1. Treatment Plan Seminar 10 - 04 - 2018

2. Patient’s Profile Age 19 years Gender Female Occupation Nationality
Student
Nationality
Saudi
Marital Status
Single
Cooperative Patient

3. Medical History The Patient is not aware of any medical conditions.
Random Blood Sugar
120 mg/dl
Blood Pressure
124/80 mmHg
Height
153 cm
Weight
65 kg

4. “I have bad oral odor and bleeding during brushing”
Chief Complaint
“I have bad oral odor and bleeding during brushing”

5. Dental History Year Procedure 2008 Restorations for teeth # 16 and 36
2012
Restorations for teeth # 45 and 47
2014
Restorations for teeth # 25, 26, 27, 37, and 35
2016
Scaling

6. Oral Hygiene Type of Tooth Brush Medium Brushing Technique Scrubbing
Frequency
One time a day

7. Extra-Oral Examination
Lymph Nodes:
No masses, swelling or Lymphadenopathy.
Temporomandibular Joints:
Right and left without clicking or deviation.

8. Intra-Oral Examination

11. Radiographic Examination

13. Periodontal Examination

14. DB B MB DP P MP CAL Mobility Diagnosis PD CEJ-GM
Tooth Number DB B MB DP P MP
CAL
Furcation
Mobility
Diagnosis M D
#17 PD 4 3 5 -
II-A2
CEJ-GM 2 1
#16 6
#15
#14

15. #13 3 1 5 2 4 #12 #11 #21 #22 #23 Tooth Number DB B MB DP P MP CAL
Furcation
Mobility
Diagnosis M D
#13 PD 3 1 5 2 4 -
II-A2
CEJ-GM
#12
#11
II-A1
#21
#22
#23

16. DB B MB DP P MP CAL Mobility Diagnosis PD CEJ-GM
Tooth Number DB B MB DP P MP
CAL
Furcation
Mobility
Diagnosis M D
#24 PD 2 1 5 3 -
II-A2
CEJ-GM
#25
II-A1
#26
#27 4

17. DB B MB DL L ML CAL Mobility Diagnosis PD CEJ-GM
Tooth Number DB B MB DL L ML
CAL
Furcation
Mobility
Diagnosis M D
#37 PD 5 3 4 2 -
II-A2
CEJ-GM 1
#36
II-A1
#35
#34

18. #33 2 1 #32 #31 #41 #42 #43 Tooth Number DB B MB DL L ML CAL Furcation
Mobility
Diagnosis M D
#33 PD 2 1 -
II-A1
CEJ-GM
#32
#31
#41
#42
#43

19. DB B MB DL L ML CAL Mobility Diagnosis PD CEJ-GM
Tooth Number DB B MB DL L ML
CAL
Furcation
Mobility
Diagnosis M D
#44 PD 2 1 -
II-A1
CEJ-GM
#45 4 3
II-A2
#46 5 15 12 7 8
III II
II-A3
#47

20. Oral Findings
Plaque Index
86 %
Bleeding Index
71 %

21. Oral Findings Caries in teeth # 12,13, 22, 23, 24, 25, 36, 44, 45, 46.
Crowding upper and lower teeth

22. Pre-treatment Consultation
Prosthodontics. Orthodontics.

23. Periodontal Diagnosis
Generalized moderate chronic periodontitis
AAP Classification 1999

24. Etiology Primary: Dental Plaque (Löe et al. 1965). Secondary:
Supra and subgingival calculus (Schroeder et al. 1969).
Crowding (Poulton 1961).
Metal band on tooth # 16

25. Overall Individual Prognosis Favorable Hopeless #46
(Kwok & Caton 2007)

26. Treatment Plan

27. Initial Treatment Plan
Phase I:
Case presentation and Patient motivation.
Oral hygiene instructions:
Soft tooth brush ( Oral B ).
Dental Floss.
Brushing technique: Modified Bass brushing technique

28. Initial Treatment Plan
Phase I:
Supra and subgingival scaling and root planning
Restoration of carious teeth
Extraction of impacted third molars

29. Initial Treatment Plan
Phase I:
# 46
Extraction with socket preservation
Delayed implant placement.
(After completion of orthodontic treatment)
Re-evaluation of tissue response after 4 weeks

30. Initial Treatment Plan
Phase II:
#15-17
Open Flap Debridement for accessibility and pocket reduction (Heitz-Mayfield 2002).
Orthodontic treatment

31. Initial Treatment Plan
Phase III:
#46
Prosthetic crown of dental implant

32. Initial Treatment Plan
Phase IV:
Recall interval every 6 months (Yang2015).

33. Re-evaluation

34. Before
After

35. Before
After

36. Before
After

37. Before
After

38. Tooth Number DB B MB DP P MP
Before
After
#17 PD 4 2 3 5
#16 6
#15 1
#14
#13 PD 3 2 1 5
#12 4
#11
#21
#22
#23
#24 PD 2 1 5 3
#25
#26
#27 4

39. Tooth Number DB B MB DL L ML
Before
After
#37 PD 5 3 2 4
#36
#35 1
#34
#33 PD 2 1
#32
#31
#41
#42
#43
#44 PD 2 1
#45 4
#46 -
#47 5 3

40. Before
After
Plaque Index
86 %
31 %
Bleeding Index
71 %
15 %

41. Definitive Treatment Plan

42. Definitive Treatment Plan
Phase II:
# 46
implant placement.

43. Definitive Treatment Plan
Phase III:
#46
Prosthetic crown of dental implant

44. Definitive Treatment Plan
Phase IV:
Recall interval every 6 months (Yang2015).

45. Periodontal Surgery

46. Extraction of Tooth # 46

47. Extraction of Tooth # 46

48. Extraction of Tooth # 46

49. Extraction of Tooth # 46

50. Socket Preservation for Socket of tooth # 46

51. After 3 Months

52. Implant Placement of Tooth #46

53. Implant Placement of Tooth #46

54. After Two Weeks

55. Thank you