Management Considerations: The Ten Step Approach                 NAME Benavides, Mark Date:  18-Aug-2001                 Occupation:  Dentist DOB 08/04/55                  Limited or Comprehensive Exam: Comprehensive                 IMMEDIATE DENTAL CONCERN:   Comprehensive Care Additional Dental Concerns:  Esthetics                 I. MEDICAL CONSIDERATIONS         Risk Assessment:                Pre-Medication (Y/N): No- Special Needs   Anesthetic Preference:  Local-;  Allergies  penicillin-PenVK; to other medications-Sulfa;  Risk Factors Heart Murmer-Mitral Valve Prolapse;  Oral Pathology    Referral/Consult  Not Answered  Medication Noted  No None Listed                             II. DENTOFACIAL             Risk Assessment: DENTOFACIAL MODERATE           COLOR:     Color Modification Planned: Restorative               MOTIVATION LEVEL:  High FACIALLY RELATED TOOTH POSITION   Alteration planned                 STEP 1: DEVELOP MAXILLARY INCISAL EDGE POSITION   Alteration planned VERTICAL POSITION           Shorten Teeth:   None amt in mm: 0 Lengthen Teeth:   7, 8, 9, 10 amt in mm: 1,2,2,1 HORIZONTAL POSITION           Labially Position:   None amt in mm: 0 Lingually Position:   None amt in mm: 0               STEP 2: DEVELOP MAXILLARY POSTERIOR OCCLUSAL PLANE  Alteration planned VERTICAL POSITION           Shorten Teeth:   2, 3, 14, 15 amt in mm: 1,1,1,1 Lengthen Teeth:   None amt in mm: 0 HORIZONTAL POSITION           Labially Position:   None amt in mm: 0 Lingually Position:   None amt in mm: 0               STEP 3: DEVELOP MANDIBULAR INCISAL EDGE POSITION   Alteration planned VERTICAL POSITION           Shorten Teeth:   23, 24 amt in mm: 1,1 Lengthen Teeth:   None amt in mm: 0 HORIZONTAL POSITION           Labially Position:   22, 23, 24, 25, 26, 27 amt in mm: 1,2,2,2,2,1 Lingually Position:   None amt in mm: 0               STEP 4: DEVELOP MANDIBULAR POSTERIOR OCCLUSAL PLANE Alteration planned VERTICAL POSITION           Shorten Teeth:   None amt in mm: 0 Lengthen Teeth:   18, 19, 20, 29, 30, 31 amt in mm: 1,1,1,1,2,1.5 HORIZONTAL POSITION           Labially Position:   None amt in mm: 0 Lingually Position:   None amt in mm: 0               STEP 5: INTRA ARCH TOOTH POSITION (Arrangement and Form) Acceptable Midline Acceptable Axially Inclined: Acceptable Age Appropriate or Ideal / Media Generated Age appropriate Diastema: None Acceptable None Unacceptable None Crowding / Overlap 23, 24, 25, 26 Acceptable 23, 24, 25, 26 Alteration Planned None Rotation None Acceptable None Unacceptable None STEP 6: GINGIVAL TISSUE ASSESSMENT              Maxillary             Lip Dynamics   Medium   Lip Dynamics   Acceptable   Horizontal Symmetry Acceptable   Scallop / Form   Normal   Mandibular             Lip Dynamics   Medium   Lip Dynamics   Acceptable   Horizontal Symmetry Acceptable   Scallop / Form   Normal Treatment Options             Periodontal N/A Restorative Yes Orthodontic Yes Orthognathic Yes                                                                                                                                                                                         Sample Picture ONLY                                                   III. Functional             Risk Assessment: Not Answered               STEP 7: THERAPUTIC CONSIDERATIONS                         Functional Analysis   Not Answered CONDYLAR POSITION:  Unknown ANTERIOR GUIDANCE Compromised OCCLUSAL VERTICAL DIMENSION Acceptable Centric Contact Points Not Answered Eccentric Contact Points Not Answered               TREATMENT OPTIONS           Appliance Therapy   Not Answered TMJ Stabilization/Reposition Not Answered Occlusal Adj / Contour Alteration Not Answered None Orthodontics   Not Answered Orthognathic Surgery   Not Answered Extraction (non-functional) Not Answered None Direct Restorations   Yes (17),03 (16),04 (15),06 (13),07 (12),08 (11),09 (21),10 (22),11 (23),13 (25),14 (26),15 (27),18 (37),19 (36),20 (35),22 (33),23 (32),24 (31),25 (41),26 (42),27 (43),29 (45),30 (46),31 (47) None Indirect Restorations   Not Answered None                   Partially Edentulous Areas           Fixed   Not Answered None Removable   Not Answered None Implants   Not Answered None Splinting Requirements Not Answered None Attachments   Not Answered None Edentulous Arch   Not Answered None Conventional CD   Not Answered None None Implant Supported/Retained Not Answered 20 Other   Not Answered Referral / Consult   Not Answered None                                                                                                                                                           Sample Picture ONLY                                                                                                                                                                                                                                                                       IV. Biomechanical             Risk Assessment: Not Answered Conventional Fluoride Therapy Not Answered Caries Management Program Not Answered                 STEP 8: RESTORATION DESIGN                             Direct None Indirect Restorations: 2, 3, 4, 6, 11, 13, 14, 22, 23, 24, 25, 26, 27, 29, 30 Root Canal Tx: None Gold None Foundation Restorations None All Ceramic None Extractions (non-restorable) None Metal Ceramic None Other:       Indirect Resin None         FPD None         Implant Retained None Referral / Consult:       Core Supported               Enamel Supported       V. Periodontal             Risk Assessment: HIGH                           STEP 9: GINGIVAL MANAGEMENT / CONTROL LOSS OF ATTACHMENT         TREATMENT OPTIONS           Supportive Periodontal Therapy Conventional Scaling And Root Planing, And Consider Adjuctive Therapies, i.e. Chemotheraputics Maintainence Interval   Periodontal findings are consistent with 3 Months Recare, however, pt states current state is 0 Extraction (Perio Hopeless) None Root Resection   None Regenerative Procedures None Orthodontic Correction None Surgical Correction   None Other     Referral / Consult   Provider preference                   STEP 10: RESTORATION ENHANCEMENT / CONCERNS           Inappropriate Visual Coronal Length Apical (2, 3, 4, 6, 7, 8, 9, 10, 11, 13, 14, 15, 18, 19, 20, 22, 23, 24, 25, 26, 27, 29, 30, 31): Consider surgical or orthodontical correction. Inadequate Preparation Length None Ferrule Compromises None Margin Location / Violation of Biologic Width None Edentulous Ridge Considerations None