A 13-year-old boy presented to your practice concerned about discolouration of his teeth. He has not seen a dentist for the last 5 years. The young boy is very conscious about the discolouration of his teeth, and he stops smiling. His mother reported that he has pain in the top right-hand side back teeth particularly when eating.

The photo shows generalized enamel loss in all upper and lower anterior teeth and brownish discolouration at the middle third of permanent incisors from canine to canine, and permeant molars are affected.

He still has two primary second molars which are not affected.

Q1. What is the condition?

A 13-year-old boy presented to your practice concerned about discolouration of his teeth. He has not seen a dentist for the last 5 years. The young boy is very conscious about the discolouration of his teeth, and he stops smiling. His mother reported that he has pain in the top right-hand side back teeth particularly when eating.

The photo shows generalized enamel loss in all upper and lower anterior teeth and brownish discolouration at the middle third of permanent incisors from canine to canine, and permeant molars are affected.

He still has two primary second molars which are not affected.

Q2. What is the most common cause of this condition?

A 13-year-old boy presented to your practice concerned about discolouration of his teeth. He has not seen a dentist for the last 5 years. The young boy is very conscious about the discolouration of his teeth, and he stops smiling. His mother reported that he has pain in the top right-hand side back teeth particularly when eating.

The photo shows generalized enamel loss in all upper and lower anterior teeth and brownish discolouration at the middle third of permanent incisors from canine to canine, and permeant molars are affected.

He still has two primary second molars which are not affected.

Q3. At what age did the defect occur?

A 13-year-old boy presented to your practice concerned about discolouration of his teeth. He has not seen a dentist for the last 5 years. The young boy is very conscious about the discolouration of his teeth, and he stops smiling. His mother reported that he has pain in the top right-hand side back teeth particularly when eating.

The photo shows generalized enamel loss in all upper and lower anterior teeth and brownish discolouration at the middle third of permanent incisors from canine to canine, and permeant molars are affected.

He still has two primary second molars which are not affected.

Q4. What will be the treatment plan to manage the anterior teeth?

A 13-year-old boy presented to your practice concerned about discolouration of his teeth. He has not seen a dentist for the last 5 years. The young boy is very conscious about the discolouration of his teeth, and he stops smiling. His mother reported that he has pain in the top right-hand side back teeth particularly when eating.

The photo shows generalized enamel loss in all upper and lower anterior teeth and brownish discolouration at the middle third of permanent incisors from canine to canine, and permeant molars are affected.

He still has two primary second molars which are not affected.

Q5. The picture shows over-retained submerged lower second molars. What could be the most likely reason for this condition?

John is a 10-year-old boy who presented with his mother complaining of pain in an upper front tooth and worried about swelling. The mother noticed that the swelling appeared overnight. He has no body temperature or any other severe or systemic symptoms.

The mother informs that he has had a previous episode of pain in the same area. The patient is a type 1 diabetic. You took an x-ray.

Q1. Based on the photo and the x-ray provided what is the defect of tooth #12?

John is a 10-year-old boy who presented with his mother complaining of pain in an upper front tooth and worried about swelling. The mother noticed that the swelling appeared overnight. He has no body temperature or any other severe or systemic symptoms.

The mother informs that he has had a previous episode of pain in the same area. The patient is a type 1 diabetic. You took an x-ray.

Q2. If you do not do treatment what complication may happen initially?

John is a 10-year-old boy who presented with his mother complaining of pain in an upper front tooth and worried about swelling. The mother noticed that the swelling appeared overnight. He has no body temperature or any other severe or systemic symptoms.

The mother informs that he has had a previous episode of pain in the same area. The patient is a type 1 diabetic. You took an x-ray.

Q3. What is the immediate management for tooth #12?

John is a 10-year-old boy who presented with his mother complaining of pain in an upper front tooth and worried about swelling. The mother noticed that the swelling appeared overnight. He has no body temperature or any other severe or systemic symptoms.

The mother informs that he has had a previous episode of pain in the same area. The patient is a type 1 diabetic. You took an x-ray.

Q4. What is your recommended definitive treatment?

John is a 10-year-old boy who presented with his mother complaining of pain in an upper front tooth and worried about swelling. The mother noticed that the swelling appeared overnight. He has no body temperature or any other severe or systemic symptoms.

The mother informs that he has had a previous episode of pain in the same area. The patient is a type 1 diabetic. You took an x-ray.

Q5. His mother expresses fear that after the extraction of tooth #22 his smile will look terrible, and she wants to seek options. What is the best replacement option?

A 70-year-old lady presents to your practice today. The patient complains of vague discomfort in teeth # 11 and 21, upon clinical examination nothing is visible. On X-ray you find ONLY tooth #11 and Tooth #21 with wire retainers, some resorption is present cervically. She had her Orthodontic treatment done as a child and the retainer was to prevent diastema from coming back. She says she has recently placed a crown on her lateral incisor. 

The thermal test for all 4 upper anterior teeth is positive and responsive. Percussion tests all negative

 
Q1. Given the attached X-ray and the patient history of vague discomfort in teeth #11 and 21, what could be the most likely finding on the X-ray/ reason for discomfort?

A 70-year-old lady presents to your practice today. The patient complains of vague discomfort in teeth # 11 and 21, upon clinical examination nothing is visible. On X-ray you find ONLY tooth #11 and Tooth #21 with wire retainers, some resorption is present cervically. She had her Orthodontic treatment done as a child and the retainer was to prevent diastema from coming back. She says she has recently placed a crown on her lateral incisor. 

The thermal test for all 4 upper anterior teeth is positive and responsive. Percussion tests all negative

 
 Q2. You are discussing the possible aetiology of the lesions with the patient. What is the most likely reason for these lesions?

A 70-year-old lady presents to your practice today. The patient complains of vague discomfort in teeth # 11 and 21, upon clinical examination nothing is visible. On X-ray you find ONLY tooth #11 and Tooth #21 with wire retainers, some resorption is present cervically. She had her Orthodontic treatment done as a child and the retainer was to prevent diastema from coming back. She says she has recently placed a crown on her lateral incisor. 

The thermal test for all 4 upper anterior teeth is positive and responsive. Percussion tests all negative

 
Q3. She advised you about the history of her daughter who encountered “root resorption” after re-implantation of tooth # 11 at the age of 14-year-old, so she has looked up the term “root resorption” and she was concerned about how her teeth got involved in this condition, what will be the most appropriate explanation to her concern?

A 70-year-old lady presents to your practice today. The patient complains of vague discomfort in teeth # 11 and 21, upon clinical examination nothing is visible. On X-ray you find ONLY tooth #11 and Tooth #21 with wire retainers, some resorption is present cervically. She had her Orthodontic treatment done as a child and the retainer was to prevent diastema from coming back. She says she has recently placed a crown on her lateral incisor. 

The thermal test for all 4 upper anterior teeth is positive and responsive. Percussion tests all negative

 
Q4. She wanted to know what should have been done properly to her daughter’s teeth at that time to prevent the root resorption which has been explained by her:

A 70-year-old lady presents to your practice today. The patient complains of vague discomfort in teeth # 11 and 21, upon clinical examination nothing is visible. On X-ray you find ONLY tooth #11 and Tooth #21 with wire retainers, some resorption is present cervically. She had her Orthodontic treatment done as a child and the retainer was to prevent diastema from coming back. She says she has recently placed a crown on her lateral incisor. 

The thermal test for all 4 upper anterior teeth is positive and responsive. Percussion tests all negative

 
Q5. You Treated the lesion with trichloroacetic acid and after removing the dam you noticed that it leaked on the palatal mucosa. How will you treat it?

Sandra is an 8-year-old girl, who attended your clinic with her father. Her father was concerned about how his daughter’s front top teeth looked; he thought something going wrong.

You completed your clinical examination with a chart for the 4 quadrants, intra-oral photos, and x-rays.

The chart shows missing 12 and erupted 13, 22 and 23.

The photos showed missing 12 without enough space to erupt, proclined and deep bite of upper anterior teeth.

The PA X-ray shows impacted 12.

Q1. Given the attached photograph and chart, what is the most evident clinical presentation that you may tell the father?

Sandra is an 8-year-old girl, who attended your clinic with her father. Her father was concerned about how his daughter’s front top teeth looked; he thought something going wrong.

You completed your clinical examination with a chart for the 4 quadrants, intra-oral photos, and x-rays.

The chart shows missing 12 and erupted 13, 22 and 23.

The photos showed missing 12 without enough space to erupt, proclined and deep bite of upper anterior teeth.

The PA X-ray shows impacted 12.

Q2. What immediate intervention would you recommend for class 2 divison1 malocclusion?

Sandra is an 8-year-old girl, who attended your clinic with her father. Her father was concerned about how his daughter’s front top teeth looked; he thought something going wrong.

You completed your clinical examination with a chart for the 4 quadrants, intra-oral photos, and x-rays.

The chart shows missing 12 and erupted 13, 22 and 23.

The photos showed missing 12 without enough space to erupt, proclined and deep bite of upper anterior teeth.

The PA X-ray shows impacted 12.

Q3. What is the radiographic entity shown in the attached x-ray on teeth 11 and 21?

Sandra is an 8-year-old girl, who attended your clinic with her father. Her father was concerned about how his daughter’s front top teeth looked; he thought something going wrong.

You completed your clinical examination with a chart for the 4 quadrants, intra-oral photos, and x-rays.

The chart shows missing 12 and erupted 13, 22 and 23.

The photos showed missing 12 without enough space to erupt, proclined and deep bite of upper anterior teeth.

The PA X-ray shows impacted 12.

Q4. You decided to take a lateral cephalometric to see the position of the protruded upper anterior teeth and to determine the skeletal classification. Based on the lateral cephalometric what is the skeletal classification?

Sandra is an 8-year-old girl, who attended your clinic with her father. Her father was concerned about how his daughter’s front top teeth looked; he thought something going wrong.

You completed your clinical examination with a chart for the 4 quadrants, intra-oral photos, and x-rays.

The chart shows missing 12 and erupted 13, 22 and 23.

The photos showed missing 12 without enough space to erupt, proclined and deep bite of upper anterior teeth.

The PA X-ray shows impacted 12.

Q5. Inspecting the lower jaw, you noticed a midline shift toward the right-hand side due to an early loss of 83. What could have been done to prevent midline shift?

An 18-year-old male presents to your clinic for a routine check-up and clean. He is asymptomatic, reporting only mild discomfort in the upper and lower jaws. An OPG taken today reveals a significant bone defect in the lower jaw.

On clinical examination, you notice punctate depressions on his palms, pearly papules on the skin, and a prominent forehead. He has a known history of type 1 diabetes, with a recent HbA1c of 16%.

The patient began orthodontic treatment 10 months ago. Upon being informed of the bone defect, he becomes visibly upset. He also expresses concern about the potential financial burden of treatment, as he is currently a student with limited financial resources.

Q1. Which statement is legally the most appropriate under Australian dental law and professional responsibilities?

An 18-year-old male presents to your clinic for a routine check-up and clean. He is asymptomatic, reporting only mild discomfort in the upper and lower jaws. An OPG taken today reveals a significant bone defect in the lower jaw.

On clinical examination, you notice punctate depressions on his palms, pearly papules on the skin, and a prominent forehead. He has a known history of type 1 diabetes, with a recent HbA1c of 16%.

The patient began orthodontic treatment 10 months ago. Upon being informed of the bone defect, he becomes visibly upset. He also expresses concern about the potential financial burden of treatment, as he is currently a student with limited financial resources.

Q2. Given the attached radiograph and the clinical and medical histories, Which of the following is the most likely differential diagnosis?

An 18-year-old male presents to your clinic for a routine check-up and clean. He is asymptomatic, reporting only mild discomfort in the upper and lower jaws. An OPG taken today reveals a significant bone defect in the lower jaw.

On clinical examination, you notice punctate depressions on his palms, pearly papules on the skin, and a prominent forehead. He has a known history of type 1 diabetes, with a recent HbA1c of 16%.

The patient began orthodontic treatment 10 months ago. Upon being informed of the bone defect, he becomes visibly upset. He also expresses concern about the potential financial burden of treatment, as he is currently a student with limited financial resources.

Q3. Which of the following would be the most helpful investigations at this stage?

An 18-year-old male presents to your clinic for a routine check-up and clean. He is asymptomatic, reporting only mild discomfort in the upper and lower jaws. An OPG taken today reveals a significant bone defect in the lower jaw.

On clinical examination, you notice punctate depressions on his palms, pearly papules on the skin, and a prominent forehead. He has a known history of type 1 diabetes, with a recent HbA1c of 16%.

The patient began orthodontic treatment 10 months ago. Upon being informed of the bone defect, he becomes visibly upset. He also expresses concern about the potential financial burden of treatment, as he is currently a student with limited financial resources.

Q4. As you plan for further investigations, which of the following is the most significant concern at this stage?

An 18-year-old male presents to your clinic for a routine check-up and clean. He is asymptomatic, reporting only mild discomfort in the upper and lower jaws. An OPG taken today reveals a significant bone defect in the lower jaw.

On clinical examination, you notice punctate depressions on his palms, pearly papules on the skin, and a prominent forehead. He has a known history of type 1 diabetes, with a recent HbA1c of 16%.

The patient began orthodontic treatment 10 months ago. Upon being informed of the bone defect, he becomes visibly upset. He also expresses concern about the potential financial burden of treatment, as he is currently a student with limited financial resources.

Q5. After a multidisciplinary team discussion, the decision is made to proceed with a surgical approach. Given this situation, what is the most serious potential complication of surgical resection?