Case Presentations DMD3 - 2026 Dr. Mina Dizdarevic Dr. Mina Dizdarevic # **Case Presentations** ## AIM OF THE ASSESSMENT The Case Presentation is designed to assess a dental student’s integrated knowledge from a combination of didactic and pre-clinical teaching, as well as patient treatment, clinical experiences, and activities throughout their time at the Dental School. The Case Presentation is designed to assess a dental student’s integrated knowledge from a combination of didactic and pre-clinical teaching, as well as patient treatment, clinical experiences, and activities throughout their time at the Dental School. # Case Presentations **AIM OF THE STUDENT** Students need to show examiners that they are maintaining their duty of care to patients by offering an appropriate and justified treatment plan, which has resulted in effective management and an improvement to the patients' dental status. #### Student Objectives Students need to show examiners that they are maintaining their duty of care to patients by offering an appropriate and justified treatment plan, which has resulted in effective management and an improvement to the patients' dental status. # Case Presentations ### Inputs leading to a Problem List * **CHIEF** **COMPLAIN &** **EXPECTATIONS** * **FAMILY** **and** **SOCIAL** **HISTORY** * **MEDICAL** **and** **DENTAL** **HISTORY** * **EXTRA** **and** **INTRA** **ORAL** **EXAM** * **ORAL** **HYGIENE** **DIET** **ANALYSIS** * **SPECIAL** **TESTS, OCCLUSAL** **ANALYSIS** * **TOOTH** **INVESTIGATION** * **SPECIALIST** **OPINIONS** ### Process <|UserData|> **Problem List** --(Analysis)--> **DIAGNOSIS** </|UserData|> ### Outputs * **DIAGNOSIS**  #### Inputs Leading to a Problem List - **Chief Complaint & Expectations** - **Family and Social History** - **Medical and Dental History** - **Extra and Intra Oral Exam** - **Oral Hygiene and Diet Analysis** - **Special Tests and Occlusal Analysis** - **Tooth Investigation** - **Specialist Opinions** #### Clinical Process - **Problem List** (Analysis) leads to **Diagnosis** #### Outputs - **Diagnosis** Flowchart diagram illustrating the 'Case Presentations' workflow. The diagram features a central rectangular node labeled 'Problem List' (in red text) which acts as a convergence point for eight surrounding circular input nodes: 'CHIEF COMPLAIN & EXPECTATIONS', 'FAMILY and SOCIAL HISTORY', 'MEDICAL and DENTAL HISTORY', 'EXTRA and INTRA ORAL EXAM', 'ORAL HYGIENE DIET ANALYSIS', 'SPECIAL TESTS, OCCLUSAL ANALYSIS', 'TOOTH INVESTIGATION', and 'SPECIALIST OPINIONS'. Arrows from these inputs feed into the Problem List. Below the central node, an arrow labeled '(Analysis)' points downwards to a final rectangular output node labeled 'DIAGNOSIS' (in red text). # Case Presentations GENERIC APPROACH 1. Chief complaint - History 2. Medical history 3. Dental History 4. Social History 5. Family History 6. Oral Hygiene 7. Diet 8. Investigation / Special tests 9. Problem list 10. Diagnosis 11. Treatment (options, complications, pros and cons) 12. Referral/s (if needed) 13. Short term and long term treatment/goals etc 14. Review appointments 1. Chief complaint - History 2. Medical history 3. Dental History 4. Social History 5. Family History 6. Oral Hygiene 7. Diet 8. Investigation / Special tests 9. Problem list 10. Diagnosis 11. Treatment (options, complications, pros and cons) 12. Referral/s (if needed) 13. Short term and long term treatment/goals etc 14. Review appointments # Case Presentations Chief / Presenting Complaint Examples: “I’m in so much pain with swelling and bleeding and is causing bad breath. It also hurts to eat on the back LHS and so I eat with my anterior teeth” “I would like my chipped front tooth fixed” “My upper and lower dentures are uncomfortable and I can’t eat” “I went to a government dental clinic in Morley and told they couldn’t replace my crown, so I came here to get it replaced.” #### Examples of Chief Complaints - "I’m in so much pain with swelling and bleeding and is causing bad breath. It also hurts to eat on the back LHS and so I eat with my anterior teeth" - "I would like my chipped front tooth fixed" - "My upper and lower dentures are uncomfortable and I can’t eat" - "I went to a government dental clinic in Morley and told they couldn’t replace my crown, so I came here to get it replaced." # Case Presentations Chief / Presenting Complaint – PAIN ASSESSMENT * **Site** – Point where you feel the pain * **Onset** – when did you first noticed the pain? * **Character** – Describe the type of pain: sharp, dull, constant, off and on, throbbing, etc. * **Radiation** – Does the pain spread out from the original source? * **Associations** – What other symptoms