1. Graduation project

2. Biographic Data patient name: H Y Gender: female Age:32
Occupation:- ربة منزل
Address: Damascus
Phone number:

3. Chief complaint:
سناني مكسرين وصفروكتير بيوجعوني
History of chief complaint:
From about 6 years ago

4. Drug history: Medical history: Recently: does not use any drug
Drug allergy: no
The use of oral contraceptive: no
Medical history:
Previous operations \hospitalization:
4Caesarian sections the last one from 4 months ago.
Systemic diseases: no
Pregnancy: no nursing: yes

5. Social history:
Married woman
Smoking: no
Alcohol consumption: no
Family history:
Diabetes mellitus (patient mother)
Dental history:
Restorative +endodontic treatment+
FPD+ extraction

6. Frontal view

7. Lateral view

8. Extraoral examination
Face symmetry: symmetric
Skin : dry skin
Lips: competent
Cranial nerves:
Facial: normal
Trigeminal: normal
Salivary glands:
Sub mental: normal
Sublingual: normal
Parotid: normal

9. Lymph nodes: Facial: normal Occipital: normal
pre-post auricular: normal
Sub mental: normal
Sub mandibular: normal
Anterior jugular: normal

10. Lateral movements: 12mm
Protrusion:3mm
Maximum opening:45mm
T.M.J: no clicking – creping or displacement
Mastication muscles:
Masseter: normal
Medial pterygoid: normal
Temporalis: normal

11. Intraoral examination
Mucosa: normal
Tongue: normal
Gingiva: gingivitis
Hard palate: low vault
Soft palate: normal

12. Panoramic image

13. Teeth examination M:missing c:caries R:restoration RC:recurrent caries

14. Oral hygiene assessment
Plaque index = 1.5 (poor oral hygiene)
Clinical attachment level (CAL): For 14 =7mm

15. Measurement of pocket depth27 26 25 24 23 22 21 11 12 13 14 15 16 17 . 4 3 2 1 . 4 3 2 1 37 36 35 34 33 32 31 41 42 43 44 45 46 47

16. Intraoral radiograph

17. Upper jaw

18. Lower jaw

19. Right side

20. Left side

22. Final diagnosis: Gingivitis Caries and bad old restorations
Bad endodontic treatment
widely broken teeth
Missing teeth

23. Study casts

26. Treatment plan
Extraction -retreatment-endodontic treatment -restorative treatment

27. Treatment plan: OHI- scaling – reevaluation
Restorative treatment for :
Retreatment on:
Root canal treatment on:
Crown lengthening on : 45
Extraction:24-27
Post and core:
Bridge: with non rigid connector
RPD: lower jaw

28. OHI- scaling

29. 27 +Extraction of 24

30. Crown lengthening of 45

31. Before surgery after surgery

32. Restorative treatment

33. Fabrication of base plate

34. Retreatment

36. !!36 -extension of restoration after retreatment
Unfortunately attempts to retrieval the extended portion were failed so we decided to leave and observe it before surgery

37. After 7 weeks of observing we exclude the periapical surgery because of the following:
There is no any clinical or radiographic symptoms and signs.
The tooth was already prepared

38. Fabrication of temporary crowns

39. Teeth preparation

40. Casted post impression

41. Fiber post on 15

42. Casted posts

43. Final impressions

44. Metal on the cast

45. Metal try in
non rigid connector

46. Bite registration

47. Shade matching
Upper jaw: A3
Lower jaw: A3.5

48. Clinical try in – lower jaw

49. Upper jaw

50. After cementation

51. RPD design

52. taking Border molding and impression

53. Framework try in

54. Jaw relations and clinical try in

55. insertion of RPD

56. Final panoramic view

57. Before
After

58. Before
After

59. Before
After

60. Before
After

61. Before
After

62. Finally!!!

63. Thank you…..