DH 23 Periodontal Case Study By: Kelli Robinson

Rationale for case selection Because of patients age I was under the impression that she would be a light, ADA I case that I could complete in two appointments max. My preconceptions were false, this case proved to me that all patients, all ages, male or female can be periodontally involved.

Patient Profile Sally Smiles Age: 16 Sex: F Ethnicity: Caucasian Occupation: Student

Chief Complaint Patients states she wants her teeth cleaned.

Medical and Dental History Pt states she wears reading glasses Pt states she ’ s current on her childhood and Hep B vaccinations Pt states she menstruates regularly Pt states she takes a One-A-Day Multivitamin Pt denied any other past or present medical info Last cleaning and dental exam: 06/2007 Previous radiographs: FMX 06/2007 (existing) and Pano 03/08 (RCC) Orthodontic Tx: 2004 for 1.5 yrs

Clinical Findings E & I: Freckles, mole below nose, fibrous lingual frenum, and mandibluar tori. Restorations: #2-O comp, #3-seal, #14-OB comp, #15-O comp, #18-O comp, #19-O comp, #20-O comp, #30-O comp, #31-O comp. Pt has lingual arch wires behind #8-9 and # MBI: 0%, BOP: 1.8%, Probing gen. 1-3mm Mobility: Slight #8, Fremetus: #8 Calculus: Pt had no subgingival calculus, only supragingival on the buccal of maxillary molars and on the lingual of mand. incisors.

Clinical Findings Perio Exam: Patient presented with localized recession- 2mm on #2-B, 12-B, 19-B, 30-B, 1mm on #20-B, 28-B, 29-B The recession brought the A.L. on #3, 12, 19, & 30 to 4mm. Radiographic Exam: Trabecular pattern was consistent throughout, lamina dura was present throughout, alveolar crest was gen. 1-2mm from CEJ with local. 3-4mm in the posterior regions, there was no widening of the PDL space. ADA II and generalized slight chronic periodontitis due to plaque and calculus

Dental Health Education Went over what recession is and why she might be having sensitivity associated with the areas of recession OHI on Automatic tooth brushing technique OHI on Bass brushing technique Flossing especially between both arch wires Tepe brush (Pink) for arch wires

Rationale for case selection Because of patients age I was under the impression that she would be a light, ADA I that I could complete in two appointments max. Thought case was interesting and felt the need to share with the class

Goals Arrest patients areas of recession Using a automatic toothbrush or bass technique Flossing four times a week, especially lingual arch wires

Treatment Plan Apt 1:Apt 3: RMH OHI Pano & 1PAX Scaled LR Assessments Scaled UL Scaled LL Apt 2: 4mrc DDS Exam 2 nd Check in PI & OHI Scaled UR

Implementation of Tx Plan Referred patient to primary DDS for examination of 3 rd molars Treatment Plan went as scheduled OHI was given at every appointment

Radiographs Pano- RCC 3/08

Oral Pictures Pre-treatment Recession Buccal #28-30 Supragingival Plaque and calculus on mandibular incisors

Oral Pictures Post-treatment Manibular incisors-Post Tx

Questions?