Читать книгу The SAC Classification in Implant Dentistry - Группа авторов - Страница 29

The clinician is central to most decisions and their practical application in implant treatment. Risks in implant dentistry can be attributed to four main sources: the patient, the treatment approach, the biomaterials, and the clinician. This relationship between the clinician, the materials, and the patient factors was first described by Chen and Schärer in 1993 (Chen & Schärer, 1993). Further, Buser and Chen (Buser & Chen, 2008), published on a model that also illustrates the potential interactions between these factors, as shown in Figure 2.

Fig 2. Potential sources of risk (Source: ITI Treatment Guide Vol. 3 “Implant Placement in Post-Extraction Sites”)

In this model, the clinician has a potentially disproportionate influence: they select the patient, the treatment approach, and the biomaterials, and they subsequently carry out the treatment on the patient. Thus, a flaw or shortcoming in their knowledge or skills will put their patient at greater risk of adverse outcomes. Therefore, in answer to the question posed earlier, we must conclude that the clinician has the potential to be a significant risk factor.

Can the SAC classification assist in reducing risk? By focusing the attention of the clinician on potential risk factors, it should ensure that the clinician-related risk is mitigated. However, the review group did not believe that the clinician could be considered as a factor in determining the SAC classification for a case, as they were not confident that all clinicians could accurately self-assess their ability. Nonetheless, discussions such as this may assist individuals in progressing along their own learning journey and improve their ability to control this potential risk.