Diagnosis

بسم الله الرحمن الرحيم

Purpose of Treatment The purpose of dental treatment is to respond to a patient's needs, both the needs perceived by the patient and those demonstrated through a clinical examination and patient interview. Objectives: control of caries and periodontal disease. restoration of individual teeth. provision of harmonious occlusal relationships. replacement of missing teeth

patient interview and diagnostic clinical examination process includes four distinct goals: (1) understanding the patient's desires or chief concerns/complaints. (2) ascertaining the patient's dental needs through a diagnostic clinical exam (3) developing a treatment plan (4) appropriately sequenced execution of the treatment with planned follow up.

PATIENT INTERVIEW

the patient comes for professional examination because of some perception of : (1)an abnormality that requires correction or (2) to maintain optimum oral health. The interview involves understanding the patient's chief complaint or concern about their oral health. symptom of pain difficulty with function, concern about their appearance problems with an existing prosthesis symptoms related to their teeth, periodontium, jaws, or previous dental treatment.

PATIENT INTERVIEW

Oral examination
Sequence for Oral Examination An oral examination should be accomplished in the following sequence: Visual examination Evaluation of teeth and periodontium Oral prophylaxis Vitality tests of individual teeth Determination of the floor of the mouth position Radiographs Impressions of each arch.


1.visual examination which is done to observe the following: a. missing teeth b. carious teeth c. areas of decalcification d. occlusal relationship of both arches.
Oral examination

2. Examination of Teeth, investing Structures, and Residual Ridges

caries susceptibility, The number of restored teeth, signs of recurrent caries, and evidence of decalcification , periodontal disease, gingival inflammation, the degree of gingival recession ,mucogingival relationship pocket depths, assessment of attachment levels, furcation involvement, mucogingival problems, and tooth mobility.

3.A Thorough and Complete Oral Prophylaxis

An adequate examination can be accomplished best with the teeth free of accumulated calculus and debris. Also, accurate diagnostic casts of the dental arches can be obtained only if the teeth are clean.

4.Complete Intraoral Radiographic survey

The objectives of a radiographic examination are: Abnormalities/Pathology presence of root fragments, foreign objects extent of caries existing restorations endodontically treated tooth periodontal conditions alveolar support of abutment teeth

Bite-wing radiograph

5. Vitality Tests of Remaining TeethThermal and Electrical
6.Determination of Height of the Floor of the Mouth 7. impressions for Making Accurate Diagnostic Casts to Be Mounted for Occlusal Examination

DIAGNOSTIC CASTS

A diagnostic cast should be an accurate reproduction of the teeth adjacent tissues and the edentulous arch. A diagnostic cast is usually made of dental stone because of its strength, and it is less easily abraded than is dental plaster. Impression is made using irreversible hydrocolloid ( alginate).

Purposes of Diagnostic Casts

1. Analysis of the existing occlusion when opposing casts are occluded . 2. permit a topographic survey of the dental arch that is to be restored by means of a removable partial denture. 3. Diagnostic casts are used to permit a logical and comprehensive presentation to the patient of present and future restorative needs. 4. Individual impression trays may be fabricated on the diagnostic casts. 5. Diagnostic casts may be used as a constant reference as the work progresses. 6. Unaltered diagnostic casts should become a permanent part of the patient's record

Differential diagnosis

Reasons of extraction of remaining teeth ●Poor prognosis of remaining teeth.• Only anterior teeth remain and they are unaesthetic.• Patient desires to extract the remaining teeth.• Malalignment of remaining teeth.• Economic reasons.

Treatment planning

The treatment of partially edentulous patient can be divided into six phases.Phase I:• Emergency treatment to control pain or infection.• Collection and evaluation of the diagnostic data – diagnostic casts and radiographs.• Developing a design and formulating a treatment plan.

Phase II Preparation of mouth.Phase III• Preparation of abutment teeth.• Final impressions and fabrication of master cast.Phase IV Fabrication of removable partial denture.Phase V• Denture insertion.• Postinsertion instructions.Phase VI• Maintenance and recall.