Localized periodontal disease, poor oral hygiene managementĤ–5 mm periodontal pockets on teeth #2, #14, #15, #18Ĭoffee and wine, biofilm accumulation, poor oral hygiene managementĮvaluate soft and hard tissue for evidence of smoking Lack of orthodontic intervention and malocclusion Teeth present with yellow extrinsic stain due to age, coffee, and wine. Tooth #8 has caries, which has extended into dentin and can be seen on the radiograph. Localized inflammation is present in the areas of teeth #2, #14, #15, and #18 with slight localized bone loss on interproximal surfaces of teeth #2, #14, and #15. The patient’s general oral health is fair. Posterior periapical of teeth #2, # 14, #15, and #18, molar and premolar bitewings were also prescribed but not shown ( Figure 8.3.1).įigure 8.3.1: Radiographic image teeth #8 and #9. She brushes twice daily, but flosses occasionally.Ģ mm maxillary overjet Class (II) occlusionĪnterior periapical was prescribed for tooth #8, #9. Tooth #9 also presents with a composite overhang on the mesial and distal surfaces. She is not interested in retreatment.ĭental examination reveals a Class III distal composite on tooth #8 with a slight open margin and recurrent caries, tooth #9 reveals a large Class IV mesial‐facial‐incisal composite with open margins and recurrent caries, as well as a Class III distal composite with an open margin and recurrent caries. Patient completed orthodontic treatment 30 years ago and only wore retainer for first year after completion of treatment. Periodontal charting was completed and reveals five areas of probing depths 4 mm or greater, #2 distal with a reading of 5 mm, #14, distal with a reading of 5 mm, #15 distal with a reading of 5 mm, and #18 mesial and distal with a reading of 4 mm. No abnormal findings with respect to intraoral structures, mucosa, and gingiva. She drinks two to three glasses of red wine on weekends, and drinks two cups of coffee daily. The patient has a prior history of smoking. The patient is not taking any medications. The medical history reveals no significant findings.
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