Christopher

Case #6
Objective #1
Samantha Seys
 OBJ #1

Diagnostic Findings
 OBJ #1

Diagnostic Findings

#3 Recurrent Decay MO Amalgam

#2 B composite
 OBJ #1

Diagnostic Findings
 OBJ #1

Diagnostic Findings

#5 Endo Tx
Fractured
 OBJ #1

Diagnostic Findings
 OBJ #1

Diagnostic Findings

#6 ML, B Composite
Recurrent decay under ML
 OBJ #1

Diagnostic Findings
 OBJ #1

Diagnostic Findings

#7 M Decay
#10 DL Composite, recurrent decay
#10 M decay
#11 B Composite, recurrent decay
 OBJ #1

Diagnostic Findings

#7 M Decay
#10 DL Composite, recurrent decay
#10 M decay
#11 MB Composite, recurrent decay
 OBJ #1

Diagnostic Findings
 OBJ #1

Diagnostic Findings

#12 B composite
#12 D decay
#13 RCT, Fill
#13 O Composite
#13 D decay, B decay
 OBJ #1

Diagnostic Findings
 OBJ #1

Diagnostic Findings

#14 M decay
#15 B Composite,
recurrent caries
 OBJ #1

Diagnostic Findings
 OBJ #1

Diagnostic Findings

#17 Mesially tipped

#19 DB decay
D decacy
 OBJ #1

Diagnostic Findings
 OBJ #1

Diagnostic Findings

#20 DO amalgam, recurrent decay

#20 M decay
#20 B composite
 OBJ #1

Diagnostic Findings
 OBJ #1

Diagnostic Findings

Sound, Calculus
 OBJ #1

Diagnostic Findings
 OBJ #1

Diagnostic Findings

#30 DO amalgam,
FX filling, recurrent
B Decay
 OBJ #1

Diagnostic Findings
 OBJ #1

Diagnostic Findings

#31 M decay
B decay
Objective #3: Cariology

Nick Shuff
 OBJ #3

Cariology

 Caries: a progressive destruction of any kind of bone

structure, including the skull, ribs and other bones and teeth.

 Dental Caries (cavity/tooth decay): one of many types

of caries that is usually a result of bacteria such as
Streptococcus mutans or Lactobacillus.
OBJ #3
 OBJ #3

Cariology

 Common Bacteria:
 Lactobacillus acidophilus
 Actinomyces viscosus
 Streptococcus mutans
 Nocardia spp.
 OBJ #3

Cariology
 These bacteria are normal constituents
of the oral environment

 Problems arise when the natural balance is tipped.

 By eating too much sugar
 By not removing primary colonizers and
allowing secondary colonizers to thrive
(establishing complex biofilm)

 Oral bacteria are contagious

 sharing drinks / eating utensils / kissing
 OBJ #3

Cariology
 Plaque: a biofilm that develops naturally on teeth.
Formed by colonizing bacteria attaching itself to
the smooth tooth surface.
 failure to remove plaque by regular brushing allows bacterial evolution
to occur

 Biofilm: an aggregate of microorganisms in which cells

adhere to each other and/or to a surface. These cells are
frequently embedded within a self-produced matrix. Biofilms
are generally composed of not only bacteria but also
extracellular DNA, proteins, and sugars.
 OBJ #3

Cariology
1. Oral anaerobic bacteria + glucose/sucrose/fructose  lactic acid

2. Lactic acid on tooth structure  demineralization of tooth structure

3. Demineralization of tooth structure  creates opening for bacteria to

invade and multiply (caries)
 OBJ #3

Cariology
Dynamic process
Demineralization <--------------->
Remineralization

 Eating sugary foods • brushing/ flossing

 Eating foods high in carbohydrates
• healthy balanced diet
 Not brushing/flossing
• good salivary flow
 Low saliva (dry mouth)
(salivary adjuncts)
 Treatment Plan
Student Names
1. Samantha Seys

Case#6
2. Nicholas Shuff
3. Jenneth Powell

Group #5
4. Josh Jones
5. Jason Miller

Patient Last Name: Group 5 Case 6

Treatment Modifications: None

Recommended Maintenance Care Interval: 6 month

Sequenced Treatment Plan:
 1-SRP Quads I,II,III,IV
 2- # 4 Extract
 3- # 3 MO Composite

4- # 5 Endo
 5- # 5 Build Up W/ PFM
 6- # 6 ML Composite
 7- # 6 B Composite

8- # 7 PFM
 9- # 10 Build Up W/ PFM
 10- # 11 ML Composite
 11- # 11 B Composite
 12- #12 DO Composite
 13- #12 B Wrap Composite
 14- # 13 Build Up W/ PFM
 15- # 14 MO Composite
 16- # 15 DOB Onlay Composite
 17- # 19 Build Up W PFM
 18- # 21 B Composite

19- # 30 Build Up W/ PFM

20- #31 PFM
 21- # 4 Implant
 22- # 4 PFM
 23- # 17 Ortho Consultation
Treatment Plan

COMPOSITE RESTORATIONS
 Teeth are prepared by
drilling away diseased
tooth structure.
 Depending on Depth of
caries, a base/liner is
indicated to prevent
sensitivity.
 6th Generation Self-Etch
bonding.
Treatment Plan

BUILD UP WITH PFM

 Porcelain fused to metal
crown preparation.
 Removal of all caries.
 Sufficient tooth structure
that draws, retains and
supports the crown.
 Composite Build Up to
provide retention and
support if tooth structure is
lacking after removal of
caries.
Treatment Plan

EXTRACTION WITH IMPLANT

 We will refer the extraction

and implant placement to
the oral surgeon.
 Once the implant has been
placed and the bone has
healed, we will fit an
abutment and crown.
Treatment Plan

ON-LAY BUILD UP

 The DB cusp of tooth

number 15 is undermined
with caries, and is
unsupported.
 Composite build up will
provide immediate
completion of pr0cedure
and provide proper support
of tooth.
 Treatment Plan
Student Names
1. Samantha Seys

Case#6
2. Nicholas Shuff
3. Jenneth Powell

Group #5
4. Josh Jones
5. Jason Miller

Patient Last Name: Group 5 Case 6

Treatment Modifications: None

Recommended Maintenance Care Interval: 6 month

Sequenced Treatment Plan:
 1-SRP Quads I,II,III,IV
 2- # 4 Extract
 3- # 3 MO Composite

4- # 5 Endo
 5- # 5 Build Up W/ PFM
 6- # 6 ML Composite
 7- # 6 B Composite

8- # 7 PFM
 9- # 10 Build Up W/ PFM
 10- # 11 ML Composite
 11- # 11 B Composite
 12- #12 DO Composite
 13- #12 B Wrap Composite
 14- # 13 Build Up W/ PFM
 15- # 14 MO Composite
 16- # 15 DOB Onlay Composite
 17- # 19 Build Up W PFM
 18- # 21 B Composite

19- # 30 Build Up W/ PFM

20- #31 PFM
 21- # 4 Implant
 22- # 4 PFM
 23- # 17 Ortho Consultation