Presentation Category
Restorative (Direct/Indirect)
Introduction/Context/Diagnosis
Patient, aged 64, presents with no significant medical history or current medications. Notably, the patient hails from Mexico and has foregone dental care for a decade, highlighting pertinent social factors. The patient's primary concern is the pursuit of comprehensive dental treatment. Following a meticulous examination, saliva analysis revealed a moderate pH, coupled with a high caries risk. Clinical findings revealed a sinus tract on tooth #31, accompanied by inflamed gingiva and multiple 5mm pocket depths in the maxillary region, necessitating two quadrant Scaling and Root Planing (SRP) procedures on the upper arch and a prophylaxis on the lower arch. Recurrent caries were observed on teeth #3, 4, 5, 10, 12, 13, 15, 21, and 28, with additional caries on the crown of tooth #20, requiring replacement. A bridge spanning teeth 29-31 was also noted. Furthermore, periapical radiolucencies were evident on teeth #32, 31, 29, and #18, mandating endodontic retreatment and subsequent crown placement. Tooth #16 was diagnosed as non-functional due to caries. The comprehensive treatment plan entailed two SRP procedures on the maxillary quadrants, endodontic retreatments on teeth #31, 29, and #18, extractions of teeth #16 and #32, a post and crown for tooth #29, and crowns for teeth #18, 20, and #31. Additionally, resin fillings were prescribed for teeth #3, 4, 5, 10, 12, 13, 15, 21, and 28. Moreover, a surgical implant placement at site #30 was proposed to address the missing tooth space. Subsequent to the bridge sectioning, tooth #29 exhibited a poor prognosis; however, the patient expressed a desire to attempt salvage. Despite retreatment and post/buildup placement, the tooth's integrity was compromised. Consequently, a revised plan involving the retention of tooth #29 with a GI Cap until immediate implant placement was devised. Additionally, a veneer block bone graft followed by implant placement was proposed for the missing tooth site, ensuring comprehensive restoration with implant crowns for both sites.
Location
Arthur A Dugoni School of Dentistry, 155 5th St, San Francisco, CA 94103, USA
Format
Presentation
Full Mouth Rehab: Finding a Dental Home
Arthur A Dugoni School of Dentistry, 155 5th St, San Francisco, CA 94103, USA
Patient, aged 64, presents with no significant medical history or current medications. Notably, the patient hails from Mexico and has foregone dental care for a decade, highlighting pertinent social factors. The patient's primary concern is the pursuit of comprehensive dental treatment. Following a meticulous examination, saliva analysis revealed a moderate pH, coupled with a high caries risk. Clinical findings revealed a sinus tract on tooth #31, accompanied by inflamed gingiva and multiple 5mm pocket depths in the maxillary region, necessitating two quadrant Scaling and Root Planing (SRP) procedures on the upper arch and a prophylaxis on the lower arch. Recurrent caries were observed on teeth #3, 4, 5, 10, 12, 13, 15, 21, and 28, with additional caries on the crown of tooth #20, requiring replacement. A bridge spanning teeth 29-31 was also noted. Furthermore, periapical radiolucencies were evident on teeth #32, 31, 29, and #18, mandating endodontic retreatment and subsequent crown placement. Tooth #16 was diagnosed as non-functional due to caries. The comprehensive treatment plan entailed two SRP procedures on the maxillary quadrants, endodontic retreatments on teeth #31, 29, and #18, extractions of teeth #16 and #32, a post and crown for tooth #29, and crowns for teeth #18, 20, and #31. Additionally, resin fillings were prescribed for teeth #3, 4, 5, 10, 12, 13, 15, 21, and 28. Moreover, a surgical implant placement at site #30 was proposed to address the missing tooth space. Subsequent to the bridge sectioning, tooth #29 exhibited a poor prognosis; however, the patient expressed a desire to attempt salvage. Despite retreatment and post/buildup placement, the tooth's integrity was compromised. Consequently, a revised plan involving the retention of tooth #29 with a GI Cap until immediate implant placement was devised. Additionally, a veneer block bone graft followed by implant placement was proposed for the missing tooth site, ensuring comprehensive restoration with implant crowns for both sites.
Comments/Acknowledgements
Presentation Category: Restorative