Templates

• RESTORATIVE # • MDHx: reviewed verbally and using documentation. Covid screening.

Vitals:

Treatment: Patient presents for appointment and restorative addressed for #.

Topical benzocaine placed. Profound anesthesia achieved subsequent to local anesthetic administration. • 34mg lidocaine, 0.018mg epinephrine (IANblock infiltration) • 68mg articaine, 0.018mg epinephrine (IANblock infiltration) • 8.5mg bupivacaine, 0.009mg epinephrine (IANblock infiltration) • 54mg mepivicaine (IANblock infiltration) • No anesthesia administered; patient did well.

Caries excavation and restorative preparation; defined considering a retentive design.

Band/mylar/wedge/cord (removed by end of appointment).

Isolation achieved. 37% H3PO4 acid etch 15s, rinse 15s. Micro-g desensitizer applied 30s, airthinned.

Prime/bond applied and airthinned, cured 10s. • Composite: packable (Filteck): Light cured 20s/2mm increment. • Composite: flowable (Evanesce): Light cured 20s/2mm increment.

• RMGI: (EquiForte):Trituration and placed, light cured 40s upon 2mm placement and setting allowed.

• Amalgam: Trituration and placed. Carving, contouring, and smoothing.

Finishing and smoothing. Flash removed, margins checked.

Occlusion checked.

Interproximal contact region checked.

Patient satisfied with bite, feel, and result.

NV:

• EXTRACTION: NONSURGICAL# • MDHx: reviewed verbally and using documentation. Covid screening.

Vitals:

Tx: Patient presents for extraction. Both verbal and written consent obtained after all RBCAs explained to and understood by patient. Dentition # addressed.

Topical benzocaine placed. Profound anesthesia achieved with local anesthetic administration. • 34mg lidocaine, 0.018mg epinephrine IAN block. • 34mg lidocaine, 0.018mg epinephrine infiltration. • 68mg articaine, 0.018mg epinephrine infiltration. • 8.5mg bupivacaine, 0.009mg epinephrine • 54mg mepivicaine

Gradual luxation with elevator instruments. Luxation with forceps gently.

• Conservative closed envelope, full thickness flap from # to #.

Tooth movement obtained and # removed with any and all apical root portions accounted for. Site debris thoroughly instrumented with currette carefully avoiding any anatomical areas of concern. Cleansing with sterile saline irrigant.

• Suture placed with 3-0 chromic gut suture.

Hemostasis achieved, fibrin clot noted. Gauze to bite. No complications encountered. POI given both verbally and written. Patient released in stable condition.

NV:

• PERIODIC EXAM, Imaging: • • COMPREHENSIVE EXAM, Imaging: •

MDHx: reviewed verbally and using documentation. Covid screening.

Vitals:

Extraoral Findings: Intraoral Findings: Radiographic Findings: Periodontal:

Treatment Indications:

• Patient presents for periodic exam. • Patient presents for comprehensive exam.

Subsequent to exam, findings evaluated and discussion facilitated. All patient questions and concerns entertained and treatment plan agreed upon.

• Rx:

NV:

• LIMITED EXAM: PROBLEM FOCUSED • MDHx: reviewed verbally and using documentation. Covid screening.

Vitals:

CC: Radiographic Findings: Extraoral findings: Intraoral findings: Radiographic Findings: • Percussion: • Palpation: • Cold Test: • EPT: • Tooth Slooth: • Probing:

Patient presents for limited exam. Subsequent to exam, findings evaluated and discussion facilitated. Treatment options presented. All patient questions and concerns entertained and treatment option or no treatment agreed upon.

• Rx:

NV:

• DRY SOCKET TREATMENT (Dx: Dry socket) • Tx: Patient agreed to dry socket treatment. Topical benzocaine placed. Profound anesthesia achieved with local anesthetic administration. • 34mg lidocaine, 0.018mg epinephrine IAN block. • 34mg lidocaine, 0.018mg epinephrine infiltration. • 68mg articaine, 0.018mg epinephrine infiltration. • 8.5mg bupivacaine, 0.009mg epinephrine • 54mg mepivicaine

Thoroughly curetted socket removing debris and foul matter. Thorough cleansing with sterile saline irrigant. Dry socket paste placed. • Gel foam utilized. • Suture utilized to hold components (3-0 chromic gut suture) • Rx:

NV:

• FINAL IMPRESSIONS • MDHx: reviewed verbally and using documentation. Covid screening.

Vitals:

Tx: Patient presents for final impressions.

• Blue Bite boarder molding. PVS medium body peripherals and light body center.

• Retention and anatomical capture of ridges was very good. PVS impressions stable and hard to remove upon checking.

• Rest seats placed. No anesthesia needed. Alginate impressions taken. Anatomical capture very good. Bite registration taken in MIP. # 	# 	# 	# 	#

NV:

• JAW RELATION • MDHx: reviewed verbally and using documentation. Covid screening.

Vitals:

Tx: Patient presents for jaw relation. The VDO and anterior/posterior relationships correctly adjusted for a good natural look and feel for the patient.

Midline and Alar extents marked.

Bite registration taken in CR.

Patient agreed on tooth shade and mold. Shade: Mold:

NV:

• TRY-IN • MDHx: reviewed verbally and using documentation. Covid screening.

Vitals:

Tx: Patient presents for removable try-in. Seated final wax up. Fixodent utilized as indicated. Patient observed look with mirror and got a feel for the bite and phonetics. Occlusion checked for appropriate approximation. Tooth mold and shade reviewed.

• Notes:

Patient approved of final tooth selection and results and have confirmed readiness for finalization of this prosthesis.

NV:

INSERTION MDHx: reviewed verbally and using documentation. Covid screening.

Vitals:

Tx: Patient presents for insertion. Seated removable prosthetic.

Stability, retention, and flanges observed and evaluated. Bite paper and PIP utilized where indicated. Adjustments performed accordingly for a comfortable fit and bite.

• Notes:

Patient satisfied with bite, feel, and esthetic result. Patient informed that PRN adjustments are common within a week as they are noticed and to return as needed for any final adjustments. POI given along with care package.

NV: