L7: Treatment Planning Flashcards
1
Q
PHTEN:
A
- P – Purpose – presenting complaint, use SOCRATES e.g. Pain top right (pt pinpoints at 16) on biting.
- H – Health: MH, SH, DH, BP, pulse, eg. No meds, no allergies, BP:120/80, pulse: 80
- T – Treatment: e.g. initial exam, OHI, agreement on TP
- E – Evaluation: e.g. limited mouth opening. Felt examination went well
- N – Next visit e.g. restore 16o
2
Q
Treatment Planning
A
![](https://s3.amazonaws.com/brainscape-prod/system/cm/383/621/907/a_image_thumb.png?1652130845)
3
Q
E/O exam:
A
- Lymph Nodes LN
- Muscles of mastication MoM
- Facial Symmetry FS
- Temporomandibular Joint TMJ
Additional
- Lip competency (competent / incompetent)
- Lip line (High/ Moderate/ Low)
- Lip support (Applicable only to denture cases)
- Loss of face height (Maceration at angles of the mouth)
- Skeletal base (I, II or III)
4
Q
I/O exam – ST:
A
- Buccal mucosa
- Floor of mouth (FOM)
- Hard/ soft palate (SP/HP)
- Tongue
- Gingival appearance (colour, extent and severity of recession, furcation involvement, general appearance)
- Periodontal Examination – Plaque & Bleeding distributions, CAL measurements
Additional:
- Furcation involvement - only record if not normal
- Saliva (amount and quality) - only record if not normal
- Screening for oral pathology (Cancer Screening)
5
Q
I/O exam – HT:
A
- DENTAL CHART
- Missing teeth
- Retained deciduous
- Caries
- Existing restorations
- Condition of existing restorations (Associated caries or discolouration, contact points, contour of restoration, marginal integrity, negative, open or positive, surface texture)
- Condition of tooth structure (Associated caries or discolouration, Fracture lines, shape, surface texture, wear facets)
- Mobility assessment
- Tooth surface loss (TSL)
6
Q
Occlusal Assessment:
A
Occlusion
- ClassI/ II (div 1 or 2) /III
- Overjet / overbite
- Occlusal planes (angulation, centre line, crowding, extrusion, intrusion, over-eruption
Articulation
- Protrusion : anterior/posterior guided
- Lateral excursions: canine / group function w/ w/out non-working side interference
- RCP/ ICP
7
Q
Prosthetic assessment:
A
- Fixed prosthesis examination
- Removable prosthesis examination
8
Q
Radiographic Examination:
A
- Type of xray
- Justification eg. LCPA36 – assessment of existing pathology
- eg. R & L BWs – investigation for caries & bone levels
- eg. DPT – investigation of PE 28, 48
- Quality Rating(1–perfect,2–diagnosticallyacceptablebutnotperfect,3–Not diagnostically acceptable and will need to repeat)
- Radiographic findings Caries – enamel: – dentine:
- eg. Caries – dentine: 35m (2o)
- Extend of restorations
- Endodontic findings
- Periapical pathology (PAP)
- Subgingival calculus deposits
- Bone levels normal/loss generalised/localised horizontal/ vertical loss
9
Q
Diagnosis –
a) Soft Tissues
A
- ST Lesion e.g. xerostomia
- Periodontal status Gingivitis / Periodontitis, Localised / Generalised Mild/ moderate/ severe, eg. Localised mild gingivitis, eg. Healthy gingiva (no bop)
- Gingival recession
- PAP, eg. Periodontal abscess apical to 25/24 5)
- Bone- related e.g. alveolar osteitis 46
10
Q
Diagnosis –
b)Hard Tissues (tooth related)
A
- Restorative status unrestored/ lightly / moderately / heavily restored dentition
- Caries risk
- Calculus
- Staining
- Caries Enamel/Dentine/Secondary caries-> low/ medium/ high, eg. localised calculus to lower anteriors lingually
- Endodontic reversible/ irreversible (symptomatic/ asymptomatic) pulpitis pulp necrosis previously treated / previously initiated endo therapy eg1. acute pulpitis 15, eg2. short-of-apex root filling 27
- Prosthetic eg. failing dental restorations
11
Q
Diagnosis –
Hard Tissues (tooth related)
A
- Tooth surface loss (use an index e.g. BEWE): Wear, Erosion, Abfractions / abrasions
- Dentinal hypersensitivity
- Fracture (enamel / dentine / restoration)
- Trauma
- Extrinsic / Intrinsic staining (eg from necrotic tooth)
- Tooth mobility
- Furcation involvement
12
Q
Diagnosis –
c)Other diagnosis
A
- Malocclusion
- TMJ disorders
- Bruxism
- Sinus infections
- Jaw tumours & cysts
- Halitosis
13
Q
TP Phases:
A
- Emergency–deal w/pain, infection, bleeding
- Investigation/ Stabilisation–prevention(OHI,Fl,periotx),investigations,
- referrals
- Restoration/ Rehabilitation–fillings,endodontic,prosthetic fixed/removable, referrals
- Maintenance & Monitoring–monitor,recall,maybedischarge
14
Q
Treatment Plan:
A
- Oral Hygiene Instructions
- Scale & polish
- Restorations
- Endodontic treatment/ Re-endo
- Prosthetic (crown/ bridge /implants/ dentures)
- Extractions (XTN)
- Monitor
- Recall
- Referrals