Treatment Planning Flashcards
Radiograph report
Diagnostically acceptable
Teeth present: 12 11
Restorations:
12 - mesial composite, veneer
11 - mesial and distal composites, RCT well condensed, to apical length
Caries: Nil
Bone loss: Nil
Periapical pathology: 11 root resorption
Radiograph report
Diagnostically acceptable
Teeth present: 21 22
Restorations:
21 - extra-coronal restoration with temp post in site, RCT acceptable apical length with some coronal voids
22 - core for extra-coronal restoration, RCT with apical voids and extruded apical
Caries: Nil
Bone loss: Nil
Periapical pathology: 22 root resorption
Radiograph report
Diagnostically acceptable
Teeth present: 22 23
Restorations:
22 - core for extra-coronal restoration, RCT with apical voids, extruded apical GP
Caries: Nil
Bone loss: Nil
Periapical pathology: 22 root resorption
Radiograph report
Right bitewing
Diagnostically acceptable
Teeth present: 17 15 14 13 47 46 45 44
Restorations:
47 occlusal amalgam
46 DO amalgam
Caries: Nil
Bone loss: generalised horizontal bone loss <10%
Radiograph report
Left bitewing
Diagnostically acceptable
Teeth present: 23 24 25 27 37 36 35 34 33
Restorations: 27 occlusal amalgam, 36DO amalgam, 35DO amalgam
Caries: Nil
Bone loss: generalised horizontal bone loss <10%, localised vertical bone loss mesial 27
Calculus present 34 36 37
Drugs with suffix -ipine
Calcium channel blockers
Relax blood vessels, therefore increasing blood supply and oxygen to the heart, and reducing heart workload while lowering blood pressure
Drugs with suffix -olol
Beta blockers
Block the release of adrenaline and noradrenaline
Prescribed for angina, heart failure, heart rhythm disorders and to lower blood pressure
Often prescribed with an ACE inhibitor or calcium channel blocker
Drugs with suffix -pril
ACE inhibitors
Angiotensin-converting enzyme inhibitors
Relax the veins are arteries to lower blood pressure
Prevent an enzyme in the body from making angiotensin 2, which narrows blood vessels
Bisphosphonates
Drugs used to slow bone loss, reducing the risk of hip and spine fractures
This is done by inhibiting osteoclastic bone resorption by attaching to hydroxyapatite binding sites on bony surfaces, especially surface undergoing active resorption
Increased risk of MRONJ
Drugs ending in -dronic acid or similar
Bisphosphonates
What type of drug is Clopidogrel
Anti platelet - used to reduce risk of heart attack
HGPECPROFA
Structure for unseen cases
Headline
Generalised observations
Perio
Endo
Crowns
Prosthetics
Restorations
Occlusion
Function
Aesthetics
Treatment plan order
Immediate
Disease control
Re-evaluation
Reconstruction
Maintenance
Warfarin
Anticoagulant used to reduce risk of blood clot by inhibition of vitamin K related enzymes, reducing the available vitamin K and therefore reducing vitamin K related clotting factors
What does INR stand for?
International normalised ratio
What is INR?
Prothrombin time used to determine blood clotting in warfarin patients
Time taken for prothrombin to convert into thrombin
What are the considerations for an extraction on a patient taking warfarin?
Must have INR 2-4 within 48 hours of the procedure
What is stable periodontitis?
No pockets more than 4mm and no bleeding at 4mm base - can be with or without gingivitis (10% bleeding)
Unstable periodontitis
Pockets of more than 4mm or bleeding at 4mm pocket bases
Possible period risk factors
Smoking
Diabetes
Family history/ genetic predisposition
(Stress/obesity/poor diet)
Stage 1 perio treatment
Supragingival scaling
OHI
Diet advice/smoking cessation
Stage 2 perio treatment
3-4 weeks later
Review periodontal health
MPBS - is the pt engaging with the process?
If yes, subgingival instrumentation
Repeat OHI and diet advice/smoking cessation
Review 6ppc at 12 weeks
Guidelines which dictate you must give a pulpal diagnosis and an apical diagnosis if carrying out pulpal treatment
AAE
Success rate for primary root treatment
85%
Components of caries risk assessment
Clinical evidence of previous disease
Dietary habits
Social history
Use of fluoride
Plaque control
Saliva
Medical history
Which patients should you avoid prescribing anti-fungals?
Warfarin
Statins
BPE 3
Perio diagnosis and how would you approach treatment?
Localised periodontitis Grade A Stage 1 currently unstable
(<15% vertical bone loss mesial to 27)
Follow BSP pathway for management of BPE3 and the S3 guidelines - carrying out step 1, supragingival scaling OHI diet advice, risk factor modification and wait 3 months before carrying out a 6ppc of the sextants that scored a 3
Diagnosis for 22 (no symptoms) and what are the tx options?
Using the AAE guidelines, previously root treated, asymptomatic apical periodontitis
Hopeless long term prognosis due to apical perforation and extruded GP - extract and provide immediate replacement denture
Depending on patient preference, cost etc
1. Leave space
2. Keep RPD long term
3. Bridge - resin retained using 23 as abutment
4. Implant
Presenting pt is 15 year old expressing concern at prominent upper centrals
U+L7-7 are erupted
OJ is measured at 10mm
What questions would you ask?
How much does this bother the pt/have they experienced any bullying?
Does it cause problems eating/chewing?
Have they suffered any trauma to these teeth - if so what/when?
Does the pt have/have they had a digit sucking habit?
What skeletal relationship would you expect when OJ measures at 10mm?
Class II - but not always, depending on how much of the malocclusion is due to skeletal/dentoalveolar factors
In OJ 10mm, proclined upper incisors and a lip trap, is this arch more likely to be crowded or spaced?
Spaced
If OJ is 10mm, what incisor relationship is this likely to be?
Class II div 1
How should you position pt for measuring OJ?
Mandible in RCP, patient not posturing
Signs of previously traumatised upper centrals
Chipped edges, composite buildups, discolouration, access cavities etc
Maximal growth period for females
11-13 years old
