Personal Introduction & Hobby Slide – (Insert Your Name Here) Personal Introduction/Hobby Slide (Optional) Tell the group a little bit about yourself! Insert your name & a photo or two highlighting your personal interests and/or family.

Treatment Planning Case Presentation Patient Name (first name only) Age Occupation Personality Type Fill-out Information

Patient’s FIRST Name Full Face - Full Smile M.I.P. Retracted Place photos Picture 1 (Full Face - Full Smile) Picture 9 (M.I.P. Retracted) Full Face - Full Smile M.I.P. Retracted

Scan and place Patient’s DENTAL HISTORY Scan and place Patient’s DENTAL HISTORY. (This works just like placing a photo.) NOTE: The thumbnail in the upper left corner is just a reminder as to what the form looks like. Please don’t attempt enlarge and fill it out! Feel free to delete the thumbnail.

Medical History Positive Answers NOTE: edit as appropriate (# and description), and what it means on Medical and Dental History, ie: 2: allergic reaction to latex use nitrile gloves 22: high cholesterol or taking statin drugs - Potential correlation between statins and pulp chambers calcification - Associative risk for periodontal disease.

Medical History Positive Answers (Duplicate slide if necessary, or delete if not needed)

Medical History Positive Answers MEDICATIONS:

Scan and place Patient’s DENTAL HISTORY Scan and place Patient’s DENTAL HISTORY. (This works just like placing a photo.) NOTE: The thumbnail in the upper left corner is just a reminder as to what the form looks like. Please don’t attempt enlarge and fill it out! Feel free to delete the thumbnail.

Dental History Positive Answers NOTE: edit as appropriate (# and description) Immediate Concern: PERSONAL HISTORY 01: Fear of Dentist GUM AND BONE 07: Gums Bleed / Painful when brushing

Dental History Positive Answers TOOTH STRUCTURE 14: Cavities in past 3 years BITE AND JAW JOINT 21: Having problems with jaw joint

Dental History Positive Answers SMILE CHARACTERISTICS

Diagnostic Opinion: PERIODONTAL Scan and place Patient’s RADIOGRAPH. (This works just like placing a photo.) Full-Mouth Radiograph or Panoramic Radiograph (Date)

Scan and place Patient’s DATA COLLECTION Scan and place Patient’s DATA COLLECTION. This works just like placing a photo. NOTE: the thumbnail in the upper left corner is just a reminder as to what the form looks like. Please don’t attempt enlarge and fill it out! Feel free to delete the thumbnail.

Diagnostic Opinion: PERIODONTAL Gingivitis (AAP I) Modified by: Attachment Loss / Chronic Periodontits (Bone Loss) Mild (AAP II) Moderate (AAP III) Severe (AAP IV) Site Specific Bone Loss: Horizontal Bone Loss: Aggressive Periodontitis: Secondary Occlusal Traumatism: Apical Root Resorption: Abrasion: Recession: Missing Teeth (due to Perio): Fill-out Information

RISK ASSESSMENT PERIODONTAL PROGNOSIS LOW MODERATE HIGH GOOD FAIR POOR HOPELESS SPECIFIC GOOD FAIR POOR HOPELESS List tooth numbers that are good/fair/poor/hopeless TOOTH NUMBERS

Diagnostic Opinion: BIOMECHANICS Scan and place Patient’s RADIOGRAPH. (This works just like placing a photo.) OR Duplicate Slide #20 and Move Here Full-Mouth Radiograph or Panoramic Radiograph (Date)

Diagnostic Opinion: BIOMECHANICS Place photos Image 13      Maxillary Occlusal View Image 14      Mandibular Occlusal View Upper Arch Lower Arch

Diagnostic Opinion: BIOMECHANICS Caries: Defective Restorations: Questionable Restorations: Structural Compromises: Erosion: Margin Location Concerns: Root Resorption: Other: Fill-out Information

Diagnostic Opinion: BIOMECHANICS Completed Root Canal Acceptable: Completed Root Canal Questionable: Completed Root Canal Unacceptable: Irreversible Pulpal Pathology: Questionable Pulpal Pathology: Future Risk for Endodontic Therapy: Missing Teeth (Biomechanics): Other: Fill-out Information

