Lec 6: Diagnosis & Treatment Planning Flashcards
Process of identifying or determining the nature and cause of a disease or injury through evaluation of patient history, examination, and review of laboratory data.
Diagnosis
Diagnosis done on first impression or complaint of patient.
Tentative diagnosis
Final identification of disease after a series of examination.
Definitive diagnosis
The prediction of the probable outcome of the treatment; final results or effects of treatment.
Prognosis
Series of treatment that has to be done and planned according to the diagnosis of the case of the patient.
Treatment plan
The reason that the patient seeks care, as described in the patient’s own words.
Chief complaint
- Easiest to treat
- Well-adjusted and easy going
- Accept their share of responsibilities and recognizes need for replacement of missing teeth
- Easily adjust to any properly constructed denture
- Does not present problems for the dentist
Philosophical patient
- Precise in everything they do
- Can only be satisfied by perception
- Many demands, dentist needs to explain the treatment step by step in detail
- Additional appointments needed; extreme care, effort and patience
- High expectation, difficult to treat
- If satisfied, they become your supporter and valuable asset
Exacting patient
- Emotionally unstable
- Excessively apprehensive
- Complaint without justification
- Never be able to wear prosthesis
- Cannot accept responsibilities for any dental problem
- With chronic / debilitating disorder (depression)
- Made to be aware that their dental problems is related to their systemic disease
- Psychiatric and medical treatment is useful.
Hysterical patient
- Lack of motivation and care to oral health
- Uncooperative, ignore instructions
- No concern in their appearance
- Prognosis of RPD is poor.
Indifferent patient
Communication model for patient interview
Shared decision making
Should precede any treatment decisions.
Oral examination
An accurate reproduction of all potential features that aid diagnosis.
Diagnostic cast
The information gathered in the patient interview and clinical examination provides the basis for establishing whether treatment is indicated, and if so, what specific treatment should be considered.
Diagnostic findings
Serves as the basis for decisions that will ultimately identify the suggested treatment.
Interpretation of examined data
FPD or RPD?
Tooth bounded edentulous regions
FPD
FPD or RPD?
Modification spaces
FPD
FPD or RPD?
Replacement of unilaterally missing molars (shortened dental arch)
FPD
FPD or RPD?
Distal extension situations
RPD
FPD or RPD?
After recent extractions
RPD
FPD or RPD?
Long span
RPD
FPD or RPD?
For bilateral stabilization
RPD
FPD or RPD?
Excessive loss of residual bone
RPD
FPD or RPD?
Unusually sound abutment teeth
RPD
FPD or RPD?
Abutments with guarded prognosis
RPD
FPD or RPD?
Economic considerations
RPD
Denture base materal that is more accurate, allows cleanliness, thinner, and thermal conducive.
Metal
Most common metal used for denture base.
Cobalt-chromium
Nickel-chromium
Disadvantages of this denture base material includes:
* Brittleness
* Allergy to MMA monomer
* High porosity
* Irritation of mucosa
* Foul smell
* Dimensional changes
Acrylic resin / PMMA (Polymethyl methacrylate)
Disadvantages of this denture base material includes:
* Expensive
* Time consuming
* Esthetics (visible)
* Heavy weight
* Difficulty in relining and rebasing
Metal
Have low density, high modulus of elasticity, low material cost, and resistance to tarnish.
Co-Cr alloys
Which has more advantage: cast framework or all-resin denture?
Cast framework
