case history diagnosis and treatment planning in pediatric dentistry
TRANSCRIPT
![Page 1: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/1.jpg)
![Page 2: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/2.jpg)
PRESENTED BY
DR. SWATI MANOHAR(PAPPULWAR)
PG STUDENT PEDODONTICS
CASE HISTORY EXAMINATION AND TREATMENT PLANNING IN PEDIATRIC
DENTISTRY
![Page 3: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/3.jpg)
INTRODUCTION
• Successful dental care for children is best achieved after thorough examination, thoughtful diagnosis and formulation of a proper treatment plan.
• Pediatric dentist has a specific skills in management, diagnosis and treatment planning of a child which are different from those experience with adult patients.
![Page 4: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/4.jpg)
IMPORTANCE OF RECORDING CASE HISTORY
![Page 5: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/5.jpg)
PERSONAL INFORMATION • Name
• Age: diseases seen in infancy, childhood and young adult
- to determine exfoliation and eruption sequence
- determine treatment plan
- behavior management technique
- child drug dose
- growth assessment parameter
• Gender
• Address
• Language known
![Page 6: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/6.jpg)
• Date birth
• Name of accompanying person
• Patient’s name and education
• Contact number
![Page 7: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/7.jpg)
• Chief complaint of the patient
![Page 8: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/8.jpg)
HISTORY OF PRESENT ILLNESS
• Information should be collect by asking various questions
include:
Mode and duration of onset
Cause of onset
Duration and progress
Any treatment done
Any medication taken
![Page 9: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/9.jpg)
DETAILED HISTORY OF PAIN
History of pain should be elicited in detail which include • Location of pain• Origin or mode of onset• Intensity of pain• Nature• Progression
![Page 10: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/10.jpg)
• Duration• Radiation of pain• Effect of functional activity• Association with any systemic effects
![Page 11: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/11.jpg)
DETAILED HISTORY OF SWELLING
• Mode of onset• Progress of swelling• Symptoms• Associated features• Secondary changes• Impairment of function• Any medication
![Page 12: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/12.jpg)
PAST MEDICAL HISTORY
• Child under any physician care
• Medication and allergy
• Hospitalization
• Blood transfusion
• Immunization status of child
![Page 13: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/13.jpg)
IMMUNIZATION SCHEDULE
![Page 14: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/14.jpg)
FAMILY HISTORY • Siblings
• Socioeconomic status
- B.G PRASAD SCALE
- PAREEK CLASSIFICATION
- KUPPUSWAMY SCALE
![Page 15: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/15.jpg)
![Page 16: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/16.jpg)
PRENATAL, NATAL AND POST NATAL HISTORY
• Health of mother during pregnancy
• Diseases to mother
• Accident/ trauma during pregnancy
• Abnormal fetal position
![Page 17: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/17.jpg)
Natal History :
Trauma, childhood disease Developmental mile stones :
Importance
Developmental milestones for infants- toddlers, 3- 6 years and 6- 12 years
Post natal history:
Feeding habit : breast feeding or bottle
![Page 18: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/18.jpg)
SOCIAL/ BEHAVIORAL HISTORY
• School• Performance at school• Fear • Learning, concentrating, reading, co operating
and understanding problem: IQ of the child
![Page 19: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/19.jpg)
PERSONAL HISTORY
• Habits • Tooth brushing techniques
Duration , frequency, technique• Tooth paste – fluoridated and non
fluoridated
![Page 20: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/20.jpg)
DIET HISTORY
• Diet diary • 24 hour recall period
![Page 21: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/21.jpg)
DENTAL HISTORY
• 1st dental visit • Tooth ache, trauma in past • Fluoride treatment
![Page 22: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/22.jpg)
EXAMINATION OF THE PATIENT
• General examination – its importance in detail
Stature
Gait
Speech
Hands
Cyanosis
Icterus
Nails
![Page 23: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/23.jpg)
![Page 24: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/24.jpg)
Extra oral examination
• Shape of head• Skin on the face• Shape of face• Facial profile & symmetry• Ears • Eyes • Nose • Neck
![Page 25: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/25.jpg)
• Lymph nodes- its examination
![Page 26: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/26.jpg)
• TMJ & function- its examination
![Page 27: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/27.jpg)
BEHAVIOR RATING
• Behavior rating scale: frankel classification
• Behavior management : verbal and non verbal communication
![Page 28: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/28.jpg)
PRESENTED BY
DR. SWATI MANOHAR
PG STUDENT
CASE HISTORY EXAMINATION AND
TREATMENT PLANNING
![Page 29: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/29.jpg)
• Protruding ears (also called prominent ears): Ears that, regardless of size, stick out more than 2 cm from the side of the head
• Constricted ears : A variety of ear deformities where the helical rim is either folded over (also called lop ear), wrinkled, or tight
• Microtia : Underdeveloped external ear• Anotia : Total absence of the ear• Stahl's ear : Ears that have a pointy shape and an extra cartilage
fold (crus) in the scapha portion of the ear
![Page 30: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/30.jpg)
• Ear tags: Also known as an accessory tragus or a branchial cleft remnant, ear tags consist of skin and cartilage
• Earlobe deformities: earlobes with clefts, duplicate earlobes, and earlobes with skin tags Cauliflower ear: Abnormal cartilage forms on top of the normal cartilage, resulting in bulky misshapen ears
• Ear keloids: Caused by excessive scar tissue formation after minor trauma, most commonly after ear piercing
• Ear hemangiomas: Most common benign tumor of infancy, can occur anywhere on the body, including the external ear and the salivary gland in front of the ear.