accompany the pain? Bad breath? Looseness of the tooth? Jaw clicking or popping? * **Time course** – What did the pain start? Does it occur at specific times of day? * **Exacerbating or relieving factors** – What makes the pain worse or better? What medications or remedies have you already tried? * **Severity** – How would you rate the pain on a scale of 1 to 10, where 1 is barely noticing some discomfort and 10 is an emergency room visit? #### Pain Assessment Criteria - **Site**: Point where you feel the pain - **Onset**: When did you first notice the pain? - **Character**: Describe the type of pain (sharp, dull, constant, off and on, throbbing, etc.) - **Radiation**: Does the pain spread out from the original source? - **Associations**: What other symptoms accompany the pain? (Bad breath, looseness of the tooth, jaw clicking or popping) - **Time course**: When did the pain start? Does it occur at specific times of day? - **Exacerbating or relieving factors**: What makes the pain worse or better? What medications or remedies have you already tried? - **Severity**: How would you rate the pain on a scale of 1 to 10 (1 is barely noticing discomfort, 10 is an emergency room visit)? # Case Presentations ## Chief / Presenting Complaint – History “My upper and lower dentures are uncomfortable, and I can’t eat” * Patient presented to OHCWA for the first time in 2022 * All teeth were periodontally compromised with hopeless prognosis * Immediate complete dentures were made in January last year after all teeth were extracted in the DMD exo clinic using a staged approach. #### Case Example: Denture Discomfort *"My upper and lower dentures are uncomfortable, and I can’t eat"* - Patient presented to OHCWA for the first time in 2022. - All teeth were periodontally compromised with hopeless prognosis. - Immediate complete dentures were made in January last year after all teeth were extracted in the DMD extraction clinic using a staged approach. ### Medical Condition | Medication | Dental Implications #### Original Table: | Medical Condition | Medication | Dental Implications | |-------------------------|---------------------------------------------------------------------------|-------------------------------------------------------------------------------------| | Hypertension | Twynsta: Telmisartan with amlodipine, 50mg, oral, once daily<br>Dithiazide: hydrochlorothiazide, 12.5mg, oral, once daily | ARBs:<br>• Dry mouth<br>• Gingival hyperplasia<br>• Dry mouth<br>Ca Channel blockers:<br>• Gingival hyperplasia<br>• Dry mouth<br>Diuretics:<br>• Dry mouth<br>• Lichenoid reactions (Southerland, 2016) | | COPD | Trelegy: Fluticasone with umeclidinium and vilanterol, one puff/day | • Breathing difficulties in supine position may require patient to be positioned more upright in dental chair (Devlin, 2014)<br>• Increased risk of oral thrush (TRELEGY, 2023) | | Gastro-Oesophageal Reflux Disease (GORD) | Nexium: Esomeprazole, 20mg, oral, once daily | Erosion of enamel (Wilder-Smith, 2004) | **Case Presentations:** - Know MOA’s. - Medical History Example: - ex: TIT has hypertension > what drugs? > how effects dental? **Medical History**  #### Medical Condition, Medication, and Dental Implications | Medical Condition | Medication | Dental Implications | | :--- | :--- | :--- | | Hypertension | Twynsta: Telmisartan with amlodipine, 50mg, oral, once daily<br>Dithiazide: hydrochlorothiazide, 12.5mg, oral, once daily | **ARBs:** Dry mouth, Gingival hyperplasia<br>**Ca Channel blockers:** Gingival hyperplasia, Dry mouth<br>**Diuretics:** Dry mouth, Lichenoid reactions | | COPD | Trelegy: Fluticasone with umeclidinium and vilanterol, one puff/day | Breathing difficulties in supine position; may require upright positioning. Increased risk of oral thrush. | | GORD | Nexium: Esomeprazole, 20mg, oral, once daily | Erosion of enamel | #### Presentation Requirements - Know Mechanisms of Action (MOA’s). - Example: If a patient has hypertension, identify the drugs and how they affect dental treatment. A structured table with three columns titled 'Medical Condition', 'Medication', and 'Dental Implications'. It lists specific conditions (Hypertension, COPD, GORD) alongside their prescribed medications and associated dental risks such as gingival hyperplasia or breathing difficulties. # Case Presentations ## Dental History * Previous dental treatment - not associated with presenting complaint ## Social History * Patient's occupation and family members: how this may influence stress levels, motivation and attendance. * Current smoker (smoke or chew tobacco), former smoker. * Note the number of cigarettes smoked/day, years of smoking * Recreational drugs * Alcohol intake (units per week) #### Dental History - Previous dental treatment not associated with the presenting complaint. #### Social History - **Occupation and Family**: How these influence stress levels, motivation, and attendance. - **Smoking Status**: Current smoker (smoke or chew tobacco) or former smoker. - Note number of cigarettes per day and years of smoking. - **Recreational Drugs** - **Alcohol Intake**: Units per week. **Family History** * Medical conditions affecting other family members (e.g. diabetes or heart disease). * History of periodontal disease in the family (tooth loss at a young age) **Oral hygiene** * Frequency * Method **Diet** * High and extreme caries risk: full diet analysis #### Family History - Medical conditions affecting family members (e.g., diabetes or heart disease). - History of periodontal disease in the family (e.g., tooth loss at a young age). #### Oral Hygiene - Frequency - Method #### Diet - High and extreme caries risk: Requires a full diet analysis. # Case Presentations ## Modifying/Risk factors ### Example: #### Social History - Patient Smokes 10-15 cigarettes/day since she was 35 years old #### Family history - Mother lost all her teeth in her 30s #### Oral hygiene - Brush 1x day with manual toothbrush, no flossing #### Modifying and Risk Factors Example - **Social History**: Patient smokes 10-15 cigarettes/day since age 35. - **Family History**: Mother lost all teeth in her 30s. - **Oral Hygiene**: Brushes 1x day with manual toothbrush; no flossing. # Case Presentations Social History, Family History, Dental History, Diet, Oral Hygiene Example ## Patient Background **Social History** * Migrated to Australia from South Africa to care for elderly mother * Currently lives alone, but has brother and son also living close by in WA * Runs a jewelry making class **Dental History** * 22 implant was placed in the 1980s, but "fell out" in 2021. * Multiple posterior PFM crowns made in the 1990s. * Direct and indirect restorations and endodontic treatment done at OHCWA over the last 3 years. **Oral Hygiene:** * Brushes twice a day (Morning and night) * Electric toothbrush * Fluoridated toothpaste * Uses Pixters daily for interdental cleaning * Rinses with salt water in the mornings and Colgate Neutrafluor mouthwash at night **Diet:** * Generally avoids soft drinks but will occasionally have diet Pepsi * 3 cups of black coffee every morning, no sugar * Does not usually eat fruits, other than tomato and avocado #### Patient Background Example **Social History** - Migrated to Australia from South Africa to care for elderly mother. - Currently lives alone; brother and son live nearby in WA. - Runs a jewelry making class. **Dental History** - 22 implant placed in the 1980s, failed ("fell out") in 2021. - Multiple posterior PFM crowns made in the 1990s. - Direct/indirect restorations and endodontic treatment at OHCWA over the last 3 years. **Oral Hygiene** - Brushes twice a day (morning and night) with an electric toothbrush and fluoridated toothpaste. - Uses Pixters daily for interdental cleaning. - Rinses with salt water in the mornings and Colgate Neutrafluor mouthwash at night. **Diet** - Generally avoids soft drinks; occasional diet Pepsi. - 3 cups of black coffee every morning, no sugar. - Does not usually eat fruits, except tomato and avocado. **Case Presentations** - Social History, Family History, Dental History, Diet, Oral Hygiene --- - Smokes 10-15 cigarettes/day Poor oral hygiene Family history of perio disease Modifying/Risk factors --- - Periodontitis Pathophysiology of disease  #### Risk Factors and Pathophysiology Summary - **Modifying/Risk Factors**: Smoking (10-15 cigarettes/day), poor oral hygiene, family history of periodontal disease. - **Pathophysiology of Disease**: Periodontitis. Flowchart diagram illustrating the pathophysiology of periodontitis. The diagram flows vertically from top to bottom: starting with a list of patient factors (Smokes 10-15 cigarettes/day, Poor oral hygiene, Family history of perio disease), leading to 'Modifying/Risk factors', then to 'Periodontitis', and finally concluding at 'Pathophysiology of disease'. Arrows indicate the causal or sequential relationship between these stages. # Case Presentations # Extra-Oral Exam Profile photos: frontal, lateral, high smile, rest position (De-identify patient) 1 . Blur bars over eyes * Facial symmetry * TMJ * MoM * Lymph nodes * Smile aesthetics * etc **NAD:** State even if there are no abnormalities detected #### Extra-Oral Exam Requirements - **Profile Photos**: Frontal, lateral, high smile, rest position (De-identify patient by blurring eyes). - **Assessment Areas**: - Facial symmetry - TMJ - Muscles of Mastication (MoM) - Lymph nodes - Smile aesthetics - **NAD**: State "No Abnormalities Detected" even if the exam is clear. **Case Presentations** **Intra-Oral Exam** Soft & hard tissues: **Labial mucosa**, **Frenal attachments**, **Gingiva**, **Palate**, **FoM**, **Tongue**, etc * **Tooth charting** * **CPITN,** * **Plaque Score,** * **Perio Chart** 11: Abutment - sat 12: Crown prep but no temporary or crown 13: Absent 14: Palatal caries 15: Absent 16: Absent 17: Heavy O wear 18: Absent 41: Absent 42: Gingival recession; D surface brown stain; comp build up, 42L caries 43: Rotated distally, translated anteriorly; Bu, M recession; heavy O wear; exposed dentine; 43M cavitation and 43L caries 44: FCC - sat 45: Absent 46: FCC - sat 47: FCC - sat 48: Absent 21: Pontic 22: Abutment - sat 23: FCC - sat 24: Bu GIC catch on margin; heavy O wear 25: Absent 26: Absent 27: Absent 28: Absent 31: Gingival recession, composite buildup 32: Absent 33: O wear; Bu recession; Bu cavitation, arrested caries 34: Ceramic onlay - sat; Bu recession, heavy O wear; class V Bu GIC, catch 35: Missing 36: FCC - sat 37: Absent 38: Absent Missing: **<ul><li>18, 22, 24, 25, 28, 38, 48</li></ul>** Non-carious tooth surface loss <ul><li>23B abrasion lesion</li></ul> Endodontically treated teeth <ul><li>44 and 46 – temporarily restored with Ketac silver and SS band</li></ul>    #### Intra-Oral Exam Components - **Soft & Hard Tissues**: Labial mucosa, frenal attachments, gingiva, palate, floor of mouth (FoM), tongue, etc. - **Clinical Metrics**: Tooth charting, CPITN, Plaque Score, Perio Chart. #### Tooth Charting Findings - **11**: Abutment - satisfactory - **12**: Crown prep; no temporary or crown - **13, 15, 16, 18**: Absent - **14**: Palatal caries - **17**: Heavy occlusal wear - **21**: Pontic - **22**: Abutment - satisfactory - **23**: FCC - satisfactory; buccal abrasion lesion - **24**: Buccal GIC catch on margin; heavy occlusal wear - **25, 26, 27, 28**: Absent - **31**: Gingival recession, composite buildup - **32, 35, 37, 38**: Absent - **33**: Occlusal wear; buccal recession; buccal cavitation, arrested caries - **34**: Ceramic onlay - satisfactory; buccal recession, heavy occlusal wear; class V buccal GIC catch - **36**: FCC - satisfactory - **41, 45, 48**: Absent - **42**: Gingival recession; distal surface brown stain; composite build up; 42L caries - **43**: Rotated distally, translated anteriorly; buccal/mesial recession; heavy occlusal wear; exposed dentine; 43M cavitation and 43L caries - **44, 46**: FCC - satisfactory; temporarily restored with Ketac silver and SS band (Endodontically treated) - **47**: FCC - satisfactory #### Summary of Findings - **Missing Teeth**: 18, 22, 24, 25, 28, 38, 48 - **Non-carious tooth surface loss**: 23B abrasion lesion - **Endodontically treated teeth**: 44 and 46 Clinical intra-oral photograph showing the maxillary arch (top) and mandibular arch (bottom). The images display the patient's dentition, soft tissues including gingiva and palate, and visible dental restorations. Dental charting table listing specific tooth numbers and their clinical status. Key findings include: Tooth 14 has palatal caries; Tooth 17 has heavy occlusal wear; Tooth 42 has gingival recession and caries on the distal surface; Tooth 43 is rotated with cavitation and caries; Teeth 44 and 46 have full ceramic crowns (FCC); Tooth 24 has a GIC catch on margin and heavy occlusal wear; Tooth 34 has a ceramic onlay. Schematic tooth diagram illustrating missing teeth, non-carious surface loss, and endodontically treated teeth. It shows 'Missing' teeth 18, 22, 24, 25, 28, 38, 48. It highlights a '23B abrasion lesion'. It indicates that teeth 44 and 46 are endodontically treated and temporarily restored with Ketac silver and an SS band. Case Presentations Denture Examination - Age - Retention - Stability - Occlusion - Aesthetics - Overall patient satisfaction <table><thead><tr><th></th><th>Maxillary</th><th>Mandibular</th></tr></thead><tbody><tr><td>Age</td><td>4.5 years</td><td>4.5 years</td></tr><tr><td>Appearance</td><td>Good</td><td>Fair (missing tooth)</td></tr><tr><td>Retention</td><td>Poor</td><td>Good</td></tr><tr><td>Stability</td><td>Poor</td><td>Good</td></tr><tr><td>Patient satisfaction</td><td>Poor</td><td>Good</td></tr></tbody></table> Intraoral photos with dentures - RPD  #### Denture Assessment Criteria - Age - Retention - Stability - Occlusion - Aesthetics - Overall patient satisfaction #### Denture Evaluation Table | Feature | Maxillary | Mandibular | | :--- | :--- | :--- | | Age | 4.5 years | 4.5 years | | Appearance | Good | Fair (missing tooth) | | Retention | Poor | Good | | Stability | Poor | Good | | Patient satisfaction | Poor | Good | *Note: Include intraoral photos with dentures (RPD).