Candidate Case and Patient initials Case 5 Edentulous mandible or maxilla with four 4 or more root form implants supporting a fixed complete implant prosthesis Medical History Write a narrative to provide a detailed medical history of the patient ID: 1046823
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1. 2024 Oral ExamCase #5 Submission template
2. Candidate #Case and Patient initials:
3. Case # 5Edentulous mandible or maxilla with four (4) or more root form implants supporting a fixed complete implant prosthesis.
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 Implant placement radiographInclude panoramic, periapical and/or CBCT if applicable with the date the radiograph was taken
8. 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.
9. Treatment Planning/ GoalsSurgical Plan/ Goals- provide details
10. Prosthodontic Rehabilitation PlanDescribe Prosthodontic Rehabilitation Plan
11. Informed Consent (insert) (de-identify your document)
12. Alternative Treatment PlansDescribe alternative treatment plans
13. Implant SurgeryOperative report of actual implant surgery. Details to include instrumentation, materials techniques and implant information.
14. Post Surgical Radiograph Include panoramic, periapical and /or CBCT if applicable with the date the radiograph was taken
15. 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.
16. MaintenanceDescribe your maintenance protocol for this patientList this patients maintenance history
17. Prosthetic RestorationDescribe the type of implant restoration placed for this patient
18. Immediate post prosthetic placement radiographInclude panoramic, periapical and/or CBCT if applicable with the date the radiograph was taken.
19. Occlusal view of maxillary arch photograph (date your photo)
20. Occlusal view of mandibular arch photograph (date your photo)
21. Frontal view in maximum intercuspation position photograph (date your photo)
22. Left side photograph MIP(date your photo)
23. Right side photograph MIP (date your photo)
24. 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)
25. One year post prosthetic placement radiograph with date Include panoramic, periapical and/or CBCT if applicable with the date the radiograph was taken.
26. Revision (if necessary)If you provide information on a revision, provide a detailed explanation and other documentation that is necessary to evaluate the case.
27.