METHODICAL INSTRUCTION
To practical classes for students of the 3 course
Lessoumber 1 (practical – 6 hours)
Professional orientation of students, from diligence and professionalism of the examination of the patient, which appealed to the clinic of prosthetic dentistry ,depends on the accuracy and validity of the previous and final diagnosis and therefore the quality and effectiveness of subsequent treatment.
Theme: Examination of the patient in clinical of prosthetic dentistry. Clinical examination methods. Additional (special) methods of examination of patients in clinic of prosthetic dentistry, previous and final diagnosis.
Aim: To learn how to conduct a survey of the patient in the clinic of prosthetic dentistry, by means of data of additional research methods to establish an accurate diagnosis and to confirm it.
Objective: To learn methods of patient examination.
1.Questions to the theme
1. Passport part. Subjective examination of the patient (complaints, medical history, history of life).
2. Sequence and rules of examination of dental patient.
3. Physical examination.
4. Clinical examination methods of oral cavity.
5. Thermoodontodiagnostics and electroodontodiagnostics.
6. Radiography (intra-and extra-, tomography, panoramic radiography, radioviziography, MRI).
7. Absolute power of masticatory muscles, chewing pressure and methods for their determination. Hnatodynamometry.
8. Static methods for determining of masticatory efficiency.
9. Functional methods for determining of masticatory efficiency.
10. Graphical methods for registering movements of the mandible and functional status of masticatory muscles. Masticatiography
11. Setting preliminary diagnosis.
12. The definitive diagnosis. Justification of diagnosis.
13. History of the disease, the rules of conduct.
14. Preparation of the oral cavity to the prosthesis.
2.Refferences:
A) Main.
1. E-mail: www.tdmu.edu.te.ua (Intranet → → to help students prepare for classes → Department of Prosthetic Dentistry → prosthetic dentistry → Theme Session)
2. K. Jeffrey Miller., Orthopedic and Neurological Examination in a Flash – 2008.
B) Additional:
1. Jeffrey H. Ahlin., Maxillofacial orthopedics 2004.
2.Frans P. G. van der Linden., Diagnosis and treatment in dentofacial orthopedics-Quintessene Pub. Co. 1987-336 pages
Practical work (9:00-12:00 hour).:
Work 1.To question a patient with orthopedic pathology.
Place of passing: Clinical room of Department of Prosthetic Dentistry.
Object: a patient with orthopedic pathology if absent a student volunteer or phantom.
Means per group:
1. dental unit – 1pc.;
2.chair for doctor – 1 pc.;
3.table for doctor – 1 pc.
Tools for the student:
1. Dental patient medical record (form number 043 / o) – 12p;
2. Tray with examination toolset-12 kits.
The task for the student: to carry out a questioning of the patient.
The time it takes to process one student: _15_ minutes.
Method of accomplishment: during the questioning we find out: 1) complaints, 2) data on working conditions, past illnesses, bad habits, and 3) the time and cause of tooth loss, and 4) if previously used removable dentures.
Special attention is paid during the conversation to whether the patient was previously treated and to what complaints he might have, etc. Communicating with the patient, you can sometimes make a rough idea of the nature of his reactions (anxiety, irritability, ability to tolerate the slightest inconvenience from the prosthesis and the like). These observations provide additional valuable data.
Work 2.The objective clinical examination of a patient with a partial loss of teeth.
Place of passing: Clinical room of Department of Prosthetic Dentistry
Object: a patient with partial loss of teeth on the upper or lower jaw, in the absence of one, student volunteer or phantom.
Means per group:
1.dental unit – 1pc.;
2.chair for doctor – 1 pc.;
3.table for doctor – 1 pc.
Tools for the student:
1.Dental patient medical record (continuation of work number 1);
2. Tray with examination toolset (continuation of work number 1).
The task for the student: to carry out an objective clinical examination of the patient.
