Treatment Planning in General Dental Practice (Dental Update) 0443071837, 9780443071836

An introduction to treatment planning in general dental practice. To be published in association with Dental Update. On

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Treatment Planning in General Dental Practice (Dental Update)
 0443071837, 9780443071836

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Treatment planning in general dental practice A problem-based approach

Dedication To my Wife Angela for her loving companionship, patience and unending support and to our children (young adults!), Gabrielle, Genevieve and Nicholas for putting up with my major time commitments to dentistry and for turning out just fine.

Commissioning Editor: Michael Parkinson Project Development Manager. Barbara Simmons Project Manager. Frances Affleck Designer: Judith Wright

Treatment planning in general dental practice A problem-based approach

Crawford A . Bain

BDS DDS MSc MBA

SenioT Lecturn in Dental Primary Care University of Glasgow Dental School Glasgow

Series editor

F.J. Trevor Burke Professor of Dental Primary Care University of Birmingham School of Dentistry

CHURCHILL LIVINGSTONE

EDINBURGH

LONDON

NEW YORI
96 missing, 3-unit bridge 9D-91, 93 prereconstructive therapy 89-99 endodontics 9&-99 healing times 99 orthodontics 94-99, 95-100 periodontal surgery 89-94> 90-95 prescription for pain 83 problem(s) active/inactive 38--40, 39 defined 35 multiple 35. 36 single 35>36 problem-based curriculum 4---5 problem-based treatment planning advantages 5 curriculum development 4---5 development 4---5 principles 1-{) problem list 35-42 active/inactive problems 38--40,39 active, treatment plan 40-42, 41 example 40 development 35-36 example 36-38,38, 40 in written communication to patient 73 problem-oriented record 5, 35 procedures, focus on 7, 8 prognosis, advanced periodontitis and fuctors affecting 11-12 pterygoid musCle, medial, examination 21 pulp extirpation 82 pulpitis, acute 48 endodontics 47, 48 R

radiograph(s) bitewing 25,26 clinical examination 24-26 i

152

considerations 24-25 dental records U9, 119 digital 26 information contained 24-25 information presentation to patient 7I panoramic 25-26 periapical 25, 47 in prognosis 11-12, 12-18 requirement 24 rapid extrusion 96, 98, 98-100 recall 101-102 receptionist's role 8 recession, above crown 38,39 recession control 90-91, 92, 93 aesthetic dentistry 127, U9 reconstructive therapy 99-101 failing 2,4 groundwork preparation see prereconstructive therapy see also bridge(s); crown(s); dental implants; partial dentures records dental see dental records medical 34 referrals importance 119 legal issues 114 to specialist 46 regular attendance 10 resin-retained bridge 44 restorative procedures aesthetic 131 life expectancy maximisation 109 see also bridge(s); corrective care; crown(s); reconstructive therapy re-treatment 109, 11D-n2 ridge augmentation 127, 127 reductioD 127, 128 risk assessment ll, 12-14 claim avoidance 116 root scratching 33, 33 separation 95, 97-98 vertical fracture 61, 62, 63 root apex, resorption and mobility 37 root canal filling, appearance 7 premolar tooth 7 root canal treatment 47 anticipation of need 67 case study 37 rushed treatment 89

S scrapbook, completed cases 72 sedation, intravenous 40 sedative dressing 82 sequence of treatment see treatment sequence service delivery 77 shortened dental arch 49,51, 51---52 criteria 51 example 51---52,52 requirements 51 skills required 113-114

INDEX

smile line aestl).etics 124-125 classification 124 ' gummy 124 125, 125 treatment 125 high 124 125 low 124 124 medium 124> 125 smoking 13 cessation 88, 89 effect on prognosis 11-12

risks 13 social history 12-17 soft tissue examination 22 space between teeth see diastema specialist examination 18 splint 49, 50 Michigan type 84, 85 temporary, for joint/muscle problems 84 splinting, preventive 61, 62, 63 cross-arch 110, 111 sternocleidomastoid muscle, examination 21

stress (emotional) 16 structural loss, teeth 52-58 students care versus treatment of patients 1, 1, 2 clinical exanIination training 18 diagnostic data and treatment plans 35 see also graduates study models see diagnostic casts subgingival calculus 14 success rates 78 symmetry 122 aspects Ill-124 clinical exanIination 19,20 depth 123, 123-124, 124 height 122, 122-123,123 incorrect 125-126 procedures 126--131,127-131 width 122

T technology adapting to new 133-138 attitudes 133 evidence-based dentistry 133-134 experimental 133 inIplants see dental implants plan presentation 70 teeth, examination 22 temporalis muscle examination 21, I I temporary cementation, longer term use 6~7

temporomandibular joints (TMIl

clicks 19 disc displacement 84 exanIination 19, 22 pain relief 84 radiographs 40 terminology, for patient 73 thumb-sucking 31, 31 time of treatment 105 tongue thrust, lateral 31, 32 tooth ache 82, 83 pain relief see pain, relief tooth breakage 43, 43 treatment options 45 tooth extraction see extractions tooth fractures see fractures (tooth) tooth loss 44, 45 adjacent to implant-supported prosthesis 64, 66, 67, 68 bridge abutment 64, 64, 65, 66 crown series 6~2, 61-63 implants 135, 135-137,136, 137 potential, partial denture arch and 60, 60

radiographs 1, 45 risk factors 13 single tooth space due to 44 45 structural loss 52-58 treaunentoptions 44-45 acceptable compromise 45 ideal 45 tooth to foreign object habits 31-33, 32 tooth to oral musculature habits 31, 31 tooth to tooth habits 11-12 assessment 30-31, 31 training staff 106--107 see also students trapezius muscle, examination 21 treatment, inadequate 1-4, 1-4 treatment options 43-68 acceptable compromises 45-46, 112 benefits of offering 7~0 example 78, 79, n-80, 80 cause-related therapy 87-88 corrective care 88, 89 reassessment 8S--89 endodontics, elective 47 !actors to discuss 43-44 flenble planning 58-64 future problem anticipation 58-64 hygienist delegation 46-47, 88 ideal treatment plans 43-45 lifespan maximization 109 occlusal objectives 48-52 'permanent' 46

p~ approach 43 plan presentation to patient see plan presentation prereconstructive therapy 89-99 problem anticipation and solution building 58-68 prognosis 46 recal1Jmaintenance care 101-102 referral to specialist 46 responsibility 45 tooth structure loss management 52-:58 vertical dimension see vertical dinIension increase treatment planning see plan (treatment) treatment sequence 81-]02 cause-related therapy 87-88 corrective care 88 reassessment 8~9 general 81 initial reassessment 88 pain relief/emergency 81-87 prereconstructive therapy 89-99 recall/maintenance care 101-102 reconstructive therapy 99--101 rime considerations 105 treatment versus care 1 Triad 84 V vertical dimension increase anterior bite plane use 57-58,58 approaches 54-55 gradual increments 55 single increase 55---56 examples 53-57, 53--58 necessity to alter 53 questions to address 52 reg uirement for 53 reversible test 28, 53, 54-:55 toleration 53-58 vestibular deepening 91, 93, 94-95 visual aids, plan presentation 70-72 W warranty 77-78 wash -out of cement 110, 111 websites, completed cases 72 white spots 5 Williams probe 23, 24 wisdom teeth, uneruptedJovererupted World Health Organization (WHO), periodontal probe 23

1

Z ZOE dressing 82

153