Dental Tribune United Kingdom Edition

Endo Tribune pages 11-13 Entry by Jamie Nelson Young Dentist Endodontic Award Endo Tribune pages 14-15 Entry by Rupal Shah Young Dentist Endodontic Award Endo Tribune pages 16-17 Entry by Lydia Harris Young Dentist Endodontic Award Endo Tribune page 12DTà Endodontic Report - Jamie Nelson This is the winning entry to the 2013 Young Dentist Endodontic Award This Case: CY – “It ain’t over till the fat lady sings” A bstract This article is an account of a patient I performed an endodontic treatment on in gen- eral practice. It gives an account of the examination findings, dem- onstrates the thought process be- hind the treatment planning for this case and a description of the treatment done as well as the re- sults. Case Details: Patient Details: Name: CY DOB: 12/05/1989 (24 yrs. old) Gender: Female Medical History: Asthma (never been hospitalised for it) Dental History: has been an ir- regular attender at a different practice Social History: Smoker (10 a day) light drinker (socially 4-5 units a week). Presenting Complaint: CY attended the practice initially for a second opinion, as had been informed that the tooth was una- ble to be saved and would require extraction. The patient was also getting pain from her LRQ, the pain itself was characterised by the pain history below: Site: LRQ – posterior region Onset: Worse when eating but usually spontaneous Character: Dull ache, sometimes feels like the tooth is throbbing Radiation: Has on occasion radi- ated up to her ear Exacerbating/relieving factors: Painkillers take the edge off the pain but don’t eliminate it Severity: A constant 5/10 but can jump up to a 9/10 at times HPC: The patient initially had pain from the tooth one month ago, but the pain then subsided for a bit, to return much worse one week prior to the initial ex- amination. Patient wishes and expecta- tions: I always like to gauge what the patient wishes to gain from the experience and make a habit of sitting with them for five to 10 minutes trying to gain the infor- mation required to help with any difficult decisions. This Pt was very concerned about losing the tooth, as had a minimally restored dentition – only two existing fill- ings on the LR6 and UL6. How- ever came in with the mindset that she would most likely require XLA, therefore anything we could do would be a bonus Examination findings: EO: – Right Submandibular Lym- phadenopathy, with mild tender- ness IO: • Soft tissues – Tenderness to buc- cal palpation LR6 • Hard Tissues – LR6 TTP and grade 1 mobile, Occlusal caries seen LL6, LL7 and LR6 • Perio – BPE – 222, 422 (9mm pocket mesial LR6), OH – poor, 50% plaque score Special Tests: • Vitality (sensibility) – LR6 non- responsive to Endofrost (-50o C) • Radiographs requested: RBW, LBW, PA LR6 Justification for Radiographs: Caries detection and periapical pathology analysis of LR6 Radiographic Report • SITE: Right and Left, Upper and Lower, distal of 7’s to mesial of 4’s • JUSTIFICATION: Caries detec- tion • EXPOSURE: 0.25ms, 6mA, 60kV • GRADE: 1 • REPORT: - Caries - Occlusal radiolucency’s LR6, LL6 and LL7 - Path - Furcation obliteration LR6 - Perio – good bone levels, no sub- gingival calculus Long Cone Periapical Radiograph (LCPA) LRQ Radiographic Report • SITE: LR6 • EXPOSURE: 0.2ms, 6mA, 60kV • GRADE: 1 • REPORT: Caries: Occlusal radiolucency LR6 ‘I always like to gauge what the patient wishes to gain from the experience and make a habit of sitting with them for five to 10 minutes trying to gain the informa- tion required to help with any difficult decisions’ Right and Left Bitewings Figures 1 and 2