Prosthodontic Consultation Summary Letter

14/05/2024

Arthur Pendelton

42 Highfield Road

Manchester, Greater Manchester, M20 2BD

Dear Arthur Pendelton,

After your recent consultation with me on 10/05/2024, I am writing to outline the main matters discussed and the proposed treatment plan.

You attended the clinic reporting difficulty chewing and dissatisfaction with the aesthetics and stability of your current upper partial denture, alongside generalised sensitivity in your lower anterior teeth.

Your dental history includes the placement of an acrylic upper removable partial denture five years ago and multiple composite restorations in the lower arch, with a history of nocturnal bruxism and moderate periodontal disease that has been previously stabilised.

Clinical examination revealed an ill-fitting maxillary acrylic partial denture with poor retention and stability, severe attrition on the lower anterior dentition with exposed dentine, and a fractured palatal cusp on the upper right first molar (UR6), though your oral hygiene is currently fair with no active caries detected.

A dental panoramic tomogram (DPT) and periapical radiographs of the upper right quadrant were completed, demonstrating generalised horizontal bone loss of 20% to 30%, a sound root canal filling on the UR6 with normal periapical tissues, and adequate bone volume in the edentulous ridges.

The proposed treatment plan involves stabilising your periodontal health with an initial hygiene phase, placing a full-coverage porcelain-fused-to-metal crown on the UR6, constructing a new cobalt-chromium maxillary removable partial denture for superior support and retention, and fabricating a lower hard Michigan-style occlusal splint to protect your remaining teeth from further grinding wear.

You were advised to leave your current upper denture out at night to allow the gum tissues to rest, to use a desensitising toothpaste twice daily applied directly to the lower front teeth, and to maintain meticulous interdental cleaning using TePe brushes.

You were prescribed chlorhexidine gluconate (Corsodyl®) 0.2% mouthwash 10 ml oromucosal BID for 14 days to manage mild denture-induced gingival inflammation, and sodium fluoride (Duraphat®) 5000 ppm toothpaste 2 cm topical TID for ongoing caries and sensitivity protection.

Your next visit will involve crown preparation and master impressions for the upper right first molar, followed by primary impressions for the new cobalt-chromium partial denture two weeks later.

Please contact me if you have any questions or concerns about your treatment plan. I look forward to seeing you at your next appointment on 28/05/2024.

With best regards

Yours sincerely,