Case report: A strategy for planning and management of comprehensive restorative case

Abstract

Case: A 35-year old man presented to the clinic requesting dental treatment. Diet history revealed high frequency of exposure to sweet food. He had poor oral hygiene with inadequate fluoride exposure. Intraoral and radiographic examination revealed multiple cavitated caries lesions, secondary caries and incipient lesions, multiple missing teeth (extracted due to caries) and malocclusion. Treatment of this high caries risk patient was performed in three phases. Firstly, dietary adjustments, a full mouth clean and polish, caries excavation and placement of temporary fillings were performed. A professional fluoride application every 2-3 weeks for 3 months was started and combined with fluoridated tooth paste for home use. Secondly, RCT in tooth 34 was performed and fluoride regimen continued. Thirdly, placement of final fillings and build-up of severely destroyed teeth and long-term provisional PFM crown for tooth 34 were performed. Fluoride regimen was continued during this phase. At the 6-month recall, the patient demonstrated good oral hygiene and dietary habits. Regular checkups and the use of fluoridated mouth wash were also recommended for the orthodontic treatment phase.