The time it takes to process one student: _20_ minutes
Method of accomplishment: a survey carried out in the following sequence:
1. Extraoral examination;
2. Examination of the oral cavity:
– Study of the mucous membrane of oral cavity;
– Survey teeth and dentition;
– Periodontal Examination;
– Survey toothless alveolar part.
The essence of diagnosis is the integrity or shape of teeth, denture or other organs of dentoalveolar system and their functions. Extra facts are carried in about the complications of the condition and accompanying diseases.
Formulating a diagnosis, it is necessary to show a cause of the disease, etiology and pathogenesis, provide insight into the pathological basis and localization, indicate the extent and nature of functional disorders, and clarify the current form of the disease. Thus, the diagnosis should consist of two parts:
1) the underlying disease and its complications;
2) accompanying diseases – dental and general.
Also, the diagnosis should include:
§ – the topography of the defect;
§ – the percentage loss of chewing efficiency;
§ – esthetic discomfort;
§ – broken speech function
Work3.Determination of masticatory efficiency by static method by І.M.Oksmanom.
Place of passing: Clinical room of Department of Prosthetic Dentistry
Object: a patient with partial loss of teeth on the upper or lower jaw, in the absence of one, student volunteer or phantom.
Means per group:
1dental unit – 1pc.
2.chair for doctor – 1 pc.;
3 table for doctor – 1 pc
Tools for the student:
1. Dental patient medical record (continuation of work number 1);
2. Tray with examination toolset (continuation of work number 1).
The task for the student: to determine the effectiveness of chewing using static method by I.M.Oksmanom.
The time it takes to process one student: _20_ minutes
Method of accomplishment: static methods are based on the definition for each tooth ratio of its participation in the process of chewing. Used during the direct examination of the oral cavity, while assess each tooth and all existing teeth and enter the data into a special table, in which share of participation of each tooth in chewing function expressed corresponding coefficient.
Oxman method takes into account not only functional value teeth that are lost, but the functional condition of the teeth remained. Also is taken into account mobility of teeth. Teeth of the first degree of mobility are normal, the second – as having saved 50% of the value of chewing and teeth mobility of third degree – as absent.
Tasks for independent study: classification of defects of dentitions at Kennedy.
References: Rozhko M.M., Nespryadko V.P. Prosthetic dentistry. – K.: Book Plus, 2003. S. 55-61, 84-107.
4. Seminary discussion of theoretical issues and practical work – 12:30-14:00.
Questions:
1.Sequence and rules of the examination of dental patient.
2. Evaluation of existing orthopedic constractions.
3. Setting preliminary diagnosis.
4. The definitive diagnosis. Justification of diagnosis.
5. History of the disease, the rules of conduct.
6. Preparation of the oral cavity to the prosthesis.
Control knowledge and skills tested by solving situational problems on each topic, answers to tests like “Step” constructive questions and others (14:15 – 15:00 hours.).
6. Student should know:
1. The method of subjective and objective examination of the patient in the clinic of prosthetic dentistry
2. Sequence and rules of examination of dental patient.
3. Clinical examination methods of the oral cavity.
4. Features of the methods such as percussion, probing and palpation in clinic of Prosthetic Dentistry
5. Additional (special) methods of examination of patients in clinic of Prosthetic Dentistry
6. Terms of formulating a diagnosis in clinic of Prosthetic Dentistry
7. Terms of conduction a history in clinic of Prosthetic Dentistry
8. Features of preparation the oral cavity for prosthetics.
7. Student should be able to:
1. Collect complaints and history of orthopedic dental patient.
2. Fill card dental patient.
3. Conduct clinical examination of the oral cavity dental orthopedic patient.
4. Interpret data additional methods of examination in clinic of Prosthetic Dentistry
5. Formulate a diagnosis clinic of Prosthetic Dentistry
Methodical instruction was formed by: Ass. Grad A.O.
Discussed and approved at the meeting of the department
January 11, 2008, protocol number 7
Reviewed and approved at the meeting of the department
11. 06. 2012 protocol number 11