* A comparison table titled 'Example' with columns for Maxillary and Mandibular dentures. Rows list Age (4.5 years), Appearance (Good vs Fair), Retention (Poor vs Good), Stability (Poor vs Good), and Patient satisfaction (Poor vs Good). Case Presentations **Investigation / Special tests** **Radiographs** • Date and Xray interpretation **Example:** Bitewings (17/03/2023) - **RHS:** Radiolucencies observed under 15 crown and 14 crown - **LHS:** radiolucency under 37B amalgam **Results for Cold, EPT, Percussion, Palpation tests**  #### Special Tests - Results for Cold, EPT, Percussion, and Palpation tests. #### Radiographic Interpretation Example **Bitewings (17/03/2023)** - **RHS**: Radiolucencies observed under 15 crown and 14 crown. - **LHS**: Radiolucency under 37B amalgam. Composite clinical radiograph (Bitewings) dated 17/03/2023 displaying two dental X-ray panels. The image demonstrates diagnostic findings of radiolucencies: specifically under the crowns of teeth 15 and 14 on the right side (RHS), and a radiolucency under the amalgam filling of tooth 37B on the left side (LHS). **Case Presentations** **Caries Risk Assessment** **CAMBRA** **Protective factors** * **Access to fluoride products, F water** * **Saliva test:** * **Resting pH** * **Stimulated saliva volume** * **Stimulated saliva buffering capacity** **Diet assessment:** * **Exposure to sugars** **Clinical/radiographic exam:** * **Plaque score** * **Caries** * **White spot lesions** * **Non-cavitated lesions (xray)** * **Existing restorations**  #### CAMBRA Assessment Factors - **Protective Factors**: - Access to fluoride products and fluoridated water. - **Saliva Test**: Resting pH, stimulated saliva volume, and stimulated saliva buffering capacity. - **Diet Assessment**: Exposure to sugars. - **Clinical/Radiographic Exam**: - Plaque score - Caries and white spot lesions - Non-cavitated lesions (X-ray) - Existing restorations A detailed 'CAMBRA caries risk assessment form' (Table 3 Part 1) for ages 6 years through adult. The table is structured into sections: 'Protective factors', 'Biological or environmental risk factors', 'Biological risk factors - Clinical Exam', and 'Disease Indicators - Clinical exam'. It includes columns for checking 'Yes', scoring (Column 1 Score=-1, Column 2 Score=+2, Column 3 Score=+3), and calculating totals. A visual scale at the bottom shows a balance beam with values -4, +6, and +6 corresponding to LOW, MODERATE, HIGH, and EXTREME risk categories. Case Presentations Periodontal Risk Assessment **DO this even p p doesn't NAy HAVE PERIØ** Periodontal risk assessment (Lang & Tonetti, 2003) | Field | Value | |---|---| | Age | 51 | | Number of teeth and implants | 17 | | Number of sites per tooth / implant | 6 | | Number of BOP-pos. sites | 82 of 102 | | Number of sites with PPD≥5mm | 21 | | Number of missing teeth | 11 | | % Alveolar bone loss | 70 | | Syst./Gen. | No | | Envir. | Occasional smoker (OS) | **HIGH RISK**  #### Periodontal Risk Assessment (Lang & Tonetti, 2003) *Note: Perform even if the patient does not have periodontitis.* | Field | Value | | :--- | :--- | | Age | 51 | | Number of teeth and implants | 17 | | Number of sites per tooth / implant | 6 | | Number of BOP-positive sites | 82 of 102 | | Number of sites with PPD ≥ 5mm | 21 | | Number of missing teeth | 11 | | % Alveolar bone loss | 70 | | Systemic/Genetic factors | No | | Environmental factors | Occasional smoker (OS) | **Risk Level: HIGH RISK** Periodontal risk assessment figure (Lang & Tonetti, 2003) displaying a radar chart on the left with axes for BOP%, PD≥5mm, Tooth loss, BL/Age, Syst./Gen., and Envir., along with input fields on the right listing patient data such as Age: 51, Number of teeth: 17, % Alveolar bone loss: 70, and Smoking status: Occasional smoker. The figure concludes with 'HIGH RISK' in red text. **Case Presentations** **Prognosis** Add reference Periodontal, Restorative, Endodontic, Occlusion - Overall | Prognoses | | | | | | | | | | | | | | | | | | | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | | Perio | | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | | **G** | | | **G** | **G** | | | | Resto | | **F** | **F** | **Q** | **F** | **F** | **G** | **G** | **G** | | **F** | | | **F** | **C** | | | | Endo | | **G** | **G** | **Q** | **G** | **G** | **G** | **G** | **G** | | **G** | | | **G** | **G** | | | | Occ | | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | | **G** | | | **G** | **G** | | | | Overall | | **F** | **F**| **Q** | **F** | **F** | **G** | **G** | **G** | | **F** | | | **F** | **C**| **C** | | | | | | **18** | **17** | **16** | **15** | **14** | **13** | **12** | **11** | **21** | **22** | **23** | | **24** | **25** | **26** | **27** | **28** | | | | | | | | | | | | | | | | | | | | | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | | 48 | 47 | 46 | 45 | 44 | 43 | 42 | 41 | 31 | 32 | 33 | 34 | 35 | 36 | 37 | 38 | | | | Perio | | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | | | | Resto | | **F** | **N** | **F** | **C** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **F** | **F** | **F** | | | | Endo | | **G** | **C** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | | | | Occ | | **G** | **F** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | **G** | | | | Overall | | **F** | **N** | **F** | **C**| **R** | **G** | **G** | **G** | **G** | **G** | **G** | **F** | **F** | **F** | | | “Your own opinion” 1, Just justify it **Prognoses** * **G** | Good * **F** | Fair * **Q** | Questionable * **C** | Compromised * **N** | Non-salvageable <text>**(Samet & Jotkowitz, 2009)**</text>  #### Prognosis by Tooth and Category (Samet & Jotkowitz, 2009) | Category | 18 | 17 | 16 | 15 | 14 | 13 | 12 | 11 | 21 | 22 | 23 | 24 | 25 | 26 | 27 | 28 | | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | | Perio | - | G | G | G | G | G | G | G | G | - | G | G | G | - | - | - | | Resto | - | F | F | Q | F | F | G | G | G | - | F | F | C | - | - | - | | Endo | - | G | G | Q | G | G | G | G | G | - | G | G | G | - | - | - | | Occ | - | G | G | G | G | G | G | G | G | - | G | G | G | - | - | - | | **Overall** | - | **F** | **F** | **Q** | **F** | **F** | **G** | **G** | **G** | - | **F** | **F** | **C** | **C** | - | - | | Category | 48 | 47 | 46 | 45 | 44 | 43 | 42 | 41 | 31 | 32 | 33 | 34 | 35 | 36 | 37 | 38 | | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | | Perio | - | G | G | G | G | G | G | G | G | G | G | G | G | G | G | G | | Resto | - | F | N | F | C | G | G | G | G | G | G | G | F | F | F | - | | Endo | - | G | C | G | G | G | G | G | G | G | G | G | G | G | G | - | | Occ | - | G | F | G | G | G | G | G | G | G | G | G | G | G | G | - | | **Overall** | - | **F** | **N** | **F** | **C** | **R** | **G** | **G** | **G** | **G** | **G** | **G** | **F** | **F** | **F** | - | #### Prognosis Key - **G**: Good - **F**: Fair - **Q**: Questionable - **C**: Compromised - **N**: Non-salvageable - **R**: Refers to your own justified opinion. A large prognostic chart for dental case presentations. The table displays prognosis ratings (G, F, Q, C, N) across multiple columns representing tooth numbers (e.g., 18, 17, 16...). Rows categorize the teeth by discipline: Perio (Periodontal), Resto (Restorative), Endo (Endodontic), Occ (Occlusion), and Overall. The 'Overall' row features color-coding: Yellow for Fair/F, Orange for Questionable/Q, Green for Good/G, Red for Compromised/C, and Black for Non-salvageable/N. A legend is present in the bottom right corner defining these colors. # Case Presentations ## Problem List * **Aesthetics:** related to natural or artificial teeth * **Host-related:** factors that affect oral and dental health (habits, medication, medical condition) * **Pathology:** related to hard and soft tissues (include the complete perio and endo diagnosis) * **Morphology:** occlusal problems, hypomineralisation, bony exostosis, hypocementosis  #### Problem List Categories - **Aesthetics**: Related to natural or artificial teeth. - **Host-related**: Factors affecting oral health (habits, medication, medical conditions). - **Pathology**: Related to hard and soft tissues (include complete periodontal and endodontic diagnoses). - **Morphology**: Occlusal problems, hypomineralisation, bony exostosis, hypocementosis. Table titled '1.17 Problem list' structured into four columns: 'Example', 'Host-related', 'Pathology', and 'Morphology'. The table details a specific case presentation including patient history (bipolar disorder, smoking), clinical findings (carious root stumps, periodontitis stages), and morphological characteristics (missing teeth, impacted teeth). # Case Presentations ## Diagnosis * Summary of problem list ## Treatment Options * Options for control and reconstructive phase * All options even if the patient cannot afford * Pros and Cons * No treatment is also an option #### Diagnosis - Provide a summary of the problem list. #### Treatment Options - Include options for both the control and reconstructive phases. - Present all options regardless of patient affordability. - Detail the Pros and Cons for each. - Note that "No treatment" is always an option. # Case Presentations ## Case Progress - Photos of the Case ## Last Slides - Reflections - Limitations - What could be done better - Reference list #### Case Progress and Conclusion - **Case Progress**: Include photos of the case. - **Reflections**: - Limitations of the case. - What could be improved or done better. - **Reference List** # Case Presentations **Prepare 2-3 cases** * Photos * Study Models * Radiographs **Why three cases?