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0
Patient Assessment
- 0.1 Patient demand
- 0.2 Overarching considerations
- 0.3 Local history
- 0.4 Anatomical location
- 0.5 General patient history
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0.6
Risk assessment & special high risk categories
- 5.1 Risk assessment & special high risk categories
- 5.2 age
- 5.3 Compliance
- 5.4 Smoking
- 5.5 Drug abuse
- 5.6 Recreational drugs and alcohol abuse
- 5.7 Parafunctions
- 5.8 Diabetes
- 5.9 Osteoporosis
- 5.10 Coagulation disorders and anticoagulant therapy
- 5.11 Steroids
- 5.12 Bisphosphonates
- 5.13 BRONJ / ARONJ
- 5.14 Radiotherapy
- 5.15 Risk factors
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1
Diagnostics
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1.1
Clinical Assessment
- 0.1 Lip line
- 0.2 Mouth opening
- 0.3 Vertical dimension
- 0.4 Maxillo-mandibular relationship
- 0.5 TMD
- 0.6 Existing prosthesis
- 0.7 Muco-gingival junction
- 0.8 Hyposalivation and Xerostomia
- 1.2 Clinical findings
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1.3
Clinical diagnostic assessments
- 2.1 Microbiology
- 2.2 Salivary output
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1.4
Diagnostic imaging
- 3.1 Imaging overview
- 3.2 Intraoral radiographs
- 3.3 Panoramic
- 3.4 CBCT
- 3.5 CT
- 1.5 Diagnostic prosthodontic guides
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1.1
Clinical Assessment
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2
Treatment Options
- 2.1 Mucosally-supported
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2.2
Implant-retained/supported, general
- 1.1 Prosthodontic options overview
- 1.2 Number of implants maxilla and mandible
- 1.3 Time to function
- 1.4 Submerged or non-submerged
- 1.5 Soft tissue management
- 1.6 Hard tissue management, mandible
- 1.7 Hard tissue management, maxilla
- 1.8 Need for grafting
- 1.9 Healed vs fresh extraction socket
- 1.10 Digital treatment planning protocols
- 2.3 Implant prosthetics - removable
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2.4
Implant prosthetics - fixed
- 2.5 Comprehensive treatment concepts
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3
Treatment Procedures
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3.1
Surgical
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3.2
Removable prosthetics
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3.3
Fixed prosthetics
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3.1
Surgical
- 4 Aftercare
美齿并发症
Key points
- 在治疗方案设计讨论时设定切合实际的期望可大幅降低患者对最初的美齿效果严重不满的风险。
- 使用临时修复体有助于设计美观的修复体
- 如果出现严重的美齿并发症,可能需要对修复体进行再加工或选择替代修复体设计
美齿参数和患者反应
审美并发症可能与对牙齿位置、角度、形状、颜色、纹理和感觉不满有关,还可能与对软组织外观和/或人造义齿的天然或人造粘膜的种植体穿龈部外形不满有关。
患者对新修复体外观的最初反应是非常重要的,因为严重不满是很难克服的。因此,进行治疗方案设计以及利用临时修复体确立患者满意度参数对于避免患者的希望和期望与可能的现实情况不符至关重要。
如果患者的最初反应是表现出轻微不满,则建议鼓励患者试戴修复体几天或几周,因为经过一段时间后,患者可能会逐渐适应自己的新外观。
修改修复体注意事项
如果有必要对修复体进行修改,临床医师必须确定是只需在口腔内稍作修改,还是应取出修复体进行修改。显然,在美观效果受损的极端情况下,通过修改达到新的期望既无法实现,也会破坏修复体的完整性,此时可能需要制作新的修复体。在此类情况下,应考虑改进修复体的设计,因为这可能是这一美齿并发症的解决方案。通常,必须考虑在患者对固定修复体的期望与可实现的美观效果及维护口腔卫生的便利性之间做出权衡。通常可通过活动修复体更好地满足美观要求,尤其是与模拟软组织相关的美观要求。