Question

a 35 year medically fit non-smoking patient presents complaining of a buccal intraoral swelling associated with his lower right posterior teeth. In addition, the patient complains of bleeding gums and wishes to improve the appearance of the gingiva around tooth FDI 23 that clinically has associated class II gingival recession.

Initial clinical examination indicates an intraoral swelling with a draining sinus between teeth FDI 45 and 46, grade I mobility of 46, generalized clinical loss of attachment of 3-4mm and generalized pocketing of 5-6mm with bleeding on probing around all teeth.

Questions:
1- describe and justify the steps you will undertake to establish a diagnosis for this patient.

2- A)explain and justify the differential diagnosis.
B)discuss the investigations you would undertake and the findings that you expect, explaining their relevance to the clinical scenario.

Answer 1

1, If there is an infection or inflammation in the odontogenic orofacial space that cause parotitis, peritonsillar access, gingivitis, gingival recession defects.
2, Tender swelling of the buccal intraoral and lower right posterior teeth indicate there are an inflammatory lesion and infection. patient bleeding gums as a sign of gingivitis and inflammation of gumline. improvement needed on the appearance of the gingiva around tooth FD1 23 associated with class II indicate gingival recession it needs concern gingival recession and tooth securing.
b, patient need a blood culture to identify the microflora. orthopantomogram to assess periodontal disease. CT of face to assess the severity of orofacial space infections. Dentistry for dental extractions, oral surgery for surgical drainage of orofacial space infection.