** * 1 for Case Pres in DMD3 * 2 for spare, resits or supplementary #### Case Preparation Requirements Prepare 2-3 cases including: - Photos - Study Models - Radiographs #### Rationale for Multiple Cases - 1 case for the DMD3 Case Presentation. - 2 cases as spares for resits or supplementary exams. Case Presentations Don’t go for anything toocomplex - i.e. if you do vd you’ll be absolutely grilled - Semester 1 (DENT5310) - CP slides/PDF (formative) - Submit for feedback - Semester 2 (DENT5311) - Case presentation (summative) + Portfolio - 45 minutes: 15–20 mins presentation 20–25 mins questions Two examiners – tutors, academic staff (examiners not disclosed). In some sessions there will be an observer #### Presentation Timeline - **Semester 1 (DENT5310)**: - Submit Case Presentation slides/PDF for formative feedback. - **Semester 2 (DENT5311)**: - Summative Case Presentation and Portfolio. - **Duration**: 45 minutes total (15–20 mins presentation, 20–25 mins questions). #### Examination Details - Two examiners (tutors or academic staff; identities not disclosed). - Observers may be present in some sessions. #### Complexity Guidance - Avoid overly complex cases (e.g., Vertical Dimension changes) to prevent excessive questioning. # Case Presentations ## Case selection: * Select your case presentation patient early. * Enough time to formulate and develop a treatment plan that you can perhaps complete before the exam* * Select reliable patients * Give preference to Multi-disciplinary cases (endo, perio, pros) or Complex medical history (polypharmacy) with completed control phase * Avoid very **Complex** cases in DMD3 * Ask help from Clinic coordinators or Module coordinator for case selection ***The selected case does not need to be finished in DMD3* #### Case Selection Criteria - Select the patient early to allow time for treatment plan development. - Choose reliable patients. - Preference should be given to: - Multi-disciplinary cases (Endodontics, Periodontics, Prosthodontics). - Complex medical history (e.g., polypharmacy) with a completed control phase. - Avoid very complex cases in DMD3. - Consult Clinic or Module coordinators for assistance with selection. *Note: The selected case does not need to be finished within DMD3.* # **Case Presentations** - Do not forget to obtain all the basic initial information and records (study models, photographs and radiographs) for all potential case presentation patient - Maintain caseload - Do not ignore your other patients #### Clinical Management Reminders - Obtain all basic initial records (study models, photographs, and radiographs) for all potential case presentation patients. - Maintain your overall caseload. - Do not ignore other patients while focusing on the case presentation. # Case Presentations ## Oral Presentation: If you are not accustomed or do not feel comfortable speaking in public: * Practice your presentation with a friend * Timing #### Presentation Preparation If you are not comfortable with public speaking: - Practice your presentation with a friend. - Focus on timing. # Case Portfolio The case portfolio patient types: * 1x periodontitis management case * 1x restorative treatment case using removable dentures ( complete or partial ) * 1x restorative treatment case using fixed restorations * 1x treatment involving the management of dental aesthetics * 1x multi-disciplinary case * *At least one case in your portfolio must include Endodontics* for the management of pulp/root canal diseases, and *Extractions* for the management of teeth with overall hopeless prognosis ( these procedures should not be limited to the multi-disciplinary case ). * *Paedodontics and Orthodontic cases can also be used in your case* portfolio to illustrate the multi-disciplinary case and aesthetic case. * The dental aesthetics case can involve for example * direct and indirect restorations, internal tooth bleaching, orthodontic procedures* #### Required Patient Case Types The case portfolio must include the following five patient types: - 1x periodontitis management case - 1x restorative treatment case using removable dentures (complete or partial) - 1x restorative treatment case using fixed restorations - 1x treatment involving the management of dental aesthetics - 1x multi-disciplinary case #### Mandatory Clinical Procedures Across the portfolio, specific clinical procedures must be demonstrated: - **Endodontics and Extractions**: At least one