Assignment Problem: Mr. Karn is a 47-year-old high school administrator who has recently moved to your city. He came to the dental office because he would like to know if it is possible to replace his missing upper right first molar tooth with a dental implant.
During Mr. Karn's first office visit, he informs you that he has been too busy lately to get a dental check-up and that he has not seen a dentist for quite a few years. Mr. Karn states that he brushes his teeth twice daily when he has time and that he does not floss regularly even though he knows that he should. He also uses an over-the-counter mouth rinse occasionally.
Patient Health History:
On the day of his first visit to your dental office Mr. Karn's blood pressure is 130/80 mm Hg and his pulse is 62 beats/min.
A review of Mr. Karn's health history reveals that he takes two medications: Zocor and Nifedipine.
Mr. Karn also states that he smokes between one half and one pack of cigarettes each day.
1. What should Mr. Karn be told about the possibility of replacing his maxillary right first molar tooth with a dental implant? Note that this question was what prompted Mr. Karn to make an appointment in your dental office.
2. What factors in Mr. Karn's profile indicate that achieving an acceptable level of patient self-care may be a problem for the dental team?
3. What factors revealed in Mr. Karn's health history will be critical for the dental team to consider during treatment?
4. What signs of gingival inflammation are evident in Mr. Karn's clinical photographs?
5. What etiologic risk factors for gingival and periodontal diseases are evident in Mr. Karn's clinical photographs?
6. How might the presence of the furcation involvements found during Mr. Karn's periodontal evaluation affect his periodontal treatment?
7. Does Mr. Karn's periodontal evaluation indicate that he has attachment loss present on some teeth?
8. What etiologic factors for gingival and periodontal diseases are evident in Mr. Karn's dental radiographs?
9. On Mr. Karn's radiographs what specific findings indicate that he has alveolar bone loss present?
10. How would you characterize Mr. Karn's periodontal condition? Do you think that he has gingivitis, periodontitis, neither, or both? What clinical or radiographic findings did you use to reach your conclusion?
11. Develop a suggested step-by-step plan for nonsurgical periodontal therapy for Mr. Karn.
12. What information should your team give Mr. Karn about his periodontal condition?
13. What should Mr. Karn be told about the possible need for periodontal surgery later in the treatment?
14. What should Mr. Karn be told about the need for continuing treatment such as periodontal maintenance?