Revascularization Study - Post Treatment Follow-up Findings
POST TREATMENT FOLLOW-UP FINDINGS
This form is for entering information from a follow-up appointment for a case in which you have already submitted the initial information. It is critical that you match the "Case ID" for the original information.
If you are looking to enter a new case exit this form and go to:
Do to page logic do not use your browser's "Back" button. If you need to edit information already entered, contact Dr. Ed Halteman,
Please enter the case ID from the case to which this follow-up relates. The case ID consists of your initials followed by a three-digit number representing which case you are entering:
(your first case was 001, your second 002, etc.) (E.g. ASL001)
Please provide the patient's initials for this case.
(leave blank if unknown)
First and Last Initials
Please indicate the time frame for this follow-up appointment:
-- Please Select --
Please indicate the level of spontaneous pain the patient was experiencing for this follow-up?
Please indicate whether any of the following were present for this follow-up.
(Select all that apply)
Swelling near or around the tooth
Sinus tract draining infection (stemming from the tooth)
Mobility (> 2mm)
None of these
Please indicate the pulp responsiveness for all applicable tests performed for the tooth in question.
Please indicate the degree to which the patient reported tenderness to percussion.
No test performed