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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
美齿效果和功能检查
Key points
- 令人愉悦的美齿效果对大多数患者而言都很重要
- 发音效果和咀嚼能力是两个最重要的功能需求
- 为了避免患者失望,适当地进行准备并在治疗过程中重新调整患者的期望至关重要
应对患者的期望
由于许多患者都期望实现理想的美齿效果和功能,因此在治疗方案设计阶段针对患者期望做出适当的准备是十分必要的。之后,在治疗过程中以及随访期间,间或向患者重申治疗前的期望对于确保修复体植入时和植入后的随访顺利进行很有帮助,对于确保患者对治疗满意也很有帮助。大多数情况下,患者会因为美观问题而变得不满。临床医师和患者必须坦诚讨论对牙齿的色度、形状、纹理、位置和角度进行改进的可能性,以便确定在所使用的材料和所选择的修复体设计的限制下,哪些缺陷能够得到纠正。
发音效果和咀嚼能力
应通过评估患者的语言能力和自述的咀嚼能力小心改善功能性、发音效果和咀嚼效能。应告知患者,预计需适应一段时间才能恢复语言能力和咀嚼能力。需要经过 4-6 周,有时甚至数月才能确定真正的发音效果和咀嚼能力。
发音效果:
修复体和/或人造义齿的腭侧轮廓及由此形成的可用舌空间是多种发音的重要决定因素。此外,前牙的正确位置和关系(特别是对擦音和齿擦音)至关重要。
咀嚼能力:
患者需要学习如何使用新修复体重新进行咀嚼。舌头和口腔肌肉需要适应咀嚼运动,以便将食团正确放置在新咬合面和牙切面上。建议患者一开始先使用新修复体咀嚼较软的食物,然后逐渐过渡到较硬或纤维较多的食物。应该在治疗方案设计阶段告知患者有关此适应期的内容,以防止患者感到失望和沮丧。