RISK ASSESSMENT BIOMECHANICS PROGNOSIS LOW MODERATE HIGH GOOD FAIR POOR HOPELESS SPECIFIC GOOD FAIR POOR HOPELESS List tooth numbers that are good/fair/poor/hopeless TOOTH NUMBERS

Occlusal View Upper Arch Lower Arch Place photos. Image 13      Maxillary Occlusal View Image 14      Mandibular Occlusal View Upper Arch Lower Arch

Diagnostic Opinion: FUNCTIONAL MINIMAL MODERATE SEVERE Attrition (Wear) Normal Force: Abnormal Attrition (Wear) / Excessive Force: Abfraction: Primary Occlusal Traumatism: Abnormal Neuromuscular Habits: Compromised OVD: Missing Teeth (due to Function): Other: Fill-out Information

Diagnostic Opinion: FUNCTIONAL Place photos. Cephalometric Radiograph Cephalometric Tracing

Cephalometric Measurements Norm Actual SNA 82° (+/- 3) SNB 79° (+/- 3) ANB 3° (+/- 2) SN-MP 32° (+/- 5) UAFH / LAFH (N-ANS / ANS-Me) .8 Upper Central to SN 103° (+/- 6) Lower Incisor to MP 90° (+/- 5) Interincisal Angle 135° (+/- 11) Fill-out Information Typing a “degree “°” symbol” Hold down “Alt” on your keyboard and using the 10-key number pad on your standard keyboard, type “0176”

Constricted Chewing Pattern Functional Diagnosis Acceptable Function Constricted Chewing Pattern Occlusal Dysfunction Fill-out Information Parafunction (Sleep Bruxism) Neurologic Disorders

RISK ASSESSMENT FUNCTIONAL PROGNOSIS LOW MODERATE HIGH GOOD FAIR POOR HOPELESS SPECIFIC GOOD FAIR POOR HOPELESS List tooth numbers that are good/fair/poor/hopeless TOOTH NUMBERS

Diagnostic Opinion: DENTOFACIAL Place photos. Image 1         Full face, frontal view, smile Image 2         Full face, frontal view, repose Full Face – Full Smile Full Face - Repose

Diagnostic Opinion: DENTOFACIAL Place photos. Image 5         Maximum Tissue Display, Frontal View (Close up Full Smile) Image 6         Lips in Repose, Frontal View (Close up Repose) Close Up – Full Smile Close Up - Repose

Diagnostic Opinion: DENTOFACIAL Place photos. Image 3         Full face, lateral view, smile (Lateral Full Smile) Image 4         Nose to Chin, lateral view, Smile (Lateral Close up Full Smile) Lateral Full Face – Full Smile Lateral Close Up - Repose

Diagnostic Opinion: DENTOFACIAL Place photos. Historical = any graduation, wedding, etc. Image 1         Full face, frontal view, smile Full Face – Full Smile (Historical) Full Face – Full Smile

Diagnostic Opinion: DENTOFACIAL Color ACCEPTABLE MODIFY Developmental Disturbances Facially Related Tooth Position 1. Maxillary Incisal Edge Position ACCEPTABLE MODIFY 2. Maxillary Posterior Occlusal Plane ACCEPTABLE MODIFY 3. Mandibular Incisal Edge Position ACCEPTABLE MODIFY 4. Mandibular Posterior Occlusal Plane ACCEPTABLE MODIFY 5. Intra-arch Tooth Position (Arrangement and Form) Fill-out Information Midline Left Right Axially Inclined ACCEPTABLE MODIFY Crowding / Overlap: Diastema: Rotations: ACCEPTABLE MODIFY ACCEPTABLE MODIFY ACCEPTABLE MODIFY

