Case History For FPD
Case History For FPD
Case History For FPD
Name
Age/Sex
Occupation
Opd no.
Chief complaint
Hypertension
Diabetes
Angina
Heart Surgery
Cardiac Pacemaker
Renal disease
Artificial Joint
Epilepsy
Depression
History of allergy
History of medication
History of Hospitalization
Personal history:-
Family history:-
GENERAL EXAMINATION :
Gait
Respiratory rate
Pulse
Cyanosis
Pallor
TMJ EXAMINATION:
Joint sounds
Clicking
Deviation
Facial symmetry
Facial profile
GINGIVA:
Color
Texture
Contour
Consistency
Bleeding on probing
Buccal mucosa
Palatal mucosa
Tongue
XXXXXXXX I
XXXXXXXX
XXXXXXXX I
XXXXXXXX
Hard Tissue Examination:
Missing teeth
Caries
Tooth mobility :
Grade -0
Grade -1
Grade -2
Grade -3
Occlusion:
Group function
Canine protected
General Alignment:
Crowding , Rotation , Supra eruption ,Spacing
Treatment Plan :