Candidate Case and Patients Initials Case 2 Edentulous posterior maxilla with pneumatized maxillary sinus requiring at least 5 mm of lateral approach sinus augmentation and two 2 or more implants and its restoration ID: 1046826
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1. 2024 Oral ExamCase #2 Submission template
2. Candidate #Case# and Patient’s Initials:
3. Case # 2Edentulous posterior maxilla with pneumatized maxillary sinus requiring at least 5 mm of lateral approach sinus augmentation and two (2) or more implants and its restoration.
4. Medical HistoryWrite a narrative to provide a detailed medical history of the patient
5. Patient ExaminationDescribe the chief complaint and patients medical /dental histories.Include the following:ASA ClassificationHouse ClassificationRelevant past/and current medical historyMedicationsAllergiesMissing teethPeriodontal statusOcclusion/ Angle Classification
6. Social HistorySmokingAlcoholDrug/substance abuse
7. Pre Sinus Augmentation radiographInclude panoramic, periapical and/or CBCT if applicable with the date the radiograph was taken
8. Post Sinus Augmentation Surgery radiographInclude panoramic, periapical and/or CBCT if applicable with the date the radiograph was taken
9. Pre Implant placement surgical radiographInclude panoramic, periapical and/or CBCT if applicable with the date the radiograph was taken
10. Pre Surgical PhotographsInclude the date the photograph was takenViews desired: Occlusal view of maxillary archOcclusal view of mandibular archFrontal view in Maximum Intercuspation Position (MIP)Left side in MIPRight side in MIPPre op photographs are optional. However, the more complete your case documentation is the easier it is for examiners to evaluate your case.
11. Treatment Planning/ GoalsSurgical Plan/ Goals- provide details
12. Prosthodontic Rehabilitation PlanDescribe Prosthodontic Rehabilitation Plan
13. Informed Consent (insert) (de-identify your document)
14. Alternative Treatment PlansDescribe alternative treatment plans
15. Implant SurgeryOperative report of actual implant surgery. Details to include instrumentation, materials techniques and implant information.
16. Post Surgical Radiograph Include panoramic, periapical and /or CBCT if applicable with the date the radiograph was taken
17. Post-Operative Care / InstructionsYou may scan a copy of the form/s that you use or type a narrative with details of post-operative instructions.
18. MaintenanceDescribe your maintenance protocol for this patientList this patients maintenance history
19. Prosthetic RestorationDescribe the type of implant restoration placed for this patient
20. Immediate post prosthetic placement radiographInclude panoramic, periapical and/or CBCT if applicable with the date the radiograph was taken.
21. Occlusal view of maxillary arch photograph (date your photo)
22. Occlusal view of mandibular arch photograph (date your photo)
23. Frontal view in maximum intercuspation position photograph (date your photo)
24. Left side photograph MIP(date your photo)
25. Right side photograph MIP (date your photo)
26. For cases that involve implant supported/retained prosthesesInsert photographic views of all implant attachment mechanisms (intra-oral)Photographic views of tissue surface areas of the removable prostheses(add slides if necessary)
27. One year post prosthetic placement radiograph with date Include panoramic, periapical and/or CBCT if applicable with the date the radiograph was taken.
28. Revision (if necessary)If you provide information on a revision, provide a detailed explanation and other documentation that is necessary to evaluate the case.
29.