+ aboi/id part ii case presentation – template 2013
TRANSCRIPT
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+
ABOI/ID Part II Case Presentation – Template
2013
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+Case #
Type of Case:
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+Implant Surgery
Date of Initial implant surgery:
Number of implants placed and where:
Did this case require pre-implant placement grafting of any
kind?
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+
Date of final prosthesis insertion
Type of restoration
Opposing dentition
Current status
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+Patient Medical History
ASA Classification
Patient’s mental status
Relevant past/and current medical history
Medications
Allergies
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+Dental History
Missing teeth
Periodontal status
Occlusion/ Angle Classification
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+Pre-Surgical X-Ray (insert)
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+Social History
Smoking
Alcohol
Drug/substance abuse
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+Treatment Planning
Surgical Plan
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+Prosthetic Plan
Prosthetic plan
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+Informed Consent (insert)
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+Alternative treatment plans discussed with patient Alternative treatments discussed:
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+Implant Surgery
Operative report of actual implant surgery
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+Post Surgical x-ray
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+Post-Operative Care
What were your post-operative instructions for this patient?
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+Maintenance
What is your maintenance protocol?
List this patients maintenance history
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+Prosthetic Restoration
What type of restoration was placed?
Explain
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+Immediate post prosthetic placement x-ray (insert)
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+Occlusal view of maxillary arch (insert)
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+Occlusal view of mandibular arch (insert)
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+Frontal view in maximum intercuspation position (insert)
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+Left side (insert)
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+Right side (insert)
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+For cases that involve implant supported/retained prostheses Insert views of all implant attachment mechanisms (intra-oral)
Views of tissue surface areas of the removable prostheses
(add slide if necessary)
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+One year post prosthetic placement x-ray (insert)
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+Revision (if necessary)
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+