dr. Steve said, your #18 is different from our #18 In the US system each tooth has a specific number, this avoids confusion. The problem isn't with us 'yanks' it's with ya'll >Even if we wanted to change, the insurance carriers al use the US system, so >our notes have to be in that form. > >I was hoping we would have converted to the metric system back in 1970. I >am still waiting for that one. >This posting is intended for informational or conversational purposes only. >Always seek the opinion of a licensed dental professional before acting on [quoted text clipped - 16 lines] >> >> George -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com |
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