Subjective:
The patient is a 60 y.o. male that was referred to our office for a maxillary full mouth extraction and excision of buccal exostosis in the right and left maxillary alveolar ridge areas.
Objective:
The patient has allergies to Penicillin and Sulfa . Serious illnesses included C.O.P.D. (Chronic Obstructive Pulmonary Disease) and a history of renal calculi. Medications taken by the patient were Prevental and Thedur. Facial examination revealed a portwine stain over the left maxillary division of the trigeminal nerve. Increase vasculature of the left soft palate and maxillary gingiva was noted. In addition, increase vasculature was noted of the conjunctiva of the left eye. Oral examination also revealed non-functional teeth #'s 2 and 3. Tooth # 4 had a fracture of the crown secondary to dental caries. Horizontal alveolar bone loss was present. Extensive right and left maxillary buccal exostosis were noted in the maxilla.
Assessment:
- Encephalotrigeminal Angiomatosis (Sturge-Weber Disease)
- Periodontitis
- Dental Caries
- Right and Left Maxillary Buccal Exostosis
- Hyperplastic Right and Left Maxillary Tuberosities
- Non-functional Teeth #' 2 and 3
- Fractured Tooth # 4
Plan / Treatment:
- Maxillary Full Mouth Extraction
- Excision of Right and Left Maxillary Buccal Exostosis
- Right and Left Maxillary Tuberosity Reduction
Patient treated by:
- Dr. Steven R. Tucker Oral and Maxillofacial Surgery
Steven R. Tucker DMD, PSC
Oral and Maxillofacial Surgery
909 Scherm Road
Owensboro, KY 42301
phone: 1-270-926-4107
fax: 1-270-926-4166
url: www.srt-psc.com
Last Modified: January 2, 2000
