Dr. Hytham N. Fageeh
Full mouth rehabilitation Case
ALL CLINICAL CASES
Patient Data
Sex: Female
Age: 66
Occupation: Nurse
Marital Status: Single
CC: “ I want a nice smile”
Summary
The patient is a 63 female with a severely worn dentition with decreased vertical dimension of occlusion and localized mild chronic periodontitis
Medical Hstory
- Blood Pressure: 123/89 p 84
- ASA: Class 2
- Allergies: Penicillin
- Past Medical Hx: Possible Hashimoto’s and controlled Hypertension
- Past Surgical Hx: Hysterectomy and Ganglion removed from right foot .
- Pre-Medication Requirements: None
- Smoking Hx: None
- Alcohol Consumption: Occasionally
- Physical Limitations: None
- Limitations to Dental Treatment: None
- Requirement for Medical Consultation: None
- Past history of TMJ pain : None
Medications
- Lisinopril- Angiotensin-converting enzyme
Dental History
- Frequency of tx: Sporadic dental tx
- Preventive tx: Pt told to brush 2x/day, floss, to use mouth rinse with fluoride. Pt given Prevident 5000
- Dental Prosthesis Hx: Resin and Amal restorations
- Dietary Considerations: None at this time
- Pt lost her Mandibular Posterior teeth in her 20s
- Pt has a history of eating lemons often as a teen
- Pt reports history of a parafunctional habit
House Classification
Clinical Exam
- Head and neck exam WNL
- Intra-Oral exam WNL
- Periodontal Assessment: Pt has fair oral health and a low plaque score of 14%
- Generalized moderate horizontal bone loss on Maxillary Posteriors
- Periodontal charting- maximum of 5 mm pockets and BOP Maxillary on posterior -#2, 3, 15, 16
- Endodontic Assessment: # 11,#20, #25, #26, #27, and # 28 are not vital
- Risk Assessment: High risk- active caries/ extractions in last 3 yrs
- PDI: Class 4
- Loss of posterior support
- Advanced wear
- Increased VDO needed
Provided TX
Initial Therapy:
- Patient motivation and oral hygiene instructions
- Scaling and root planing of all quadrants
Surgical Phase:
- Extraction of hopeless teeth #2, 11, 15 ,16, 20, 21, 22, 23,24, 25, 26, 27, 28
- Surgical crown lengthening of #7- 10
- Alveololasty of mandibular arch
- 5 Endosteal bone level implants (AstraTech EV 3.6 x 11mm)
Restorative Phase:
- MOD Amalgam #14
- Root canal therapy #6, 7, 8, 9, 10, 12
- Centric occlusion recorded, Jaw records, Lucia rig, wax up, mock up
- Upper partial and complete lower interim denture
- Metal ceramic restorations #4- 13
- Implant supported screw retained hybrid denture for lower arch
Maintasince Phase
– 3 month recall interval
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ALL CLINICAL CASES
Permission granted for publication on Zerodonto blog and to the excellence in prosthodontics award committee, 2015.
– Case submitted on Behalf of Dr. Hytham Fageeh, Dr. Beecher Whiteaker and Dr. Nabeeh AlQahtani
