Graduation project
Biographic Data patient name: H Y Gender: female Age:32 Occupation:- ربة منزل Address: Damascus Phone number: 4523572
Chief complaint: سناني مكسرين وصفروكتير بيوجعوني History of chief complaint: From about 6 years ago
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
Social history: Married woman Smoking: no Alcohol consumption: no Family history: Diabetes mellitus (patient mother) Dental history: Restorative +endodontic treatment+ FPD+ extraction
Frontal view
Lateral view
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
Lymph nodes: Facial: normal Occipital: normal pre-post auricular: normal Sub mental: normal Sub mandibular: normal Anterior jugular: normal
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
Intraoral examination Mucosa: normal Tongue: normal Gingiva: gingivitis Hard palate: low vault Soft palate: normal
Panoramic image
Teeth examination M:missing c:caries R:restoration RC:recurrent caries
Oral hygiene assessment Plaque index = 1.5 (poor oral hygiene) Clinical attachment level (CAL): For 14 =7mm
Measurement of pocket depth 27 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
Intraoral radiograph
Upper jaw
Lower jaw
Right side
Left side
Final diagnosis: Gingivitis Caries and bad old restorations Bad endodontic treatment widely broken teeth Missing teeth
Study casts
Treatment plan Extraction -retreatment-endodontic treatment -restorative treatment
Treatment plan: OHI- scaling – reevaluation Restorative treatment for : 17-16-34-42-43-44 Retreatment on: 15-14-23-25-27-36-45 Root canal treatment on: 13-34 Crown lengthening on : 45 Extraction:24-27 Post and core: 13-14-15-23-25-27-36-45 Bridge:23-25-27 with non rigid connector RPD: lower jaw
OHI- scaling
27 +Extraction of 24
Crown lengthening of 45
Before surgery after surgery
Restorative treatment
Fabrication of base plate
Retreatment
!!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
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
Fabrication of temporary crowns
Teeth preparation
Casted post impression
Fiber post on 15
Casted posts
Final impressions
Metal on the cast
Metal try in non rigid connector
Bite registration
Shade matching Upper jaw: A3 Lower jaw: A3.5
Clinical try in – lower jaw
Upper jaw
After cementation
RPD design
taking Border molding and impression
Framework try in
Jaw relations and clinical try in
insertion of RPD
Final panoramic view
Before After
Before After
Before After
Before After
Before After
Finally!!!
Thank you…..