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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