CURSO DE ODONTOLOGIA

PLANEJAMENTO DE PROCEDIMENTO CLÍNICO DIÁRIO

Disciplina: Estágio Supervisionado em Reabilitação Oral Bloco:

Aluno CD:
Aluno Aux:
Nome do paciente: Idade:
Nº do prontuário: Data do procedimento: / /
Aspectos relevantes da anamnese e do exame clínico:
Aspectos relevantes do exame radiográfico:
Diagnóstico:
Nome do procedimento:
Planejamento Clínico
Protocolo clínico (descrição do procedimento a ser realizado no dia, de acordo com o plano de
tratamento)
A- INSTRUMENTAÇÃO

Técnica:__________________________________________________

Odontometria: Radiográfica ( ) ou Eletrônica ( ) Ambas ( )

CANAIS CDR CEI CP CT LM Ponto de referência

Brocas empregadas → Acesso:

Abertura Coronária
Forma de contorno:

Isolamento Absoluto → Número do grampo: ________

Solução irrigadora empregada →

Passo a passo da Técnica de Preparo Biomecânico – Sistema utilizado: _____________________________

__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
 CURSO DE ODONTOLOGIA
PLANEJAMENTO DE PROCEDIMENTO CLÍNICO DIÁRIO

__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

Curativo de demora e tempo de emprego: ___________________________________________________________

Selamento Coronário: ____________________________________________________________________________

Intercorrências:

Passo a passo da Técnica de Obturação:

Técnica utilizada: __________________________________________ Cimento: __________________

_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
 CURSO DE ODONTOLOGIA
PLANEJAMENTO DE PROCEDIMENTO CLÍNICO DIÁRIO

_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________

Intercorrências:

LEGENDA: CDR: Comprimento do Dente na Radiografia (Comprimento Aparente do Dente), CEI: Comprimento de
Exploração Inicial (Comprimento de Trabalho Provisório), CP: Comprimento de Patência (Comprimento Real do Dente),
CT: Comprimento de Trabalho, LM: Lima Memória.

Assinatura do Professor
Nome do professor orientador:
(autorização):
Markelane Santana
Luanne Mara