Mary

Mary’s Examination Results

PART I: Pa)ent History

PART II: Examina)on
PART III: Radiographic Examina)on

Key:
In the coming slides you will see the results of the history and clinical and radiographic examinations. 

ý indicates presence of a finding or condition,
o indicates absence or no finding.
(I) Patient History - Mary Mary

• Click to edit Master text

1. Chief complaint styles
Reduced func)on following loss of 2 teeth in lower right. One tooth recently fractured on
lower le8.

2. Local symptoms
ý Pain 37 occasional moderate, spontaneous pain, las)ng minutes, avoids chewing on tooth
o Infec)on, Inflamma)on
o Bleeding gums
o Food impac)on
o Bad taste
o Tooth mobility, Migra)on
ý Impaired chewing func)on
ý Enough teeth o Yes ý No
o Aesthe)c concerns
(I) Patient History - Mary Mary

3. Dental history
ý Last visit to the den)st: 5 months ago (for 18 extrac)on at oral surgery dept.)
ý Last tooth cleaning: ~2 years ago
o Periodontal therapy
o Pregnancy gingivi)s
o Orthodon)c therapy
o TMJ dysfunc)on
o Pain o Clicking o Crepitus
ý Loss of teeth
o Caries o Perio o Accident o Ortho
ý Tooth replacement

ý Fixed o Removable o Sa)sfied
(I) Patient History - Mary Mary

• Click to edit Master text

4. Oral hygiene styles
ý Toothbrush
oSoU ý Medium o Hard
ý Nylon o Natural o Electric
ý Applica)on: 5 mins / 2 x daily
o Disclosing
ý Addi)onal aids
ý Floss 1 x Daily o Irrigator
o Tooth picks o Interdental brush
ý Fluoride
o Tablets o Gel o Mouth rinse
ý Toothpaste
 Title Text

Ms. C.S.C. , 1968

 Mary
• Click to edit Master text
styles
Mary
Mary
Mary
Mary
(I) Patient History - Mary Mary

• Click to edit Master text

5. General medical risk assessment
styles
o Allergies
o Rheuma)c fever
o Cardiovascular diseases
o Blood diseases
o Neoplasms
o Diabetes
o Hepa))s o Hep. A o Hep. B o Hep. C
ý Other Osteopenia diagnosed 3 years ago.
(I) Patient History - Mary Mary

• Click to edit Master text

6. Medica)on styles
o Insulin
o Cor)costeroids
o Dilan)n
o An)coagulant
o An)bio)cs
o Immunosuppressives
ý Others 1) Fosamax per os, 35 mg / week (3 years).

2) Calcium Carbonate dietary supplement (occasional). 3) Vitamin D (100 IU/day)

7. Smoking history
o Smoke
ý Non-smoker
(II) Examination - Mary Mary

• Click to edit Master text

1. Extraoral examina)on styles
o Skin
o Head
o Eyes
o Neck
o Hands
o Pigmenta)on
o Halitosis
o Other
(II) Examination - Mary Mary

• Click to edit Master text

2. Intraoral examina)on styles
o Lips
o Labial mucosa
o Buccal mucosa
o Alveolar mucosa
o Hard palate
o SoU palate
o Tonsils
o Floor of the mouth
o Tongue
o Salivary glands o Saliva
 (II) Examination - Mary Mary

3. Clinical dental examina)on

17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

Restoration

Abrasion / Attrition / Erosion A&r A&r A&r A&r A&r A&r A&r A&r
CO2-Test (cold ) (+ for vital pulp) + + + + + + + + + + + + + + +

Caries

Defective restoration
(overhang)
(II) Examination - Mary Mary

3. Clinical dental examina)on• Click to edit Master text

styles

Restoration

CO2-Test + + + + + + + + + + + + - +
Abr/ Attr / Eros A&r A&r A&r

Caries

48 45 44 43 42 41 31 32 33 34 35 36 37 38
(III) Radiographic Examination - Mary Mary
(III) Radiographic Examination - Mary Mary
(II) Examination - Mary Mary

• Click to edit Master text

4. 4. Func)onal analysis
styles
ý 1/2 Min. Test (Shore 1958): TMJ palpa)on during movements
o Pain o Crepitus
Restricted mobility: oYes ýNo Opening: 55 mm
o Lateral pterygoid muscles tender to palpa)on
o Parafunc)on ý Bruxism
ý Occlusal class:
Angle I: R ý L ý Angle II: R o L o Angle III: o R o L
o Prognathism
o Overbite: Anterior open bite o Deep bite: o Primary o Secondary
ý Overjet: 2 mm
(II) Examination - Mary Mary

4. Func)onal analysis (con)nued)

o Crossbite 18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

o Premature contacts in CR
18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

ý Slide in centric: o Yes ý No

0 mm Sagibal
0 mm Lateral (right)
0 mm Ver)cal
ý Posterior contacts in protrusion

18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38
(II) Examination - Mary Mary

4. Func)onal analysis (con)nued)

ý Working side movements
18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

ý Group func)on ý R ý L
o Canine guidance o R o L
ý Balancing interferences
18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

ý Wear facets

18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38
(II) Examination - Mary Mary

5. Periodontal screening

(Basic Periodontal Examina)on: BPE)

1 1 1
BPE
1 2 1
(II) Examination - Mary Mary

6. Periodontal indices

ý Plaque Index (O‘Leary et al. 1975): 23 %

ý Bleeding on probing (BOP): 61 %

 Summary Mary

• Click to edit Master text

styles
1. Chief complaint
Reduced mas)catory efficiency following loss of three posterior teeth

2. Financial situa)on
Nego)able