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- I would need to know the amount of treatment the patient can afford.
- Are implants within the patient’s budget?
- Is patient happy with aesthetics of upper teeth as well?
- What are the patient’s expectations? Is the patient only interested in an increase in function? If so, how much of an increase in function?
- Are there any esthetic expectations? Will the patient accept fixed bridges or does he want individual functioning teeth?
- Is the patient open to having dental implants?
- Is the patient open to having a denture, if it is more securely retained with locator attachments?
- Further information is needed about the patient’s involvement history in his dental care or about his current treatment goals.
- Does the patient wish to go with a complete fixed option or with an implant-supported set-up?
- From patient’s perspective, what was it about the lower denture that was unsatisfactory?
- What is the patient’s INR?
- How stable is the patient’s BP?
- Is the patient a smoker?
- Medically speaking, can the patient safely have dental implants placed?
- What are the risks associated with discontinuing Coumadin prior to surgery, what is the current patient’s INR, and what is the potential of having the surgery without interrupting Coumadin treatment?
- What is the periodontal and dental condition of the remaining mandibular and maxillary teeth?
- How old is the upper crowns/bridge?
- Does the patient come in for regular maintenance of his teeth/mouth?
- Is the maxillary situation healthy and stable? Although photos appear to show that, it is hard to tell if there is burnout on Panorex or caries in the cervical areas.
- Is occlusion stable?
- Does the patient grind or have any para-functional habits?
- What is the proper vertical dimension? Is the patient over-closed?
- Could the patient tolerate an opened vertical dimension?
- Is there cuspid-guided or group function? Has there been any loss of VDO? Are the current LPD teeth worn down at all from use over time which could decrease VDO. Is there a CR-CO discrepancy?
- Are there any interferences or slides?
- How old is the existing partial lower denture and whether it is loose?
- Are the remaining teeth from 43 to 33 healthy and stable? Does the patient want to retain these?
- What is the thickness of the alveolar ridge?
- What is the quality of the alveolar ridge and its height?
- Is this the first RPD worn by the patient; and if not, is this the first free-end RPD?
- Has the patient tolerated the acrylic flanges to date; and if not, how are the flanges a concern?
- Is there food entrapped under the RPD?
- What was the patient’s chief complaint with the current partial denture?
- Were there any restrictions as to what could or could not be eaten?
- Are there any speech limitations?
- Has the partial denture been relined?
- What are the mobilities and periodontal probings around the key teeth i.e. 43/33?
- How healthy is the tissue where the free end RPD has been resting?
- Is there any rubbing or irritation to the gingiva/mucosa? What is the periodontal status of each tooth in the mouth?
- I would like to see a cone beam CT scan, and study models mounted.
- A sharper Panorex or a cone beam CT to evaluate the IDNC
- CAT scan
- Study models, diagnostic wax-up of teeth in the posterior mandible bilaterally to fabricate a radiographic stent, (doped with barium and). A CBCT scan of the mandible to assess bone volume, thickness and height posterior to the cuspids for possible implant-supported fixed bridges bilaterally.
- Need a further radiographic investigation to assess the quality and quantity of bone in the edentulous areas.
- I was unable to get a clear and prolonged view of radiographs. I would like a set of tomographs with a stent/marker in place bilaterally to explore 3-D bone views.