-I rauUNIVERSITATEA DE MEDICIN I FARMACIE "GR. T. POPA IAI FACULTATEA DE MEDICIN DENTAR

Nr. fi: ________________ Medic: _________________ Sudent: ________________Specialist Primar

Student

Nespecialist

FOAIE DE OBSERVA IE - PARODONTOLOGIE DATE GENERALENume: Vrsta : Adresa: Tel. fix: Loc munc: ______________________ Prenume: ______________________ Sex ______________________________________ ______________________ Tel. mobil: ______________________ Ocupa ie: ______________________ ______________________ ______________________ ______________________ ______________________

Men iuni: _____________________________________________________________________________________________________________

MOTIVELE PREZENTRIIsngerare gingival probleme estetice legate de recesiuni sau migrri dentar tulburri masticatorii legate de mobilitate dentar halitoz, gust neplcut n cavitatea oral senza ie tensiune sau prurit la nivelul gingiei simptomatologie legat de complica iile bolii parodontale (abcese parodontale, parestezii, sindrom endo-parodontal) probleme odontale (carii simple i complicate) probleme endodontice (durere cu caracterele specifice)

ISTORICUL AFEC IUNII PARODONTALEDurat Debut Semne de debut Evolu ie A mai fost tratat? zile _______ luni _______ lent provocat sngerare durere stagnant lent periodicitate da ani _______ brusc neprovocat tumefac ie mobilitate rapid n pusee (stare de activitate / inactivitate) nu

ANTECEDENTE ANTECEDENTE HEREDO-COLATERALEAntecedente heredo-colaterale generale:Men iuni: _____________________________________________________________________________________________________________

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Antecedente heredo-colaterale stomatologice:Men iuni: _____________________________________________________________________________________________________________

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ANTECEDENTE PERSONALEAntecedente personale generale:Men iuni: _____________________________________________________________________________________________________________

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Antecedente personale stomatologice:Men iuni: _____________________________________________________________________________________________________________

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CONDI II DE VIA I MUNCMen iuni: _____________________________________________________________________________________________________________

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FACTORII DE RISC PARODONTALVrsta: _______ Obiceiuri vicioase: fumat alcool frecven tip Tipul de alimenta ie (carbohidra i, etc.): da da nr. igri / zi ______ cosumator ocazional bere vin nu nu de cnd ______ luni / ______ ani frecvent trii cronic

Men iuni: _____________________________________________________________________________________________________________

______________________________________________________________________________________ Igiena oral deficitar: periaj dentar nr. periaje / zi ______ tip periaj __________________ substan e antiplac folosire zilnic rar Tratamente dentare defectuoase: lucrari protetice obtura ii Malocluzii: da nuMen iuni: _____________________________________________________________________________________________________________

______________________________________________________________________________________ Respira ia oral: da nuMen iuni: _____________________________________________________________________________________________________________

______________________________________________________________________________________ Istoric de boala parodontal: da nu da nu Stresul: Afec iuni sistemice (teren imunocompromis): diabet afec iuni cardiovasculare afec iuni hematologice afec iuni virale infec ia HIV Stri fiziologice: pubertatea sarcina menopauza Factori ereditari:Men iuni: _____________________________________________________________________________________________________________

______________________________________________________________________________________ Etnia: _________________________________________________________________________________

IGIENAbun medie necorespunztoare

PERIAJUL DENTARRitmicitate: Tehnica periaj: dup fiecare mas incorect diminea a i seara corect bass charters bass modificat rotativ neregulat

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PERIU

A DENTARmanual moale 3 luni electric medie deteriorare dur

Tipul periutei: Duritate: Schimbat la:

PASTA DE DIN

Icosmetic medical

MIJLOACE SUPLIMENTARE DE IGIENA ORALApe de gur Fir interdentar Periu e interdentare Scobitori interdentare Duuri bucale cronologia cltirilor ______________________________________ durata cltirii ________________________________________ da nu da nu da nu da nu

INDICI DE IGIENIndice de plac: ___________________________________________________________________ Indice de plac PLI (Silness & Loe) ______________________________________________________ Indice de tartru ___________________________________________________________________Men iuni: _____________________________________________________________________________________________________________

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EXAMEN EXOBUCAL TEGUMENTE / MUCOASEAspect Culoare Integritate Sensibilitate Tumefac ii Adenopatii _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________

Men iuni: _____________________________________________________________________________________________________________

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EXAMEN CLINIC PARODONTALParodon iu de nveliGingia marginalCuloarea: roz-coral rou intens rou-violaceu Consisten a: ferm moale Forma: _________________________________________________________________________ Textura: granitat neted Volum: _________________________________________________________________________ Pozi ia: zona de pe arcad unde apar modificri. Inflama ie: localizare localizat generalizat zona _________________________________________________ form: acut periodic cronic

Gingia ataatabsent zona _________________________________________________

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ngust lat

zona _________________________________________________ zona _________________________________________________

Frenuri brideInserare: aproape mediu la distan zona _________________________________________________ zona _________________________________________________ zona _________________________________________________

Indicele PSR / sextan i (cod 0, 1, 2.4)Sextant 1 __________________ Sextant 6 __________________ Sextant 2 __________________ Sextant 5 __________________ Sextant 3 __________________ Sextant 4 __________________

Parodon iul de sus inerePungi parodontale: supraosoase infraosoase mixte

Sngerareaabsent la periaj malpozi ii la sondaj mobilitate spontan

Din iimigrri

PARODONTOGRAMA INI IALIndice de sntate a papilei inter-dentare:

Men iuni: _____________________________________________________________________________________________________________

______________________________________________________________________________________ ______________________________________________________________________________________

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MAXILAR

Indicele gingival sau GI: indicele lui Le i Silness (0, 1, 1,5) ______________________________________________________________________ Indice de sngerare papilar PBI ______________________________________________________________________ Indice de sngerare gingival ______________________________________________________________________

Indice de hipercretere ______________________________________________________________________ Indicele CPITN - Community Periodontal Index (0, 1, 2, 3, 4, 5, 6) ______________________________________________________________________ Indice de mobilitate(0, 1, 2, 3) ______________________________________________________________________

Men iuni: _______________________________________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________ 5

MANDIBULAR

Indicele gingival sau GI: indicele lui Le i Silness (0, 1, 1,5) ______________________________________________________________________ Indice de sngerare papilar PBI ______________________________________________________________________ Indice de sngerare gingival ______________________________________________________________________

Indice de hipercretere ______________________________________________________________________ Indicele CPITN - Community Periodontal Index (0, 1, 2, 3, 4, 5, 6) ______________________________________________________________________ Indice de mobilitate(0, 1, 2, 3) ______________________________________________________________________

Men iuni: _______________________________________________________________________________________________________________________________________________________________________

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DIAGNOSTIC PARODONTALCod 1Cadranul I Cadranul II Cadranul III Cadranul IV 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8

Integritatea parodontal Anatomo-clinic + forma clinic Abces parodontal 1.1 Gingivita necomplicata 1.1.1 modulata 1.1.2endocrin medicamentos

1.2 1.3 1.3.1 1.3.2 1.3.3 1.3.3.1 1.3.3.2 1.3.3.3 1.3.4 1.3.5 1.3.6 2 2.1 2.2 3 3.1 3.2 3.3 3.4 3.5 3.6 3.8 3.9 4 4.1 4.2 4.3 4.4 5 5.1 5.2 5.3 6 6.1 6.2 6.3 6.4 7 7.1 7.2 7.3 8 8.1 8.2 8.2.1 8.2.2 8.2.3 8.2.4

Gingivita ulcero-necrotic Parodontita juvenila rapid progresiva a adultuluisuperficiala medie profunda

refractara din SIDA ulcero-necrotica Topografie Localizat Generalizat Etiologie Microbian Teren Stri fiziologice Patologii sistemice Medica ie Traumatic Iatrogenic Plurifactorial Tulburri func ionale Masticatorio Fizionomice Fonetice Degluti ie Evolu ie Stabilizat Lent Rapid Complica ii Locale La distan Imediate Tardive Prognostic Favorabil Rezervat Nefavorabil Tratament Netratat Tratatcorect incorect complet incomplet

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PLAN DE TRATAMENT TRATAMENTUL ETIOLOGICCod (A) 1 2 3 Manopere Consultatia in cadrul dispensarizarii (include si educatia pentru sanatatea bucodentara, determinarea indicelui de placa bacteriana si a indicilor de inflamatie parodontali) Educatia pentru individualizarea tehnicilor de indepartare a placii bacteriene / sedinta Periaj dentar profesional / sedintaNr. edin e 1 2 3 4 5 6 7 8

Igiena oral:Periu a de din i: Metoda de periaj: Periu a interdentar: Firul interdentar: Cltiri antiseptice:Cod (E) 1 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Manopere

soft circular da da daCadranul I

medium Charters nu nu nuCadranul II

hard Bass

Cadranul III

Cadranul IV

1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8

Profilaxia i tratamentul antimicrobian Detartraj manual supra si subgingival per dinte Detartraj mecanic supra si subgingival per dinte Detartraj ultrasunete Surfasaj radicular / dinte

Periaj profesional / dinteTratament medicamentos local Tratamentul abcesului parodontal

TRATAMENTUL CORECTIV2 2.1 2.2 2.3 2.4 2.5 3 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Tratamentul chirurgical Chiuretaj in camp inchis Chiuretaj parodontal in camp deschis / sextant Echilibrare ocluzala prin slefuire selectiva per sedinta Tratamentul aftei bucale per sedinta Tratamentul gingivo stomatitelor per sedinta Conten ie / imobilizare Contentie provizorie prin ligaturi de sarma Imobilizare cu compozite Imobilizare cu amalgam Imobilizare cu compozit i srm Imobilizare cu compozit i plas de srm Imobilizare cu compozit i band de polifibr Pun i stabilizatoare

ETAPA DE MENCod (A) 1

INERE / CONTROL (la 3 luni, 6 luni, 1 an)Nr. edin e 1 2 3 4 5 6 7 8

Manopere Consultatia in cadrul dispensarizarii (include si educatia pentru sanatatea bucodentara, determinarea indicelui de placa bacteriana si a indicilor de inflamatie parodontali)

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MAXILAR

Indicele gingival sau GI: indicele lui Le i Silness (0, 1, 1,5) ______________________________________________________________________ Indice de sngerare papilar PBI ______________________________________________________________________ Indice de sngerare gingival ______________________________________________________________________

Indice de hipercretere ______________________________________________________________________ Indicele CPITN - Community Periodontal Index (0, 1, 2, 3, 4, 5, 6) ______________________________________________________________________ Indice de mobilitate(0, 1, 2, 3) ______________________________________________________________________

Men iuni: _______________________________________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________ 9

MANDIBULAR

Indicele gingival sau GI: indicele lui Le i Silness (0, 1, 1,5) ______________________________________________________________________ Indice de sngerare papilar PBI ______________________________________________________________________ Indice de sngerare gingival ______________________________________________________________________

Indice de hipercretere ______________________________________________________________________ Indicele CPITN - Community Periodontal Index (0, 1, 2, 3, 4, 5, 6) ______________________________________________________________________ Indice de mobilitate(0, 1, 2, 3) ______________________________________________________________________

Men iuni: _______________________________________________________________________________________________________________________________________________________________________

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EVOLU IA PACIENTULUI + DEVIZNR. CRT. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 DATA MANOPER (COD) TARIF MATERIAL

DIAGNOSTIC FINAL______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

Caz terminat

Medic,

Pacient,

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