1

Pedo lab
Rakan Khtoum
Case Presentation

A child presenting with a permanent left central and lateral incisors and a primary
right central incisor. It is necessary in this case to take a radiograph.
The radiograph showed a presence of a supernumerary tooth that prevented the
eruption of the permanent incisor.
Writing a treatment plan
the information needed to draw a chart:
7s: unerupted.
16: amalgam restoration occlusally.
55: disto-occlusal cavity.
54: sound.
53: buccal caries.
11: Fractured mesially & incisally (due to trauma).
..
64: disto-occlusal cavity.
65: filling mesio-occlusally.
..
36: cavitated occlusally.
75: remaining root.
74: stainless steel crown (SSC).
..
LR primary 1
st
molar: extracted.
LR primary 2
nd
molar: mesial cavity.
46: recurrent caries.
85: mesial cavity.
2

The spaces between the teeth are closed.
Bitewings are needed to detect interproximal caries especially when spaces
between teeth are limited.
Periapical are needed for:
Tooth (74) to make sure that the tooth has received good treatment
(Pulpotomy + SSC) and it is still successful.
They are also needed for grossly carious teeth (Teeth 55, 64) to detect the
presence of any abscess, pulp necrosis and periapical radiolucency.
In case of extraction (LR primary 1
st
molar) to determine the need for space
maintainer.
Remaining root (tooth 75); to avoid complicated extraction.
Restored teeth.
Radiographic images showed the following results:
Tooth (55): interproximal caries in the mesial side extending to more than
thickness of enamel, while the distal carious lesion extends to more than
thickness of dentine.
Tooth (54): interproximal caries in the distal side extending to less than
thickness of enamel.
Tooth (65): interradicular lesion.
Tooth (75): interradicular lesion.
Tooth (64): distal carious lesion extending to less than thickness of
dentine.
Tooth (85): mesial carious lesion extending to less than thickness of
dentine.



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Treatment plan
The first visit: Preventive OH instructions, Fluoride application & diet sheet.
Diet Sheet:
1
st
day 2
nd
day 3
rd
day
breakfast
In between
lunch
In between ) (
dinner

Dies sheet analysis:
1
st
2
nd
3
rd
Total
Solution Meal 0 0 1 1
In between 1 1 0 2
Retentive Meal 1 1 0 2
In between 1 0 2 3

We start treating the quadrant with the chief compliant. If there is no chief
compliant or emergent case, we usually start with the easiest quadrant.
The second visit: you give the patient OH instructions again and you do analysis
for the diet sheet you gave the patient in the first visit.
OH instructions are given in each visit.
Treatment plan for each quadrant
1
st
quadrant:
(53): Class V filling using glass ionomer or compomer.
(11): Class IV composite filling.
(55): pulpotomy + SSC.
4

2
nd
quadrant:
(64): Class II filling.
(65): Extraction.
Band selection for space maintainer.
3
rd
quadrant:
(75): Extraction.
Band selection for space maintainer.
4
st
quadrant
(46): repeat cavity preparation and restoration.
(85): class II filling.
Band selection on the (85) for band & loop space maintainer.



Patient name:
Patient File#: 11816