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Discipline/Quality
Assessment Area |
Unacceptable |
Additional Treatment
Needed/Comments |
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Examination, Diagnosis & Treatment Planning: |
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·
Medical and
Dental History |
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·
Extraoral Head
and Neck Exam |
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·
Intraoral Exam |
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·
Radiographic Exam |
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Diagnosis |
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Treatment
Planning |
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·
Case
Presentation/Consultation |
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Periodontics: |
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·
Gingivitis |
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·
Periodontitis |
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·
Mucogingival
Abnormalities |
|
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·
Supportive
Periodontal Treatment |
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Endodontics: |
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·
Vital Pulp
Therapy |
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·
Root Canal
Therapy |
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·
Access/Obturation |
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Operative Dentistry: |
|
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|
·
Anatomic Form and
Occlusion |
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·
Surface and
Esthetics |
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·
Periodontal
Consideration |
|
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|
·
Endodontic
Consideration |
|
|
|
·
Treatment Plan
and Diagnosis |
|
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·
Pain Control |
|
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·
Marginal
Integrity |
|
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·
Outline Form and
Cavity Preparation |
|
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Crowns
and Fixed Partial Prosthodontics: |
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|
·
Treatment
Planning |
|
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|
·
Surface and Color |
|
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·
Anatomic Form and
Occlusion |
|
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·
Margin Integrity |
|
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Removable Partial Prosthodontics: |
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·
Material |
|
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·
Function |
|
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·
Stability |
|
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·
Retention |
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|
Complete Denture Prosthodontics: |
|
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|
·
Extension |
|
|
|
·
Occlusion |
|
|
|
·
Stability |
|
|
|
·
Retention |
|
|
|
·
Esthetics |
|
|
|
Oral &
Maxillofacial Surgery: |
|
|
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·
Dental & Medical
History & Physical Examination |
|
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·
Radiographs |
|
|
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·
Surgical
Considerations |
|
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|
·
Technique |
|
|
|
·
Maintenance of
Records |
|
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|
·
Post-Operative
Availability |
|
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Discomfort: |
|
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|
|
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Appropriateness of Care: |
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Other
Comments: |