case in your portfolio must include Endodontics for the management of pulp/root canal diseases, and Extractions for the management of teeth with an overall hopeless prognosis. These procedures should not be limited solely to the multi-disciplinary case. - **Paedodontics and Orthodontics**: These cases can be used to illustrate the multi-disciplinary or aesthetic case requirements. - **Aesthetic Management**: The dental aesthetics case may involve procedures such as: - Direct and indirect restorations - Internal tooth bleaching - Orthodontic procedures **Dr. Mina Dizdarevic** * Example Case Pres * Rubric’s * Logbook #### Clinical Education Materials - **Dr. Mina Dizdarevic** - Example Case Presentations - Grading Rubrics - Clinical Logbook [^1]: Original PDF page 1: [[Case Presentation DMD3 Tips- annotated.pdf#page=1|Case Presentation DMD3 Tips- annotated, p.1]] [^2]: Original PDF page 2: [[Case Presentation DMD3 Tips- annotated.pdf#page=2|Case Presentation DMD3 Tips- annotated, p.2]] [^3]: Original PDF page 3: [[Case Presentation DMD3 Tips- annotated.pdf#page=3|Case Presentation DMD3 Tips- annotated, p.3]] [^4]: Original PDF page 4: [[Case Presentation DMD3 Tips- annotated.pdf#page=4|Case Presentation DMD3 Tips- annotated, p.4]] [^5]: Original PDF page 5: [[Case Presentation DMD3 Tips- annotated.pdf#page=5|Case Presentation DMD3 Tips- annotated, p.5]] [^6]: Original PDF page 6: [[Case Presentation DMD3 Tips- annotated.pdf#page=6|Case Presentation DMD3 Tips- annotated, p.6]] [^7]: Original PDF page 7: [[Case Presentation DMD3 Tips- annotated.pdf#page=7|Case Presentation DMD3 Tips- annotated, p.7]] [^8]: Original PDF page 8: [[Case Presentation DMD3 Tips- annotated.pdf#page=8|Case Presentation DMD3 Tips- annotated, p.8]] [^9]: Original PDF page 9: [[Case Presentation DMD3 Tips- annotated.pdf#page=9|Case Presentation DMD3 Tips- annotated, p.9]] [^10]: Original PDF page 10: [[Case Presentation DMD3 Tips- annotated.pdf#page=10|Case Presentation DMD3 Tips- annotated, p.10]] [^11]: Original PDF page 11: [[Case Presentation DMD3 Tips- annotated.pdf#page=11|Case Presentation DMD3 Tips- annotated, p.11]] [^12]: Original PDF page 12: [[Case Presentation DMD3 Tips- annotated.pdf#page=12|Case Presentation DMD3 Tips- annotated, p.12]] [^13]: Original PDF page 13: [[Case Presentation DMD3 Tips- annotated.pdf#page=13|Case Presentation DMD3 Tips- annotated, p.13]] [^14]: Original PDF page 14: [[Case Presentation DMD3 Tips- annotated.pdf#page=14|Case Presentation DMD3 Tips- annotated, p.14]] [^15]: Original PDF page 15: [[Case Presentation DMD3 Tips- annotated.pdf#page=15|Case Presentation DMD3 Tips- annotated, p.15]] [^16]: Original PDF page 16: [[Case Presentation DMD3 Tips- annotated.pdf#page=16|Case Presentation DMD3 Tips- annotated, p.16]] [^17]: Original PDF page 17: [[Case Presentation DMD3 Tips- annotated.pdf#page=17|Case Presentation DMD3 Tips- annotated, p.17]] [^18]: Original PDF page 18: [[Case Presentation DMD3 Tips- annotated.pdf#page=18|Case Presentation DMD3 Tips- annotated, p.18]] [^19]: Original PDF page 19: [[Case Presentation DMD3 Tips- annotated.pdf#page=19|Case Presentation DMD3 Tips- annotated, p.19]] [^20]: Original PDF page 20: [[Case Presentation DMD3 Tips- annotated.pdf#page=20|Case Presentation DMD3 Tips- annotated, p.20]] [^21]: Original PDF page 21: [[Case Presentation DMD3 Tips- annotated.pdf#page=21|Case Presentation DMD3 Tips- annotated, p.21]] [^22]: Original PDF page 22: [[Case Presentation DMD3 Tips- annotated.pdf#page=22|Case Presentation DMD3 Tips- annotated, p.22]] [^23]: Original PDF page 23: [[Case Presentation DMD3 Tips- annotated.pdf#page=23|Case Presentation DMD3 Tips- annotated, p.23]] [^24]: Original PDF page 24: [[Case Presentation DMD3 Tips- annotated.pdf#page=24|Case Presentation DMD3 Tips- annotated, p.24]] [^25]: Original PDF page 25: [[Case Presentation DMD3 Tips- annotated.pdf#page=25|Case Presentation DMD3 Tips- annotated, p.25]] [^26]: Original PDF page 26: [[Case Presentation DMD3 Tips- annotated.pdf#page=26|Case Presentation DMD3 Tips- annotated, p.26]] [^27]: Original PDF page 27: [[Case Presentation DMD3 Tips- annotated.pdf#page=27|Case Presentation DMD3 Tips- annotated, p.27]] [^28]: Original PDF page 28: [[Case Presentation DMD3 Tips- annotated.pdf#page=28|Case Presentation DMD3 Tips- annotated, p.28]] [^29]: Original PDF page 29: [[Case Presentation DMD3 Tips- annotated.pdf#page=29|Case Presentation DMD3 Tips- annotated, p.29]] [^30]: Original PDF page 30: [[Case Presentation DMD3 Tips- annotated.pdf#page=30|Case Presentation DMD3 Tips- annotated, p.30]] [^31]: Original PDF page 31: [[Case Presentation DMD3 Tips- annotated.pdf#page=31|Case Presentation DMD3 Tips- annotated, p.31]]