CASE PRESENTATION CLINICAL OPERATIVE 2

Name: Ibrahim Abdullah AlsharifStudent Number: 2009120327

Level:8 Group:3

CHIEF COMPLAINT & HPI• A 25 years old male came to the clinic complaining of

sensitivity.

Onset About 1 year

Duration Several seconds

Stimulation Cold drinks and air

Severity of pain (1-10) 3

Character of pain Sharp

Associated problems Non

Relieving factors Non

HISTORY• Medical history: Patient is medically free

• Family history:

• Habits: Smoking, eating chocolate.

Disease Relative

Diabetes Mother and father

Hypertension Mother and father

Endocrine Mother (Hypothyroidism)

DENTAL HISTORYLast visit 4 years ago

Procedure Root canal treatment (Tooth #36)

Complications Non

ORAL HYGIENE

Tooth brushing Once a day

Flossing -

Mouth rinses -

Other -

Extraoral exam: No significant findingsIntraoral exam: Patient has a pigmented gingiva and localized gingival recession associated with cervical lesions in teeth (11,13&23).

EXAMINATION

DENTAL CHARTING

PHOTOGRAPHS Right side

PHOTOGRAPHS Left side

PHOTOGRAPHS Upper teeth

PHOTOGRAPHS Lower teeth

RADIOGRAPHS Panoramic

RADIOGRAPHS Right B.w (premolars)

RADIOGRAPHS Right B.w (molars)

RADIOGRAPHS Left B.w (premolars)

RADIOGRAPHS Left B.w (molars)

RADIOGRAPHS Upper anterior

RADIOGRAPHS Lower anterior

DIAGNOSIS

• Gingival pigmentation is caused by smoking “smoker’s melanosis”.

• Gingival recession and the cervical lesion in teeth (11,13 & 23), is caused by rough tooth brushing (Abrasion).

• Patient has a “Generalized chronic marginal gingivitis”.• Patient has occlusal caries in teeth:

(18,17,16,15,14,24,25,26,27,28,34,35,37,46,47)

TREATMENT PLAN• The sequence of the treatment should be as follows:

• Firstly, the partially impacted third molars (38 & 48) and their opposite teeth (18 & 28) should be extracted to prevent further complications.

TREATMENT PLAN• Secondly, Restorative treatment.

Tooth number

Defect Restorative material Class

17 Occlusal caries Composite I

16 Occlusal caries Composite I

26 Occlusal caries Composite I

27 Occlusal caries Composite I

34 Occlusal caries Composite I

36 Faulty restoration (high occlusion) Metal ceramic crown -

37 Occlusal caries Composite I

46 Occlusal and proximal caries Composite II

47 Occlusal and proximal caries Composite II

TREATMENT PLAN

• Finally, periodontal treatment.• Gingival pigmentation will resolve after smoking

cessation. • There Is not need for treating teeth abrasion, since the

lesions are small.• The patient should be instructed to use very soft tooth

brush with light pressure, treatment will become required if the sensitivity persists or for esthetic needs.

THANK YOU