Читать книгу Practical Procedures in Implant Dentistry - Группа авторов - Страница 24

Questioning on past history of dental treatment is helpful to understand the reason for tooth loss and to identify any risk factors that the patient may present with. The aetiology for tooth loss may be congenitally missing, periodontal disease, fractured or carious tooth beyond restoration, endodontic complications, along with other reasons. Patients that present with a history of periodontal disease may have lost significant amounts of alveolar bone, complicating implant treatment with the need for bony augmentation, as well as being in the higher risk category of peri‐implantitis. Questions about how the tooth was removed or if there was difficulty in removal of the tooth may provide useful information, as surgical removal of the tooth and difficulty in extraction resulting in bone removal may indicate a need for future hard or soft tissue augmentation. Valuable information is gathered in the history that may enlighten the clinician as to what progressed prior to their visit to the practice.

Determining the level of the patient's expectations is important to assess whether it will be possible to achieve the desired result, or whether they may need to be referred to a more experienced colleague for assistance. In cases of deficient soft tissue, it may be virtually impossible to recreate perfect soft tissue aesthetics with natural dental papilla, and discussions on the use of pink replacement with porcelain may be necessary.

Excellent patient compliance is necessary for long‐term success of dental implants, with regular dental attendance providing continual assessment, occlusal verification, and reinforcement of correct hygiene techniques. This provides the supportive care that a patient requires and at initial consultation it is necessary to advise the patient on the need for continual care. Regular oral hygiene with excellent plaque control will provide the environment for healthy peri‐implant tissues, and implant therapy should only be initiated once this has been achieved.