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Periodontal case study project

Periodontal case study project. Dental Hygiene Clinical Practice II Shannon Kelleher. Patient profile. 59 year old Caucasian male Health history reveals : Job related stress High blood pressure controlled with medication Vitals WNL ASA Class II. Dental history reveals :

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Periodontal case study project

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  1. Periodontal case study project Dental Hygiene Clinical Practice II Shannon Kelleher

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

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

  4. Intra oral photos

  5. Dental chart

  6. Periodontal charting

  7. Periodontal evaluation

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

  9. Gingival description • Generalized slight cyanotic, recessed, rounded, firm stippled tissue with localized bleeding on probing.

  10. Contributory factors • Calculus • Faulty restorations • Root morphology • Root resorption • Mouth breathing • Food impaction • Malocclusion • Occlusal discrepancies • Un-replaced teeth • Clenching

  11. Periodontal risk factors • Stress • Nutritional deficiencies • Obesity

  12. radiographs • See hard copy (scanner not working)

  13. Periodontal diagnosis • 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 • AAP IV

  14. Treatment plan

  15. Procedures • First & second visit completed assessments • Third visit • 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

  16. procedures • 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 • 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 NaFl gel trays

  17. summary • 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. • 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.

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