Ivoclar Vivadent IPS Empress Direct- Student Composite Competition Student: Robert Campbell Aberdeen University (BDS 5) Case Presentation: Mr LN, 63 year old male patient. Medical HistoryPatient suffers from chronic obstructive pulmonary disorder for which he uses a Seretide 250 inhaler (25 micrograms of salmeterol and 250 micrograms of fluticasone) twice daily. He also has a 100 microgram Salbutamol inhaler to use when required for shortness of breath but rarely needs to as his condition is well controlled. He has a history of osteoarthritis affecting his back for which he takes Naproxen 500 mg twice daily and co-codamol (30mg codeine and 500mg of paracetamol) when required for breakthrough pain. He also has a history of repeated chest infections for which he has had multiple short term courses of penicillin antibiotics which is currently being further investigated by his General medical Practitioner. Social HistoryUntil the start of 2014 the patient had been a long time smoker (over 20 years) of around 5-10 cigarettes daily however has managed to quit since the new year without any pharmacological assistance. He is a light social drinker, estimating to consume around 8 units of alcohol weekly. He is employed by the city council and works full time. Dental HistoryThe patient was a regular attender of an area general dental practitioner and has had numerous dental treatments in the past including fillings in both amalgam and composite, crowns. After around 20 years of treatment the patient’s dentist retired prompting him to self-refer to Aberdeen Dental School. His first exam was around 4 months post his last appointment at the previous dentist. Patient ConcernsOriginally the patient presented with some occasional pain from tooth 22. His main concerns were to treat his pain and reassess his heavily restored dentition for any further treatment required. He was aware that in his maxillary anterior region a number of composite restorations had become quite unaesthetic; however felt that the function of these teeth was more important to him than their appearance. A full examination both clinically and radiographically was made of his dentition and a treatment plan formulated including; EMERGENCY TREATMENT- Root canal treatment of teeth 21 and 22. PREVENTATIVE TREATMENT- Diet analysis, tooth brushing, interdental brushing and further oral hygiene instruction. A full mouth scale to remove calculus. Monitoring this with plaque and bleeding analysis.