Shaun Whitney DDS Inland Empire Perio Study Club 10/6/2017

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Presentation transcript:

Shaun Whitney DDS Inland Empire Perio Study Club 10/6/2017 Treatment Planning Shaun Whitney DDS Inland Empire Perio Study Club 10/6/2017

Initial Visit 12/7/07 Chief Complaint: “I have gum disease, and need to have my teeth cleaned”

Medical History 34 year old caucasian female Heart murmur Smoker – 16 pack year history ASA Class II

Dental History Gross caries Recent anterior restorations Endodontic therapy #19 Previous full coverage restorations Orthodontic treatment Previous extractions

Initial Clinical Findings Radiographic Caries (#3M, #4M, #6D #10M, #13D, #14D, #15M) Clinical caries Furcation Involvements #’s 2, 3, 14, 15 Mobility/Fremitus BOP Gingival recession Supragingival/subgingival deposits Class I L/R Mutually Protected Occlusion

Clinical Photos 1/7/08

Radiographs 12/7/07

Clinical Photos 1/7/08

Radiographs 12/7/07

Clinical Photos 1/7/08

Radiographs 12/7/07

Clinical Photos 1/7/08 Occlusal View

Pano 12/7/07

Diagnoses Generalized moderate to severe aggressive periodontitis

Etiology and Risk Factors Bacterial plaque Supra/subgingival calculus Smoking Faulty restorations

“Ideal” Treatment Plan Maxillary Right Posterior Scaling/Root planing Caries control #’s 4,6 RCT #3 Flap/osseous or Flap/Regeneration

“Ideal” Treatment Plan Maxillary Anterior Scaling/Root planing Finish subgingival margins Flap/Bone graft

“Ideal” Treatment Plan Maxillary Left Posterior Scaling/Root Planing Caries control #’s 13,14,15 Flap/osseous or Flap/regeneration

“Ideal” Treatment Plan Mandibular Left Posterior Localized Scaling/Root planing Crown lengthening #19 Implant #18 Flap/osseous or Flap/regeneration mesial # 21

“Ideal” Treatment Plan Mandibular Anterior Scaling/Root planing Flap/osseous CTG #27

“Ideal” Treatment Plan Mandibular Right Posterior Extraction #31 APF w/ or w/o osseous #28/29 Implants #30/31 Restore DF #29

“Realistic” Treatment Plan Scaling/Root planing X 4 Quads Flap/Osseous X 4 Quads Extraction #31 Crown lengthening #19 Mandibular RPD RCT #3

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