Case Study 23

Patient Profile: Patient is a 35-year old White Caucasian male.

Chief Complaint: "My gums are sore and bleed when I brush."

Dental History: He had a prophylaxis two years ago and has not returned for dental care since.

Medical History: The patient reports a history of sinus infections and occasionally seeks medical care. He is currently taking (Sulfamethoxazole) Septra® and reports he is in good health.

Extraoral Examination:

  • The patient presents with a thrombosed varix on his lower lip.
  • Varix measures 5mm x 5mm round, raised with smooth edges, purple/blue in color and the patient reports no pain.

Supplemental Information:

  • Patient reports TMJ discomfort and bilateral clicking sounds occur upon opening and closing.

Health Behaviors:

  • Patient uses a power toothbrush once daily.
  • Patient does not floss daily.


Case 23 Pictorial Chart


Mandibular AnteriorLingual/Maxillary Palatal Maxillary Palatal/Mandibular Anterior Lingual
Full Direct Full Direct
Right Side Right Side
Left Side Left Side


Case 23 Radiograph

Full Direct Full Direct
Lip Lip
Left Side Left Side
Right Side Right Side
Maxillary Occlusal Maxillary Occlusal
Mandibular Occlusal Mandibular Occlusal


Your Faculty has access to the answers in this case study. Please ask them to look in the Faculty Corner for the answers to this case.
  1. In viewing the panoramic radiograph, which of the following anatomical landmarks is radiopaque?
  1. According to the ASA physical status classification, what BEST describes this patient?
  1. What is the description for the positioning of tooth #10?
  1. The radiopaque image extending horizontally above the apices of the maxillary molar teeth from left to right is MOST likely:
  1. The gingival inflammation in the mandibular anterior sextant is MOST likely attributed to:
  1. The patient’s sulfa medication is used to treat what:
  1. What classification BEST describes the interarch relationship of teeth #10 and #22?
  1. Based on the patient's health behaviors, the dental hygienist should introduce:
  1. Using the G.V. Black's classification of restorations, what describes the restoration on tooth #9?
  1. What BEST identifies the type of periodontal pocket between teeth #18 and #19?