Gingival Tissue Assessment DENTOFACIAL Gingival Tissue Assessment LOW MEDIUM HIGH MAXILLA ACCEPTABLE MODIFY Lip Dynamics LOW MEDIUM HIGH MANDIBLE ACCEPTABLE MODIFY MAXILLA FLAT NORMAL HIGH Scallop / Form Fill-out Information MANDIBLE FLAT NORMAL HIGH MAXILLA ACCEPTABLE MODIFY Horizontal Symmetry MANDIBLE ACCEPTABLE MODIFY

RISK ASSESSMENT DENTOFACIAL PROGNOSIS LOW MODERATE HIGH GOOD FAIR POOR HOPELESS SPECIFIC GOOD FAIR POOR HOPELESS List tooth numbers that are good/fair/poor/hopeless TOOTH NUMBERS

Case In Review Insert duplicate copy of slides 11, 20 & 25 below for quick case review during course

Patient’s Name Full Face - Full Smile M.I.P. Retracted

Full-Mouth Radiograph or Panoramic Radiograph (Date) RADIOGRAPHS Insert duplicate slide - #20 Full-Mouth Radiograph or Panoramic Radiograph (Date)

OCCLUSAL PHOTOS Insert duplicate slide - #25 Upper Arch Lower Arch

STEPS 1-5 DENTOFACIAL Non-Invasive/Restorative

Step 6: Dentofacial Orthognathic Surgery Orthodontic Restorative Periodontal The 10 Step is MANDATORY for the Mentor Exam, optional (but encouraged!) for all other uses. The slides are ‘hidden’ and won’t show when doing a presentation.

Step 7: Functional - Therapeutic Considerations Functional Analysis Monitor Maximum Intercuspation Neuromuscular TMJ C.R. Adapted C.R. Position Occlusal Vertical Dimension Unchanged Increase Decrease Place Centric Contact Points Posterior Teeth Anterior Platform Fill-out Information. NOTE: DUPLICATE SLIDE – SEE SLIDE 59 (you could copy/paste to slide 59 if so inclined) Anterior Pathway Unchanged Steepen Flatten Eccentric Guidance Cuspid Rise Pathway Anterior Group Function Posterior Group Function

Step 7: Functional - Therapeutic Considerations Appliance Therapy Pre-Treatment Post – Treatment TMJ Stabilization/Reposition Occlusal Adj. Contour Alteration Orthodontic / Orthognathic Surgery Extraction (non-functional) Direct Restorations Indirect Restorations Partially Edentulous Areas FPD RPD Implants The 10 Step is MANDATORY for the Mentor Exam, optional (but encouraged!) for all other uses. The slides are ‘hidden’ and won’t show when doing a presentation.

Step 7: Functional - Therapeutic Considerations Edentulous Arch Maxilla Mandible Conventional CD Implant Supported / Retained Other Referral / Consult The 10 Step is MANDATORY for the Mentor Exam, optional (but encouraged!) for all other uses. The slides are ‘hidden’ and won’t show when doing a presentation.

Step 8: Restoration Design – Treatment Options DIRECT RESTORATIONS: Root Canal Tx Foundation Restorations Extractions (non-restorable) Other INDIRECT RESTORATIONS: All Metal Core Supported Enamel Supported FPD Implant Retained Referral/Consult The 10 Step is MANDATORY for the Mentor Exam, optional (but encouraged!) for all other uses. The slides are ‘hidden’ and won’t show when doing a presentation.

Step 9: Gingival Management Treatment Options: Supportive Periodontal Therapy: Scale / Root Plane (SRP) Adjunctive Chemotherapeutics Maintenance Interval: 3 4 6 12 Other Extraction (Perio Hopeless): Root Resection: Regenerative Procedures: Orthodontic Correction: Surgical Correction: Other: Referral / Consult: Fill-out Information (DUPLICATE – SEE SLIDE 42 – you could copy paste to slide 42 if you wish)

Step 10: Restoration Enhancement Inappropriate Visual Coronal Length: Inadequate Preparation Length: Ferrule Compromises: Margin Location / Violation of Biologic Width: Edentulous Ridge Considerations: Treatment Options: Orthodontic Considerations: Surgical Correction: Other: Referral / Consult: Fill-out Information (DUPLICATE – SEE SLIDE 71)