Case Study 24

Patient Profile: Patient is a 62-year old White Caucasian female returning for her 3 month recall/recare appointment.

Chief Complaint: "My bottom teeth seem to be getting longer and my gums seem to be disappearing."

Dental History: The patient has only received recall/recare appointments for the past five years.

Medical History: The patient was diagnosed with type 2 diabetes and hypertension. She reports only one surgery, a hysterectomy 12 years ago. Her daily medications are: (Nisoldipine) Sular®, (Metformin hydrochloride) Glucophage® and 81 mg aspirin. Vital signs recorded: Blood Pressure RAS: 125/78; Pulse: 68 BPM; Respiration: 19 Breaths/Minute.

Extraoral Examination:

  • The submental and submandibular nodes were tender when palpated.

Supplemental Information:

  • She demonstrated how she scrubs twice daily with a manual toothbrush in order for her teeth to be nice and clean.
  • Upon waking in the morning, she often has a sore mouth.

Health Behaviors:

  • She uses a phenol mouthrinse in order to combat bad breath.
  • Flosses only when she can see food between her teeth.
Gingival Description: Generalized mild erythema and edema with generalized rolled margins.

Bleeding Index: 60%

Plaque Free Score: 25%

PERIODONTAL CHARTING

Case 24 Pictorial Chart

RADIOGRAPHIC IMAGES

R
Case 24 Pictorial Chart
L

Intraoral Images

Mandibular Occlusal Mandibular Occlusal
Full Direct Full Direct
Right Side Right Side

QUESTIONS

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. What classification BEST represents the patient's periodontal status?
  1. What is the patient's ASA physical status classification?
  1. What BEST describes the prognosis for teeth #30 and #31?
  1. What BEST describes the furcation involvement in tooth #30 when loss of some bone is apparent between the roots?
  1. The patient's blood pressure recording represents what category?
  1. What would improve the diagnostic quality in the left premolar bitewing radiograph?
  1. Which of the following oral hygiene aids would BEST assist the patient in addressing her chief complaint?
  1. In viewing the radiographic images, which of the following teeth have an overhang margin?
  1. The BEST method to determine her extraoral findings is:
  1. The radiopacity on the occlusal surface of tooth #29 is most likely: