Mouse over treatment row or say "tooth number whatever (ex. tooth number 2) to enter treatment decisions.
Select treatments on a tooth by tooth basis. Where caries is noted, assume it has destroyed an average amount of the surface.
Enter treatments which could include Extractions, Perio (On the specific tooth), Restorations, Root Canal Treatment, Post Cores, Crowns, Bridges and Implants.
Note that credit will be given for recommending Extraction even if the system deems the Extraction as Optional. Also note that Upper Anteriors and Lower Canines have a higher strategic value.
If there are missing teeth, you may enter treatments such as Bridges (FPDs), Implants, or Removable Partial Dentures (RPDs).
Use the 'Pontic' button to indicate a bridge. Use the 'Crown' button to indicate retainers. Long span (greater than 3 units) bridges are not recommended in this system.
Decisions are triggered by a set of findings and circumstances that cause certain treatments to be recommended.
Below you will find some guidance as to what findings to look for in determining a certain treatment.
The most complicated decision may be when to recommend a Denture.
Depending upon the degree of Periodontal Disease, Mobility, Caries and Missing Teeth, a decision may be made to go to a Complete Denture.
If Complete Denture is selected and the system determines that a Complete Denture is recommended, scoring increases.
Depending upon circumstances, the system may recommend a Removable Partial Denture, while at the same time allowing a Complete Denture.
In this case, points are given for either answer.
Another controversial scenario is when to recommend a crown.
If endo is NOT planned and there are more than (3) involved surfaces (caries and/or existing restorations), the system will recommend a crown.
If endo IS planned, your class instructor recommends crowns (after endo) when there are () or more caries/restored surfaces (including access).
Access surfaces are 'O' for Posteriors and 'L' for Anteriors.
Please note if a crown already exists, the system recommends a new crown following endo with a new underlying build-up restoration.
Third molars are not considered strategic and the system recommends Extraction when certain pathological findings are present (moderate perio disease, mobility, caries).
Optional Extractions are generally counted as correct in Posteriors and Lower Incisors where more than (3) surfaces are involved and caries is present.
The most strategic teeth are Maxillary Anteriors and Mandibular Canines. To avoid Lower Complete Dentures, Mandibular Canines should be preserved for anchoring future Removable Partial Dentures.
Optional Extractions are counted as correct in these strategic teeth when MORE than (4) surfaces are involved.
If PAIN and restorable caries is present the system will recommend Endo (Endo involvement would be highly likely).
If PAIN is present with restorations, but no caries, the system will NOT recommend treatment (Endo will not be recommended due increased chances of other causes).
If PAIN is present with a Post or Implant, Extraction will be a correct answer. However, Bridge Pontics and Implants (New) will be correct within certain conditions.
The Defective stripe generally indicates a Defective Restoration, Crown, Implant or Post Core.
If a Defective stripe appears over Endo treatment, the Defective will only apply to the Restoration.
If there is a Restoration present and there is a Defective stripe, assume the Endo is NOT defective and the restoration IS Defective.