Abstract Title

Oral Rehabilitation Following Trauma and Disease

Lead Author Affiliation

DDS

Lead Author Status

DDS Year 1

Expected Graduation Date

2019

Presentation Category

Clinical

Introduction/Context/Diagnosis

Patient, 30, Navy submariner, suffered severe automobile accident in August 2018. As a result of the accident he had severe damage to the oral cavity, including maxillary and mandibular fractures, dental trauma, and lacerations. Additional complications included broken vertebrae, femur, tibia, ulna, and sepsis with fifty lbs. weight loss. Patient presented four months post-accident, missing 7-13, 22, fractured 27, severe bone loss, with pulpal necrosis on many teeth, asking for his smile back. This is a clinical case demonstrating all disciplines in a comprehensive dental treatment following severe trauma.

Methods/Treatment Plan

Diagnostic w/ consultations from Prosth, Perio, OS, Restorative, Ortho, Endo, Implants

OHI/Perio/CAMBRA

EXT 22-26, necrotic bone removal, with allograft and collagen membrane

-Preformed under my care with Dr. Mashkoor as a result of training in advanced OS

Endo #6, Endo #28

Vital Bleaching #6

Occlusal Composite Restorations 6,28

Upper RPD (w/ R2D2 Clasping)

Lower resin stayplate

CBCT / Implants 22, 24, 27 (Surgery planned for the end of this month post optimal bone graft

Healing timeline)

-I combined CBCT and STL trios file to virtually place and treatment plan implants, I used Implant studio of 3Shape to design surgical guide, and 3D printed in our very own lab. All steps performed by me and approved by Dr. Gonzalez at critical stages. Would greatly like to demonstrate process on excellence day so all students can be doing this in the future.

Plan:

Implant supported bride on lower (22,24,27)

Future upper implant supported hybrid prosthesis (may require block grafting)

Recall

Results/Outcome

Patient disease was removed and he was restored to an aesthetic and functional level. The future will require an advanced level of treatment for non-removable options (implant supported hybrid prosthesis). This stage has been treatment planned and started. Patient is extremely satisfied.

Significance/Conclusions

This case demonstrated all disciplines in a comprehensive dental treatment following severe trauma. The case was started and largely completed in four months. Students are fully capable of treatment planning and executing large cases. With proper guidance and mentorship our school can take on cases at an incredible value to patients and students. If healthcare professionals from multiple disciplines of dentistry and general medicine work more cohesively as a unit they can create better treatment and results. I am passionate about becoming part of an exceedingly advanced dental team in order to serve dental and general health needs in one comprehensive dental setting.

Comments/Acknowledgements

David, is an incredible patient and father of two, and as he often tells his story, he was told “there is no medical reasoning for how he survived”. Quoted over $50,000 for his treatment outside, I am happy to have helped him get his smile back and to provide a foundation for his future oral health and total well-being.

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Oral Rehabilitation Following Trauma and Disease

Patient, 30, Navy submariner, suffered severe automobile accident in August 2018. As a result of the accident he had severe damage to the oral cavity, including maxillary and mandibular fractures, dental trauma, and lacerations. Additional complications included broken vertebrae, femur, tibia, ulna, and sepsis with fifty lbs. weight loss. Patient presented four months post-accident, missing 7-13, 22, fractured 27, severe bone loss, with pulpal necrosis on many teeth, asking for his smile back. This is a clinical case demonstrating all disciplines in a comprehensive dental treatment following severe trauma.