Situational task №1

Patient R., 55 years old, was referred to the doctor-hiruga-dentist department for a
consultation on planning and conducting treatment with dental implants. He
complained of a lack of teeth in the upper jaw, difficulty chewing food. A history
of acute respiratory viral infections, acute respiratory infections, childhood
diseases, Botkin’s disease at the age of 15. Increased gag reflex. The teeth on the
upper jaw were removed during life due to chronic inflammatory processes. The
patient was made a complete removable denture, but satisfactory fixation of the
prosthesis was not achieved, and also because of the increased vomiting reflex, the
patient cannot use the prosthesis. Objectively: an external examination reveals a
retraction of the upper lip, impaired diction during a conversation. When
examining the oral cavity, the mucous membrane is pale pink, moderately moist.
The presence of a defect and deformation of the lateral parts of the alveolar ridge
of the upper jaw is noted. Missing: 1.8-1.1, 2.1-2.8, 3.5, 4.4, 4.6. Bite - not fixed.
On the roentgenogram - defects of the alveolar ridge of the upper jaw are noted in
the region of missing 1.7-1.5, 2.4 - 2.8. In the area of missing 1.4-2.3, bone
deficiency was not detected. In the area of teeth 3.1, 4.1 in the projection of the
apices of the roots, the presence of a lesion of bone tissue 1.5 / 1.0 cm in size, with
clear boundaries, is noted.
Questions and Tasks:
1) Make a diagnosis.
2) Indicate what orthopedic design must be made in
this clinical situation and explain why?

Situational task №2
A 28-year-old patient went to the clinic to treat the consequences of a car injury six
months ago. During an accident, the patient received a complete dislocation of the
teeth 12, 11, 21. Subsequently, in the clinic at the place of residence, the patient
made a removable partial laminar denture on the upper jaw, which did not satisfy
her aesthetics and phonetics. The patient, in her words, is somatically healthy. The
face configuration is not changed. Opening the mouth within normal limits. The
mucous membrane of the oral cavity and the vestibule of normal hydration, pale
pink. Orthognathic bite. On the upper jaw is a partial removable laminar denture
that replaces the missing 12, 11, 21 teeth. The prosthesis is not stable under load,
artificial teeth are very different from the native in color. The alveolar process of
the upper jaw in the area of missing teeth is thinned due to a lack of bone tissue
from the vestibular side. The gum in the specified zone is not changed. The teeth of
the upper jaw adjacent to the defect are stable, unchanged in color and mobility.
When removing the prosthesis, a strong retraction of the upper lip is noted. The
presented orthopantomogram shows a decrease in the height of the alveolar process
of the upper jaw by 2 mm and an increase in its transparency.
The questions are:
1) Make a diagnosis.
2) What methods of treatment are possible in this clinical situation.
3) Is it necessary to conduct additional examination methods?

Situational task №3
Patient K., 43 years old, turned for consultation regarding the installation of a
dental implant in the upper jaw on the left in the area of missing 25-27 teeth. From
the anamnesis it was found that for 3 years he suffers from chronic left-sided
maxillary sinusitis, in connection with which he repeatedly turned to an ENT
doctor during periods of exacerbation. 25,26,27 teeth removed due to
complications of caries. On the orthopantomogram, the pneumatic type of the
maxillary sinus is determined, the distance from the crest of the alveolar process in
the zone 26-27 to the bottom of the sinus is 5 mm.
The task:
Identify the possibility of dental implantation.

Situational task №4
Patient K., 66 years old, turned for consultation regarding the installation of a
dental implant on the lower jaw in the area of missing 34-47 teeth. From the
anamnesis it was found that for 7 years, decompensated form of thyroid disease
suffers.
The task:
Identify the possibility of dental implantation.