PATIENT: Bruce
TYPE: Asleep (Hospital general anesthesia sedation)
REFERRAL SOURCE: Dr. Paul Subar, Assistant Professor and the Director of the Special Care Clinic and Hospital Dentistry Program at the University f the Pacific (UOP)
GENDER: Male
AGE: 65
SPECIAL NEED: Cerebral Palsy
MEDICAL HISTORY: Previous neck injury and surgery resulting in delicate cervical tissues with functional limitations.
CHIEF COMPLAINT: Long overdue check-up and broken teeth
MAINTENANCE CARE: In-office check-ups and hygiene care

BACKGROUND: Bruce is in the public eye as a member of the SFMTA and through his work as an advocate for the special needs community. He was referred to the Blende Dental Group for complex, comprehensive dental care by Dr. Paul Subar, Assistant Professor and Director of the Special Care Clinic and Hospital Dentistry Program at University of the Pacific. Bruce has cerebral palsy and a previous neck injury, making it difficult to be positioned comfortably and treated in a traditional dental office setting. Bruce was brought in by his concern over multiple broken teeth, and the the fact that it had been several years since his last dental check up.

CLINICAL FINDINGS:
Multiple broken teeth
Significant dental caries
Attrition secondary to parafunction

DENTAL/MEDICAL TEAM:
Prosthetics and Oral Surgery Dr. David Blende, D.D.S.

TREATMENT SUMMARY:
Four-hour operating room procedure at Kaiser Permanente San Francisco Medical Center
Extraction of three teeth
Composite restorations on three teeth
Nine crowns
Four bridges

TREATMENT DETAILS: Vertical dimension of occlusion was opened to compensate for tooth structure lost due to parafunction.