Capstone: Simulated Complex Patient
A treatment plan for a hypothetical complex case.
Objectives: Pediatric inferior alveolar nerve block landmarks are poorly defined and quantitative assessments of their efficacy are unavailable. We assessed landmarks/planes employed in pediatric IA blocks, and a new landmark, to establish their value.
Various systematic reviews and original articles were studied and analyzed to identify external cervical root resorption, its pathogenesis, and potential predisposing factors. Although several potential aetiological factors have been associated with the development and progression of ECR, the etiology, and pathogenesis of ECR are still poorly understood and as a result, many of these resorptive defects are misdiagnosed and mismanaged.
The objective of this retrospective longitudinal study is to evaluate the treatment effects of clear aligners in patients with deep bite malocclusion by examining the dental and skeletal changes between the initial and final treatment time points. Our null hypothesis states that there are no significant differences between the two-time points for the variables studied.
The objective of this project is to address potential sources of occupational acid tooth erosion and identify effective supportive therapies for patients who suffer from it. Specifically in this case I identified the fumes from chromic acid used in welding shops to clean metal as the main etiologic factor in my patient’s acid tooth erosion. I came to this conclusion by conducting a thorough history as well as a diet analysis. When this proved inconclusive, I reviewed the patient’s lifestyle habits including occupation and was able to find research on welders experiencing acid tooth erosion. I implemented supportive therapy for this patient through patient education, changing work habits (wearing a proper respirator at all times), chewing pH neutralizing xylitol gum at work, restoring eroded/missing dentition, and use of a nighttime occlusal appliance. Although difficult to measure over a short period, the patient has since experienced less xerostomia, lower incidence of caries and tooth fracturing due to acid erosion. The patient has also shared some of the supportive strategies with his fellow co-workers at the welding shop who did not know that chromic acid gas inhalation could have such an affect on their oral health. It is very important to conduct a thorough history with patients experiencing acid tooth erosion because it may be coming from the source we least expect it to. If we can intervene early, we can help prevent its progression and improve the oral health status of the patients affected by it.
The zirconia maryland bridge may be small, but is quite mighty. The patient presented with a fractured #23 at the gingival margin. He was concerned with the unsightly appearance of his smile.
A clinical case managing undiagnosed diabetes, active chronic moderate periodontitis with severe localized contributions, moderate to severe attrition on lower natural dentition (managing parafunctional habit), existing full upper arch PFM and Gold crowns with recurrent decay and open margins and anatomically incorrect crowns that contributed to the progression of periodontal disease, loss of VDO, and high caries risk.
This patient case involved comprehensive care to a patient who sought to regain a smile that has been lost due to many years of not seeing a dentist. This dental treatment was a journey that involved many changes to the treatment plan and involved multidisciplinary dental and medical care.
Comprehensive dental care is essential for restoring patients’ oral health, function, and aesthetics. In this clinical presentation, I will discuss the comprehensive oral rehabilitation of a patient who presented with a chief concern of restoring occlusion function and improving aesthetics and overall oral health.