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Graduation project
Biographic Data
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patient name: H Y
Gender: female
Age:32
Occupation:- ‫ربة منزل‬
Address: Damascus
Phone number: 4523572
• Chief complaint:
‫سناني مكسرين وصفروكتير بيوجعوني‬
• History of chief complaint:
From about 6 years ago
• Drug history:
Recently: does not use any drug
Drug allergy: no
The use of oral contraceptive: no
• Medical history:
Previous operations \hospitalization:
4Caesarian sections the last one from 4 months ago.
Systemic diseases: no
Pregnancy: no
nursing: yes
• Social history:
Married woman
Smoking: no
Alcohol consumption: no
• Family history:
Diabetes mellitus (patient mother)
• Dental history:
Restorative +endodontic treatment+
FPD+ extraction
Frontal view
Lateral view
Extraoral examination
• Face symmetry: symmetric
• Skin : dry skin
• Lips: competent
• Cranial nerves:
Facial: normal
Trigeminal: normal
• Salivary glands:
Sub mental: normal
Sublingual: normal
Parotid: normal
• Lymph nodes:
• Facial: normal
• Occipital: normal
• pre-post auricular: normal
• Sub mental: normal
• Sub mandibular: normal
• Anterior jugular: normal
• Lateral movements: 12mm
• Protrusion:3mm
• Maximum opening:45mm
• T.M.J: no clicking – creping or displacement
Mastication muscles:
Masseter: normal
Medial pterygoid: normal
Temporalis: normal
Intraoral examination
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Mucosa: normal
Tongue: normal
Gingiva: gingivitis
Hard palate: low vault
Soft palate: normal
Panoramic image
Teeth examination
M:missing
c:caries
R:restoration
M
C
C
R
R
C
R
M
M
M
C+R
C
C+R
C
R
R
RC:recurrent caries
R
R+C
C
R
R+C
R+C
M
R
R
C
M
R+C
M
M
Oral hygiene assessment
• Plaque index = 1.5 (poor oral hygiene)
• Clinical attachment level (CAL): For 14 =7mm
Measurement of pocket depth
17
16
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15
14
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13
12
11
21
22
23
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24
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25
26
27
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3 3 3 3 3 3 4 3 3 3 4 3 3 2 2 2 1 1 2 1 1 1 2 2 2 1 2 3 3 3 3 2 3 3 3 4 3 3 3 3 3 4
3 3 2 3 3 3 3 3 4 4 4 4 3 2 2 1 1 2 1 1 1 1 1 2 2 1 1 2 3 2 3 3 3 3 3 2 3 3 3 3 3 3
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46
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2 2 2 2 2 2 1 1 2 1 1 2 2 1 2 2 1 1 1 1 2 2 2 3 3 2 3
3 4 4
3 2 3 3 2 2 2 2 1 1 1 2 1 2 2 1 1 1 2 2 2 2 1 2 2 3 3
3 3 3
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47
. . .
45
44
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43
42
41
31
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32
33
34
35
36
37
Intraoral radiograph
Upper jaw
Lower jaw
Right side
Left side
Final diagnosis:
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3.
4.
5.
Gingivitis
Caries and bad old restorations
Bad endodontic treatment
widely broken teeth
Missing teeth
Study casts
Treatment plan
Extraction -retreatment-endodontic treatment -restorative treatment
Treatment plan:
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OHI- scaling – reevaluation
Restorative treatment for : 17-16-34-42-43-44
Retreatment on: 15-14-23-25-27-36-45
Root canal treatment on: 13-34
Crown lengthening on : 45
Extraction:24-27
Post and core: 13-14-15-23-25-27-36-45
Bridge:23-25-27 with non rigid connector
RPD: lower jaw
OHI- scaling
Extraction of 24+ 27
Crown lengthening of 45
Before surgery
after surgery
Restorative treatment
Fabrication of base plate
Retreatment
36 -extension of restoration after retreatment !!
Unfortunately attempts to retrieval the extended
portion were failed so we decided to leave and
observe it before surgery
• After 7 weeks of observing we exclude the
periapical surgery because of the following:
There is no any clinical or radiographic
symptoms and signs.
The tooth was already prepared
Fabrication of temporary crowns
Teeth preparation
Casted post impression
Fiber post on 15
Casted posts
Final impressions
Metal on the cast
Metal try in
non rigid
connector
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Bite registration
Shade matching
• Upper jaw: A3
• Lower jaw: A3.5
Clinical try in – lower jaw
Upper jaw
After cementation
RPD design
Border molding and impression taking
Framework try in
Jaw relations and clinical try in
insertion of RPD
Final panoramic view
Before
After
Before
After
Before
After
Before
After
Before
After
Finally!!!