CASE ANALYSIS AND DIAGNOSTIC DATA FOR

FIXED PARTIAL DENTURE

CASE HISTORY PROFORMA

Name

Age/Sex

Occupation

Opd no.

Chief complaint

History of Present illness

Past Medical history

Hypertension

Diabetes

Angina

Heart Surgery

Cardiac Pacemaker

Renal disease

Asthma, Persistent Cough

Artificial Joint

Infectious Disease, HIV infection, Syphilis , Hepatitis

Epilepsy

Depression

History of allergy

History of medication

History of Hospitalization

Personal history:-

Family history:-

GENERAL EXAMINATION :

Gait

Respiratory rate

Pulse

Cyanosis

Pallor

TMJ EXAMINATION:

Joint sounds

Clicking

Deviation

Lymph node examination

Examination of muscles of mastication

EXTRA ORAL EXAMINATION:

Facial symmetry

Facial profile

Lips : Length Mobility-

INTRA ORAL EXAMINATION

GINGIVA:

Color

Texture

Contour

Consistency

Any exudate or pus

Bleeding on probing

Buccal mucosa

Palatal mucosa

Tongue

Depth of Pockets in mm :( Russel Index)

XXXXXXXX I
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XXXXXXXX I
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Hard Tissue Examination:

Missing teeth

Caries

Tooth mobility :

Grade -0

Grade -1
Grade -2
Grade -3

Furcation involvement: Grade -I

Grade -II
Grade -III
Grade -IV

Occlusion:

Group function
Canine protected

Inter arch relationship:

Class I, II, III

General Alignment:
Crowding , Rotation , Supra eruption ,Spacing

Residual ridge defect:( Siebert)

Class I -defects- faciolingual loss of tissue width with normal
ridge height.
Class II -defects -loss of ridge height with normal ridge width
Class III -defects -a combination of loss in both dimensions
Radiographic examination:( wrt abutment teeth)
1.Lamina dura:
2.Widening of periodontal ligament:
3.Shape and length of roots:
4.Number of roots
5.Crown root ratio
6.Axial inclination

7.Residual root/teeth, radiolucent areas , calcifications, foreign bodies or

impacted teeth:
8.Periapical pathosis:
9.Proximity of caries and restorations to the dental pulp and alveolar
crest:
10.Pulpal morphology and previous endodontic treatment:
11.Calculus deposits, overhangs , root fracture, root resorption and
adequacy of root canal obturation :
Diagnosis :

Treatment Plan :