Case

Presentation on
SSProstho
By: John Rev Lorenzo
DDMVI-B
A 28 yrs old housewife from
Talangban, Millan, Sibunag
Guimaras seeks Dental
consultation and
treatment.
She complaints about the ff;
Damo guba akon unto.
Indi ako kapustiso kay may
unto nga nagtubo sa ngala-
ngala ko.
HISTORY OF PRESENT ILLNESS
The patient noticed
that her teeth became much
susceptible to caries during
pregnancy. 2yrs prior to consult
the mesial of tooth #11(with
Class IV) was chipped off after
hitting it on a glass of water.
The mesiodens was
already present since her
gradeschool and she hadnt
mind it until the need of
prosthesis.

PAST MEDICAL HISTORY
The patient has no history of hospitalization for the past 2 years, no systemic
diseases present and is not taking any medications at the moment.

PAST DENTAL HISTORY
Class I and V( amalgam)tooth #s: 34and35 (May 2014)
Extraction of tooth #s: 14 and 15 (May 2014)
17 and 47 (August 5, 2014)
mesiodens and 26 (08/11/14)
EXTRA-ORAL EXAMINATION
Symmetrical face
Ovoid Face
Straight profile
Normal temporomandibular joint
Normal Lip Mobility
INTRA-ORAL EXAMINATION`
Max and Man Arches MEDIUM
NORMAL: Palatal Sensitivity,
Tongue Position , Saliva
Occlusion: Class I
Caries: Moderate
Restorations: Amalgam
Calculus: None
ABNORMALITIES: Mesiodens, Gemination

DENTAL CHARTING (FDI)
Caries- tooth #s 18, 17, 16,14, 12, 11,21,22, 24, 25, 27, 28, 38, 37, 36
Root Fragments- tooth #s 15, 26, 47
Indicated for Extraction- tooth #s 15, 26, 47, 18, 14

Restoration- tooth #s 34, 35 (amalgam)

Mesiodens- palatal of tooth # 21

Gemination- tooth #42
RADIOGRAPHIC EXAMINATION
Radiolucency's in
apices of tooth #s 16,
26, 47, mesial of 11 and
21 involving enamel
and dentin with the 11
extending to incisal.
Severely Carious teeth
#16(2/3 crown
destroyed) and
18(almost all crown
destroyed) exposing
the pulp.
Mesiodens located
palatal to tooth # 21,
about 15mm.
Tooth # 42 appears to
have 1 pulp canal but
two pulp chamber.
DIAGNOSIS
Severely carious teeth with pulpal
involvement and retained root
fragments
Mesiodens palatal of 21
Caries on tooth #s 17, 12,
11,21,22, 24, 25, 27, 28, 38, 37, 36
Gemination of #42
Kennedy Class III Mod. 1
(maxillary)
Posterior Fixed Bridge
(mandibular)
TREATMENT PLAN
Extraction of carious teeth
with pulpal involvement, RF
tooth #s 15, 26, 47, 18, 14
and Mesiodens
VLC Restoration of tooth
#s 17, 12, 11,21,22, 24, 25,
27, 28, 38, 37, 36 and
Gemination.
RPD (max)
PFMC(man)

PFMC (CANTILEVER) to replace
Tooth # 47, abutments are
Tooth # 46 and 45.
DESIGNS
Class III Tooth-Borne
Palatal Strap as Major
Connector
Abutment Teeth- 13, 17,
25, 27
Rests and rest seats: Tooth
#s 13cingulum, 17M, 25D,
27M
C-clasp- Tooth #s17, 25, 27
RPI Tooth # 13