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| RADIOGRAPHIC ANALYSIS |
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| BW |
PA: |
FMX |
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PANOREX |
OTHER |
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07/02/97 |
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| GENERAL TOOTH SURVEY |
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| MISSING TEETH: |
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1, 5, 12, 16, 17, 21, 28, 32 |
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Length of Time Missing |
removed at age 29,34,29,29,29,34,34,34 |
| IMPACTIONS: |
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None |
| ROOT TIPS: |
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None |
| PEG: |
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None |
| IMPLANT: |
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None |
| PONTIC: |
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None |
| CORONAL TOOTH STRUCTURE |
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| CARIES |
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UNACCEPTABLE |
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QUESTIONABLE |
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M: |
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M: |
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O: |
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O: |
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D: |
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D: |
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F: |
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F: |
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L: |
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L: |
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I: |
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I: |
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MO: |
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MO: |
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| FRACTURE |
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None |
| PREVIOUS RESTORATIONS |
2, 3, 4, 13, 14, 15, 18, 19, 20, 22, 29, 30, 31 |
| PIN PLACEMENT |
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Tooth |
None |
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Location |
Acceptable |
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Unacceptable |
Furcation |
None |
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Pulp Chamber |
None |
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Fluting |
None |
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Surface: |
M: |
None |
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D: |
None |
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F: |
None |
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L: |
None |
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M & D: |
None |
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| RADICULAR TOOTH STRUCTURE |
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Replacement Resorption |
None |
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Internal: |
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None |
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External: |
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None |
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Surface M: |
None |
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D: |
None |
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F: |
None |
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L: |
None |
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Severity |
Minimal |
None |
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Moderate |
None |
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Severe |
None |
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Proximity |
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Tooth Number |
None |
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Root Canal System |
Normal |
2, 3, 4, 6, 7, 8, 9, 10, 11, 13, 14, 15, 18, 19, 20, 22, 23, 24, 25, 26, 27,
29, 30, 31 |
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Calcification |
Minimal |
None |
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Moderate |
None |
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Obliterated |
None |
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Blunderbuss |
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None |
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Root Configuration |
Normal |
2, 3, 4, 6, 7, 8, 9, 10, 11, 13, 14, 15, 18, 19, 20, 22, 23, 24, 25, 26, 27,
29, 30, 31 |
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Excessively Short |
None |
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Excessively Curved |
None |
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Additional Concerns: |
None |
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| RADIOGRAPHIC ANALYSIS |
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Root Canal Treatment |
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Acceptable |
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18 |
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Questionable |
Short Fill |
None |
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Inadequate Fill |
None |
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Perforation |
None |
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Unacceptable: |
Short Fill |
None |
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Inadequate Fill |
None |
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Perforation |
None |
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Root Canal Material |
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Gutta Percha |
18 |
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Silver Point |
None |
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Paste |
None |
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Post Placement |
NONE |
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Acceptable |
None |
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Questionable |
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Length |
None |
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Diameter |
None |
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Perforation |
None |
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Fracture |
None |
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Unacceptable: |
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Length |
None |
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