Periodontic and Restorative Case Full
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© 2017 www.centralenglandreferrals.co.uk KNOWLEDGE HUB Periodontal and Restorative Case Treatment planning - Dr. Neil Wilson Treatment - Victoria Richards-Carter Sharing knowledge and stimulating conversation between dental professionals. This gentleman, in his late forties was referred to the centre by his GDP for treatment of Generalised Chronic Periodontitis. Look through the case and join in the conversations online. Periodontal & Restorative Case Neil Wilson & Victoria Richards-Carter
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Transcript of Periodontic and Restorative Case Full
©2017 www.centralenglandreferrals.co.uk
KNOWLEDGEHUB
PeriodontalandRestorativeCaseTreatmentplanning-Dr.NeilWilsonTreatment-VictoriaRichards-Carter
Sharingknowledgeandstimulatingconversation
betweendentalprofessionals.
Thisgentleman,inhislatefortieswasreferredtothe
centrebyhisGDPfortreatmentofGeneralisedChronic
Periodontitis.
Lookthroughthecaseandjoinintheconversationsonline.
Periodontal&RestorativeCaseNeilWilson&VictoriaRichards-Carter
INITIA
LPROBLE
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www.centralenglandreferrals.co.uk©2017Periodontal&RestorativeCaseNeilWilson&VictoriaRichards-Carter
ThepatientwasreferredbyhisGDPforassistancewithtreatinghisperiodontaldisease.TheOPGradiographshowsgeneralisedsevereboneloss.
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www.centralenglandreferrals.co.uk©2017
Onexamination,thepatientwassufferingfromgeneralisedchronicperiodontitisandtoothsurfacelosslocalisedtotheanteriorteeth.Bothuppercentralincisorswere6mminlength.
BPE’srecordedwere4*/4/4*4*/4/4*
Largeamountsofsupraandsubgingivalcalculuswaspresent.ThepatienthadahistoryofseeingGDPforscalingandpolishingofhisteeth,buthadneverseenahygienist.
Theissuesofperiodontitisaswellastoothsurfacelosswerediscussedwiththepatient.
Periodontal&RestorativeCaseNeilWilson&VictoriaRichards-Carter
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www.centralenglandreferrals.co.uk©2017Periodontal&RestorativeCaseNeilWilson&VictoriaRichards-Carter
Priortoundertakinganycomplexrestorativedentaltreatment,itwasexplainedtothepatientthatgingivalhealthneededtoimprovesignificantly.ItwasdecidedthatthepatientwastogothroughacourseofFullMouthDisinfectionunderthecoverofantibiotics,duetothechronicnatureoftheperiodontitis.Thenatureofthetreatmentwasexplainedtothepatient,along
withtheexpectedoutcomes.
Aninitialhygieneappointmentwasundertaken.Adetailedpocketchart(inc.recession,mobility&furcationcharting)identifieddeeppocketing,especiallyinmolarregions.Thebleedingscorewas36.1%.
ThroughoralhygienetechniquesweredemonstratedtothepatienttoimproveplaquecontrolpriortoFullMouthDisinfection.
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www.centralenglandreferrals.co.uk©2017Periodontal&RestorativeCaseNeilWilson&VictoriaRichards-Carter
Followingtheinitialhygieneappointment,thepatientunderwent2x90minappointmentswithin24hours.A7daycourseofantibiotics(amoxicillin500mg&Metronidazole200mg)werestartedatthefirstofthese
appointments.LAwasusedinordertocarryoutRSDatthe2x90minappointments.
Thepatientwasgivenchlorhexidenebasedproductstousefollowinghisappointments,theseincluded;mouthwash,gel&spray.
6weekslater,thepatientwasseenforareviewandstainremoval.At12weekspostFullMouthDisinfection,anewdetailedpocketchartwascarriedout,identifyingsignificant
reductioninpocketing.Bleedingscorewasnowat6.5%
Hygienerecallsweresetat3months.
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www.centralenglandreferrals.co.uk©2017
3monthslater,duetosignificanttoothsurfaceloss,adiagnosticwax-upwasmadeoftheupper3-3,inordertocreateaDahlrestoration.
A‘suckdown’wasproduced,andusedtoshowthepatientinhisownmouthhowhecouldlookaftertreatment.Thepatientwasadvisedthattherewouldbenoposteriortoothcontactanditmaybeanumberofmonthsbeforeteeth
couldcomebackintoocclusion.The6anteriorteethwerebuiltupincomposite–FiltekSupreme,shadeA2,thenpolished.
Thepatienthasre-visitedtheCentreforfurtherpolishingandareview.Posteriorteethhavebeguntocomebackintoocclusion.
Periodontal&RestorativeCaseNeilWilson&VictoriaRichards-Carter
RES
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www.centralenglandreferrals.co.uk©2017
Thepatientwasadvisedthatthecompositerestorationscanstainandwearovertime,meaningtherewillbefurtherinvestmentintheirbuildups.However,thetreatmentcarriedouthasbeenveryconservativeastoothstructurehas
notbeendamaged.Thiswasaveryrecentcase,butthepatientwasextremelyhappywiththeresult.Wewillcontinuetoreviewthe
patientandhelphimtomaintainhisperiodontalhealth.
Periodontal&RestorativeCaseNeilWilson&VictoriaRichards-Carter
Click here to refer to CESRC or: Call 0121 478 3770 Email [email protected]
Typesofpatienttobereferred:
Advancedrestorative
Complexdentalimplantwork
ProsthodonticsReferra ls to Ne i l Wi l son
www.centralenglandreferrals.co.uk©2017Periodontal&RestorativeCaseNeilWilson&VictoriaRichards-Carter