![Page 31: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/31.jpg)
INTRA ORAL EXAMINATION IN CHILDREN
• Examination in infants and toddlers: differs form other age group
![Page 32: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/32.jpg)
• Lip and labial/ buccal mucosa • Tongue,• Palate, • Floor of mouth,
![Page 33: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/33.jpg)
GINGIVA
• Color , size, contour, shape, consistency, surface texture, position.
• Stippling • Bleeding on probing
![Page 34: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/34.jpg)
FRENUM
• TYPES OF FRENUM
Type 1- mucosal attached frenum
Type 2- gingival frenal attachment
Type 3- papillary frenal attachment
Type 4 papillary penetrating frenal attachment
![Page 35: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/35.jpg)
Gingiva in children
Reddish in color Thinner epithelium, a lesser degree of keratinization, and greater vascularity
Gingiva in adults
Coral pink, due to thickness and degree of keratinization , vascularity and pigmented cells
Lack of stippling: Shorter and flatter papillae from the lamina propria.
Stippling is present: it is a form of adaptive specialization or reinforcement for function. Degree of keratinization and prominence of stippling appear to be related
Rounded and rolled gingival margins:Hyperemia and edema that accompanies eruption. Pronounced cervical ridge of the crown in deciduous teeth
Knife edge margins
Consistency is flaccid and retractable: immature connective tissue composition, immature gingival fibres system, increased vascularization
Firm and resilient: increase in collagenous nature of the lamina propria and its contiguity with mucoperiosteum of alveolar bone
![Page 36: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/36.jpg)
• Gingiva:
The connective tissue has comparatively less well-developed net of collagen fibres than in adults. The surface of the col was said to be covered by an odontogenically-derived epithelium that is atrophic, (four cell-layers thick) and has a diminished proliferative activity.
• Alveolar Bone:
The lamina dura is thinner; there are fewer trabecular and larger marrow spaces. There is a smaller amount of calcification greater blood and lymph supply and the alveolar crest appears flatter.
![Page 37: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/37.jpg)
• Periodontal Ligament: It is wider, has fewer and less dense fibers per unit area and has increased hydration with a greater blood and lymph supply than in adults. During eruption the principal fibres are parallel to the long axis of the teeth. The bundle arrangement occurs after the teeth encounter their functional antagonists
• Cementum: It is often thinner and less dense than of adults. It shows a tendency to hyperplasia of cementoid apical to the epithelial attachment. Before the tooth reaches the occlusal plane, a cellular cementum is formed
![Page 38: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/38.jpg)
• Williams periodontal probe is marked in millimeters at the following distances from the probe tip. 1, 2, 3, 5 then 7, 8, 9 and 10 millimeters. The spaces between the 3 and 5 millimeter marking and between the 5 and 7 millimeter marking are to avoid confusion in the reading of the measurement.
• Probing depth is recorded for all teeth on each of six locations (buccal, lingual, mesio-buccal, mesio-lingual, disto-lingual, disto-buccal).
• The probe should be inserted parallel to the long axis of the tooth and walked around each surface of each tooth to detect the depth of pocket at each -surface. A probing force of 25 grams (0.75 Newtons)
![Page 39: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/39.jpg)
![Page 40: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/40.jpg)
• Tonsils and adenoids
• Openings of salivary gland ducts
![Page 41: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/41.jpg)
INTRA ORAL HARD TISSUE EXAMINATION
• Examination of teeth:
Number, size, color and malformation of teeth
Nomenclature : universal system, Zsigmondy's, and palmer method, FDI (Fédération Dentaire Internationale system of nomenclature
![Page 42: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/42.jpg)
Retained teeth Dental anomaliesSupernummery teethDental caries and oral hygiene status ( calculus and stains)
![Page 43: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/43.jpg)
![Page 44: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/44.jpg)
![Page 45: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/45.jpg)
ORTHODONTIC EVALUATION
• Classification
Molar and canine relationship and classification
![Page 46: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/46.jpg)
• Open bite is defined as a condition where a space exists between the occlusal or incisal surfaces of the maxillary and mandibular teeth in the buccal or anterior segments when the mandible is brought into a habitual or centric occlusion (Graber).
• Cross bite is a condition where one or more teeth may be abnormally malposed buccal or lingually or labially with reference to opposing teeth.
