38 years old Caucasian male presented for the dental cleaning. He has concerns about “his upper teeth in a back: the gums are going away and I have sensitivity there”. Medical History reviewed, no allergies to the medications or food were noted, patient did not take any non-prescribed or prescribed medications, ASA I. Blood pressure readings was 104/79 Pulse 66. Non smoker, non drinker. Dental history: Patient never had dental cleaning done, non radiographs were exposed. Patient reported using Powered tooth brush with soft bristles two times a day, but used to prefer a manual hard bristled tooth brush in a past, prefers Colgate Sensitive as dentifrice, flosses once a week, uses Listerine mouth rinse every day, brushes tongue occasionally with tongue cleaner.
ExtraOral examination revealed bilateral crepitation on TMJ, asymptomatic, patient was not aware of it presence. During IntraOral Examination centered fissured tongue, white coating of the tongue were noted. Bilateral cheek bite adjacent to the distal of surfaces of #17 and #32. Dental: Class I Occlusion, overjet 5mm, overbite 50%. Severe crowding on the mandibular anterior teeth, moderate on maxillary anterior teeth. Attrition was present on the #22-#26. Non mobility was noted, Grade II furcation on the #14F, grade I on the #13F and #30F. Generalized extrinsic brown stains, generalized heavy subgingival deposits, localized moderate supragingival calculus was present on the lingual of mandibular anteriors. Generalized severe sensitivity. Generalized pink, resilient, well contoured gingiva, moderate generalized inflammation. Patient was qualified as Heavy type II/localized III type. FMS was exposed and revealed generalized moderate horizontal bone loss, localized vertical #3MB, #14MB/DB, #30MB/30DB. #14 was superimpose due to missing #19. Patient was approved for Arestin treatment on the #3MB, #14MB/DB, #30MB/DB. Detailed perio chart can be found below. Due to severe sensitivity and tenasious deposits patient had to be treated with local anesthesia. Arestin to the approved sides was placed on the last third visit. Patient was given post-instructions.
Evaluation of Arestin Treatment: Patient was evaluated five weeks after. Surfaces were probed and results documented. There were an improvement on all the sides by 1-2mm.
Pre Treatment pocket depths: Post Treatment pocket depths:
#3MB- 7mm #3MB-5mm #14MB-4mm #14MB-3mm #14DB-6mm #14DB-5mm #30MB-7mm #30MB-5mm #30DB-5mm #30MB-4mm
Patient was very pleased with the results. And we discussed again the importance of oral hygiene in order to be successful with Arestin treatment.
