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Operative V > L7: Treatment Planning > Flashcards

L7: Treatment Planning Flashcards

1
Q

PHTEN:

A
  1. P – Purpose – presenting complaint, use SOCRATES e.g. Pain top right (pt pinpoints at 16) on biting.
  2. H – Health: MH, SH, DH, BP, pulse, eg. No meds, no allergies, BP:120/80, pulse: 80
  3. T – Treatment: e.g. initial exam, OHI, agreement on TP
  4. E – Evaluation: e.g. limited mouth opening. Felt examination went well
  5. N – Next visit e.g. restore 16o
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2
Q

Treatment Planning

A
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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)
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4
Q

I/O exam – ST:

A
  1. Buccal mucosa
  2. Floor of mouth (FOM)
  3. Hard/ soft palate (SP/HP)
  4. Tongue
  5. Gingival appearance (colour, extent and severity of recession, furcation involvement, general appearance)
  6. 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)
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5
Q

I/O exam – HT:

A
  • DENTAL CHART
  1. Missing teeth
  2. Retained deciduous
  3. Caries
  4. 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)
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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
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7
Q

Prosthetic assessment:

A
  • Fixed prosthesis examination
  • Removable prosthesis examination
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8
Q

Radiographic Examination:

A
  • Type of xray
  • Justification eg. LCPA36 – assessment of existing pathology
  1. eg. R & L BWs – investigation for caries & bone levels
  2. 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:
  1. 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
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9
Q

Diagnosis –

a) Soft Tissues

A
  1. ST Lesion e.g. xerostomia
  2. Periodontal status Gingivitis / Periodontitis, Localised / Generalised Mild/ moderate/ severe, eg. Localised mild gingivitis, eg. Healthy gingiva (no bop)
  3. Gingival recession
  4. PAP, eg. Periodontal abscess apical to 25/24 5)
  5. Bone- related e.g. alveolar osteitis 46
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10
Q

Diagnosis –

b)Hard Tissues (tooth related)

A
  1. Restorative status unrestored/ lightly / moderately / heavily restored dentition
  2. Caries risk
  3. Calculus
  4. Staining
  5. Caries Enamel/Dentine/Secondary caries-> low/ medium/ high, eg. localised calculus to lower anteriors lingually
  6. 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
  7. Prosthetic eg. failing dental restorations
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11
Q

Diagnosis –

Hard Tissues (tooth related)

A
  1. Tooth surface loss (use an index e.g. BEWE): Wear, Erosion, Abfractions / abrasions
  2. Dentinal hypersensitivity
  3. Fracture (enamel / dentine / restoration)
  4. Trauma
  5. Extrinsic / Intrinsic staining (eg from necrotic tooth)
  6. Tooth mobility
  7. Furcation involvement
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12
Q

Diagnosis –

c)Other diagnosis

A
  • Malocclusion
  • TMJ disorders
  • Bruxism
  • Sinus infections
  • Jaw tumours & cysts
  • Halitosis
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13
Q

TP Phases:

A
  1. Emergency–deal w/pain, infection, bleeding
  2. Investigation/ Stabilisation–prevention(OHI,Fl,periotx),investigations,
  3. referrals
  4. Restoration/ Rehabilitation–fillings,endodontic,prosthetic fixed/removable, referrals
  5. Maintenance & Monitoring–monitor,recall,maybedischarge
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14
Q

Treatment Plan:

A
  1. Oral Hygiene Instructions
  2. Scale & polish
  3. Restorations
  4. Endodontic treatment/ Re-endo
  5. Prosthetic (crown/ bridge /implants/ dentures)
  6. Extractions (XTN)
  7. Monitor
  8. Recall
  9. Referrals
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Operative V (12 decks)

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