FD053-23 V1 Anexo de Endodoncia
FD053-23 V1 Anexo de Endodoncia
FD053-23 V1 Anexo de Endodoncia
ANEXO DE ENDODONCIA
Versión: 1
Fecha: Enero 2015
NÚMERO DE HISTORIA
CLÍNICA
APELLIDO
1: APELLIDO 2:
NOMBRES:
MOTIVO DE CONSULTA
DIENTE ________________________________________________________________________________
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DOLOR NO ( ) SI ( )
HALLAZGOS CLÍNICOS
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HALLAZGOS RADIOGRÁFICOS
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MOVILIDAD
No se realiza
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Negativo
Positivo
PRUEBAS CLINICAS
SONDAJE
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CALOR DIAGNÓSTICO
FRIO ___________________________________________________________
TEST CAVITARIO
ESTIM. DIRECTA
PERCUSIÓN
PALPACIÓN
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PRONÓSTICO ___________________________________________________________
TRATAMIENTO __________________________________________________________
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SECUENCIA DE TRATAMIENTO
OBSERVACIONES:
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