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Patient Info

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Last Name
Dazo
First Name
Divine Grace
Middle Name
Quebec
Birthdate
August 16, 1985
Age
33
Street
B10 l3 Manzanilla St.
Barangay
Bacoor Molino
City
Cavite
Country
PHILIPINES
Zip Code
Contact number
09509061089
Procedure
09/18/21 all upper to left lower rotation 33 10/16/21- *33 restore as 34 upper to left 11 coil spring 12 11/26/21- ADJ chipmunk #12 to midline 2/4/22- move 12/ chipmunk 13 to 43 03/16/22- move 13 elastic chipmunk 13 to 43/ chain 12 to 23 4/23/22 same wire. upper to left elastic rabbit 23to 36 05/28/22 rabbit 22 to 36 33 intrude/ RW D of 12 7/2/22- 18 niti U, observe #22 reattached # 22, 34 08/13/22- chain lower/ same wire/ RW 33 09/17/22- upper for midline to left 16/16ss Upper/ lower same wire/ button 23 to 33 1/21/23- same wire Chain #13 -#22 #43 -#33 12/07/22- adj 01/21/23-adj 4/15/23- ADJ - RW on # 12Distal ,same wire, chain lower 05/13/23- UL - same wire/RW #33D/Class 3 Rabbit (left) 09/06/23- LC #16 M/O, 26 O/D, 28 O 09/16/23- Fiber post/ tooth #13-14-16 10/07/23- RCT #24 recrotic / Open canal, Eugenol 10/21/23- #24 B- 22mm L-21mm, Camphenol 10/28/23 RCT #24 cAOH PASTE 11/03/23- #24 Obturation B- 22mm = 20mm MC L- 21mm = 20mm MC, MTA Fillapex 24-25-26- Fiber reinforced 11/25/23- LC #46- Occlusal, Mesial #34 Facial, Distal 06/28/24 OP LC #35 O,M CaOH
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Retain Record
Yes