Читать книгу Bone and Soft Tissue Augmentation in Implantology - Группа авторов - Страница 30

Depending on the patient’s expectations and willingness to cooperate, it is necessary to precisely define the aim of the treatment. Clarify right from the start in detail the various available grafting techniques and their suitability for the specific patient. Also, alternative methods should be considered such as diameter-reduced or ultrashort and tilted implant placement to avoid grafting procedures.^69,77 To achieve the best possible patient cooperation and satisfaction, it is not sufficient to only explain the intra- and postoperative surgical risks. Patients need information about the overall treatment duration, costs involved, and possible alternative procedures.⁷⁷ During the course of clarifying the implant prosthetic treatment requirements and procedures, it may happen that the patient’s original expectations change once the realization sinks in that the time involved, the material costs, the surgical procedure itself or the increased risks of surgery, especially in the presence of systemic disease, are too much for the patient.

Especially in patients with alveolar crest defects, it is important to describe the entire treatment at the beginning. To achieve high patient satisfaction, it is vital to match the patient’s expectations and the necessary treatment steps as closely as possible.⁸

Fig 2-2g Clinical situation in the left maxilla showing exposed implant neck due to lack of bone and soft tissue.

For the definition of the selected therapy, special attention should be paid to the motivation of the patient in an extensive implant prosthetic treatment in order to achieve good cooperation in the long-lasting and intensive course of therapy. Important information about the patient’s motivation is provided by the cause of the tooth loss and the patient’s attitude toward it (Fig 2-3a and b). The possibilities of the prosthetic design also depend on the awareness of the patient regarding hygiene. Depending on the patient’s oral hygiene status, the choice between fixed, conditionally removable, and removable prostheses should be differentiated.