GR. T.

POPA UNIVERSITY OF MEDICINE AND

PHARMACY
FACULTY OF DENTAL MEDICINE
PERIODONTOLOGY
CLINICAL

CLINICAL CASE PRESENTATION!

Student: ALI BAGHDADI

6th Year English program!
Group coordinator: Univ. Assist. Cristala Nitescu!

GENERAL DATA!

GENERAL DATA
Name: FILIP ALEXANDRU
Age: 23
Sex: masculine
Lives in Iasi
Occupation: student

ANAMNESIS

Reason for patient presentation:

Dental problems: multiple cavities,

simple and complicated;
Dental Pain at 1.7 and 4.7
Halitosis: bad taste in the mouth;
Bleeding gums when brushing;
Disruption of masticator function and
esthetic stomatognathic system

FAMILY HISTORY!

General History: insignificant

Dental History:
mother - severe chronic periodontitis,
dental treatments
Dad - dental and surgical treatments
General Personal history: The patient
denies.
Personal history dentistry: dental
treatment

Living and working

Smoke - 20 cigarettes / day

Consume 1 coffee / day
Balanced diet, with irregular schedule
Microclimate social and family: very
good

HISTORY

PERSONAL MD. HISTORY:

Hypertension (Tertensif Ca-blocker)

1999 broken leg with normal healing Allergy
eggs

Hygiene:

average
Brushing unsteady
improper technique
Dental Toothbrush: manual, medium
Toothpaste: Beauty

Periodontal risk
factors:

Type of food: rich in carbohydrates;

Oral hygiene: - Inappropriate; -Number
of brushing: 1 / day; Do not use
additional means of oral hygiene
(mouthwash, interdentally wire etc.);
malocclusion;
oral Breathing
Sub gingival calculus and over

Clinical examination
extraoral

Superficial palpation:
Temperature, humidity and normal sensitivity
Contours bone integrity, continuity, painless
Emergence of painful trigeminal points
Deep palpation:
Impalpable nodes, painless
Muscle normotonic, normokinetic, normal consistency
ATM examination:
Condylar excursion unchanged (synergistic
movements, symmetrical, equal amplitude)
The trip chin in step
Compression on chin painless

Intraoral clinical
examination

Texture normal lips, lip contour

asymmetric dry lips, mouth opening
amplitude normal labial jugal mucosa
integrity, coloring normal articular
interline absent, Stenon channel
permeable, deep palate, palatine torus
absent, buccal vestibule without
pathological formations.

Intraoral examination:

mandibular arch

maxillary arch

Intraoral
examination:

Multiple cavities: 1.5, 1.2, 1.1, 2.5;

Scrap root: 3.6, 4.5, 4.6;
Esthetic fillings: 3.7, 4.7;

Maxillary arch:

Integra continues.
Multiple fillings: 1.1,2.1,4.6
Marginal gingiva: red-violet,
texture soft and smooth texture.
Attached gingiva: narrow in
sextant 2 lata in sextant 1 to 3.
labial frenulum inserted distance.
Bride inserted at an average
distance.
Bleeding in the survey (sextant I,
II, III)
Deposits of plaque in the sextant
I, II and III

Mandibular arch:

Marginal gingiva: red-violet,

texture soft and smooth texture.
Attached gingiva: narrow and
broad in sextant 5.6 4.
Labial and lingual Frenulum
inserted at a distance from the
ridge.
Closing shutters poor marginal
at 4.6
Bleeding from the survey
(sextant IV, V and VI)
Deposits of plaque in the
sextant IV, V and VI.

Periodontal clinical examination:

Marginal gingiva:
-Color Pink purple;
- Consistent Edematous soft;
-Textur Smooth, glossy;
- Gum recession
Generalized 1-3 mm, maxillary
and mandibular;
Attached gingiva between 2 and
6 mm;
Frenulum and envelopes
inserted away from fixed gum;

Periodontal clinical
examination:

Bleeding: this brushing and boring;

1-3 mm pockets;
Depression generalized 1-3 mm;
This lesions miloloza 1.4,1.3,2.3,2.4,3.4,4.3
teeth;

Evaluation of oral hygiene:

Periodontograma maxillary page

Evaluation of oral
hygiene:

Periodontograma mandibular page:

Clinical and biological

indices:

Gingival inflammation indices:

Gingival index (GI) of Loe and Silness = 2
Papillary bleeding index (PBI) = 2
Gingival bleeding index (SBI) 3, bleeding, mild
edema, color changes
Indices of periodontal inflammation:
Ramfjord periodontal index (PDI):
Gum = 2 (moderate gingivitis gum entire edge
around the tooth)
Periodontal = 5 (3-6 mm attachment loss)
Tooth mobility index = 0
CPITN index = 3 (pockets of less than 5 mm)

Diagnostic odontal:

Proximal carious lesions, Class II. Black,

at the level of 1.5 and 2.4 .1.2,1.1;
microbial etiology with slow evolution
without complications, with favorable
prognosis with treatment

Diagnosis of occlusal
integrity:

Malocclusion by interrupting occlusal

areas with changing parameters altered
occlusion static and dynamic occlusion,
masticator disorders, favorable
prognosis, course of treatment

Periodontal
Diagnosis:

Periodontal diagnosis is:

- Superficial generalized chronic
periodontitis etiology plurifactorial
(plaque, cavities multiple root residues),
esthetic and masticator disorders, slow
evolution, with favorable prognosis,
untreated.

Treatment Plan

1) Treatment etiologic:
Motivation and awareness of the patient in order to
achieve proper oral hygiene;
For self plaque, the patient explained modified Bass
brushing technique and the need disorganization
bacterial biofilm and indicated using a soft toothbrush
and toothpaste use Elgydium anti plaque, oral rinses
and recommendation Corsodyl use interdentally wire
Oral B Floss, and explanation for the use of it.
Disorganization plaque by mechanical debridement
(scaling and planning over, surfacing through
contemporary technology in 24 hours)
Cleaning and sanitation of the oral cavity (provisional
treatment of dental injuries, extraction of root residues)

Etiological treatment:

Achievement Motivation Using oral hygiene

plaque staining;

Etiological treatment:

Etiological treatment:

professional brushing

Techniques of self-control
board

Learning Bass brushing technique;

Using a soft toothbrush;
Using Oral B Floss-interdental wire
Using toothpaste: Parodontax
Oral rinses with antiseptic solutions:
- 0.12% Parodontax 2X / day for 1 minute at 30 minutes after
brushing

Treatment of maintenance and control

Includes consultations within

dispensary :
6 months

1 year.

THANK YOU