CLINICAL CASE

Patient A, aged 52, addressed the dentist with the following accusations: permanent gum ache in the
gum at both jaws; insignificant gingival bleeding during dental brushing and hard food mastication;
dental mobility.

Anamnesis: The onset of the disease from the patient's report took place after the age of 35,
when the first complaints for dental treatment were the present accusations and the dentist established
the diagnosis of the existing pathology. Over the years, the above-mentioned clinical signs have
intensified with periodic flare, mostly in spring and autumn. During these periods the patient had dental
treatments with temporary relief of symptoms. Any other diseases, drug and food allergies do not occur.
Last address to the dentist - 6 months ago.

Clinical examination: Exo-oral - no morpho-functional and aesthetic changes. Opening of the

mouth within normal limits. Endo-oral - oral mucous and mouth vestibule without pathological changes;
orthogonal occlusion, integral dental arcades, bimaxial dental bridges present; generalized dental
mobility grade I-II, present supra and subgingival tatar; dental percussion sensitive to predominance in
upper jaw teeth; the swollen marginal, swollen, gentle, in case of palpation it causes pain and slight
bleeding; at sounding - bone bags with different depths, from 4 to 8 mm are appreciated.

The radiological examination is shown in the figure (Figure 1 and 2).

requirements:

1. Formulate the presumptive diagnosis based on the symptoms / signs described in the statement of
the case.
2. Propose the presumptive diagnosis.
3. Describe the radiographic image shown.
4. Perform the differential diagnosis with its argument.
5. Indicate additional clinical / paraclinical examinations with justification of their need (if applicable).
6. Formulate the final diagnosis and argue it.
7. Establish the treatment plan (surgically and / or therapeutically and / or medication) required by the
patient for the given pathology and argue their behavior.
8. Establish on the basis of present radiography what other investigations and treatments (surgical,
therapeutic or prosthetic) should be performed with the patient for rehabilitation.
Figure 1. Patient A. OPG

Figura 1. OPG a pacientei A.