• Deep bite: condition of excessive overbite where the vertical measurements between maxillary and mandibular incisal margins is excessive when mandible is brought into habitual centric occlusion
![Page 47: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/47.jpg)
![Page 48: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/48.jpg)
• Primate space:
• Leeway space is the size differential between the primary posterior teeth (canine, first and second molars labeled C, D and E in the picture), and the permanent canine and first and second premolar (labeled 3, 4 and 5)
• Incisor liability:
• Space loss: criteria by owen ( Mac Donald's)
![Page 49: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/49.jpg)
PROVISIONAL DIAGNOSIS
![Page 50: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/50.jpg)
DIFFERENTIAL DIAGNOSIS
![Page 51: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/51.jpg)
![Page 52: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/52.jpg)
INVESTIGATIONS
• Types Of Film
• Intra Oral Radiographs-
Bitewing
Periapical
Occlusal Radiograph
![Page 53: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/53.jpg)
EXTRA ORAL RADIOGRAPHY
![Page 54: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/54.jpg)
APPLICATIONS OF CBCT IN DENTISTRY• Investigate the exact location and extent of jaw
pathologies and assess impacted or supernumerary teeth and the relationship of these teeth to vital structures
• CBCT imaging is a useful tool for diagnosing periapical lesions
• CBCT is used widely for planning orthognathic and facial orthomorphic surgeries,
• Detect root resorption (external or internal) and cervical resorption, it can also identify the extent of a lesion
• It can be used to determine the number and morphology of roots and associated canals (both main and accessory), establish working lengths, and determine the type and degree of root angulation
![Page 55: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/55.jpg)
• Hematological investigation
Coagulation factor deficiencies
Congenital Hemophilia A and B von Willebrand’s disease Other factor deficiencies (rare) Acquired Liver disease Vitamin K deficiency, warfarin use Disseminated intravascular coagulation
Platelet disorders Quantitative disorder (thrombocytopenia) Immune-mediated: Idiopathic ,Drug-induced, Collagen vascular disease, Sarcoidosis Non-immune-mediated: Disseminated intravascular coagulation Microangiopathic hemolytic anemia Leukemia Myelofibrosis Qualitative disorder Congenita:l Glanzmann thrombasthenia von Willebrand’s disease Acquired : Drug-induced Liver disease Alcoholism
Vascular disorders Scurvy, Purpura, Hereditary hemorrhagic telangiectasia, Cushing syndrome, Ehlers-Danlos syndrome
Fibrinolytic defects S Streptokinase therapy, Disseminated intravascular coagulation
![Page 56: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/56.jpg)
• Histo pathological investigation it refers to the microscopic examination of tissue in order to study the manifestations of disease- oral diseases such as cyst, tumors etc
![Page 57: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/57.jpg)
FINAL DIAGNOSIS
• It usually identify the diagnosis for the patients primary complaint first with subsidiary diagnosis of concurrent problems
• Their may be possibility that more than one disease may be present at the same time.
• Most important in an unusual cases consultation with other specialist or general physician is necessary before a final diagnosis.
![Page 58: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/58.jpg)
TREATMENT PLANNING
Practitioner needs an organized approach to diagnose correct and prevent problem with a proper treatment planning.
Advantages of treatment planning:
![Page 59: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/59.jpg)
• General outline suggested by FINN
1. Medical treatment
Referral to physician
2. Systemic treatment
Premedication
Therapy for oral infection
3. Preparatory treatment
Caries control
Oral prophylaxis
Orthodontic consultation
Oral surgery
Endodontic therapy
![Page 60: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/60.jpg)
4. Corrective treatment
Operative dentistry
Prosthodontic correction
Orthodontic correction
5. periodic recall examination and maintenance treatment
![Page 61: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/61.jpg)
ACC TO STEPHEN WEI
1. Preventive phase:
Caries stabilization
Oral hygiene instruction
Dietary analysis and advice
Prophylaxis, Topical fluoride application, Pit and fissure sealants
2. Surgical phase:
Extraction of teeth with poor prognosis
Surgical exploration of desirable teeth
Extraction of undesirable teeth and for orthodontic reasons
![Page 62: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/62.jpg)
3. RESTORATIVE PHASE:
Composite restoration
GIC restorations
Pulp therapy procedure
Stainless steel crown cementation
4. ORTHODONTIC PHASE:
Space management
Removable appliance therapy
Functional appliance therapy
Fixed appliance therapy
![Page 63: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/63.jpg)
ACC TO BARBER AND LUKE
• Four basic areas of concern in diagnosis and treatment planning are
1. Oral medical problem
2. Periodontal consideration for long term
3. Dental caries- restorative
4. Occlusion – craniofacial growth and development
![Page 64: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/64.jpg)
ACC TO BRAHAM MORRIS
1. Systemic phase: premedication, medical consultation
2. Preparatory phase: preventive therapy, orthodontic consultation, endodontic therapy
3. Corrective phase: prosthodontic correction, orthodontic corrections, stainless steel crown cementation
4. Maintenance phase: recall for preventive and orthodontic visits.
![Page 65: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/65.jpg)
CONCLUSION
![Page 66: Case history diagnosis and treatment planning in pediatric dentistry](https://reader036.vdocument.in/reader036/viewer/2022062310/5871765b1a28ab230b8b50af/html5/thumbnails/66.jpg)