Читать книгу Fundamentals of Implant Dentistry - John III Beumer - Страница 7

PREFACE

Afirst edition is always a work in progress, and this is especially true in a field as dynamic as implant pros- thodontics. Moreover, dentistry and dental education are in the midst of revolutionary change, primarily because of the refinement of CAD/CAM technologies. These changes are by no means confined to implant prosthodontics. For example, removable partial denture (RPD) metal frameworks designed digitally and printed using selective laser melting now achieve precision and strength equivalent to that produced by the most skilled laboratory technician using analog methods. Fabrication of complete dentures using digital technologies is now possible—although the best outcomes are achieved when time-tested analog impression techniques are combined with digital methods. The digital revolution has allowed us to explore the use of new restorative materials for our implant-borne restorations, to visualize the local anatomy of our patients in three dimensions prior to treatment, and to execute our surgical and prosthodontic treatments with improved precision and efficiency. One of the goals of this new edition is to illustrate when and how digital technologies can be combined with analog techniques to create workable and efficient prosthodontic workflows.

As in the first edition, the book is divided into sections. Several new topics and chapters have been added to the second edition. In chapter 3, a synopsis of biomechanics as it pertains to implant prosthodontics is presented along with our view of the proper approach to occlusal and component design. Where possible, clinical data are combined with engineering principles to illustrate practical application of biomechanical concepts. Mechanotransduction and tissue response to mechanical loading are included to emphasize the dynamic nature of the bone-implant interface. New chapters on digital technologies and contemporary materials used in implant dentistry have also been added. Issues pertinent to maintenance, implant and prosthodontic complications, and their treatment are combined in another new chapter. The chapter on the use of implants in irradiated tissues has been enhanced to include a section on the use of implants in patients treated with bisphosphonates. Another chapter has been added devoted to implant surgery and tailored for nonsurgically trained dentists.

The impetus for this supplement has been the recent mandate by CODA (Commission on Dental Accreditation of the American Dental Association) to train prosthodontic residents in the basic fundamentals of implant surgery. Furthermore, throughout the book, we have tried to present clinical follow-ups of patients displayed in the first edition, some over 30 years postdelivery.

We continue to emphasize the importance of considering conventional prosthodontic methods and presenting these to the patient. As in the first edition, we indicate when conventional approaches (tooth-supported fixed dental prostheses, RPDs, and restoring diseased teeth with endodontic therapy and conventional restorations) should be considered. Frequently, conventional treatments are just as effective in restoring form and function (and sometimes more so), are more time efficient, and more often than not are more cost effective than implant options.

We continue to believe that most patients are best served with an interdisciplinary effort. Some patients present with relatively simple problems and can be handled by a solo practitioner (hence, the addition of the chapter devoted to implant surgery for nonsurgically trained dentists). However, most patients present with significant prosthodontic complexities such as occlusal plane discrepancies, malposed teeth and unfavorable jaw relations, periodontal compromise of existing dentition, and significant bone and soft tissue defects associated with the potential implant sites, especially in the esthetic zone. Achieving sustainable outcomes for such patients requires the prosthodontist or restorative dentist to develop close professional interaction with oral and maxillofacial surgeons, periodontists, orthodontists, and endodontists as well as dental technicians and staff associated with biomedical modeling centers.

An important objective of this edition is to reinforce the basic principles of fixed and removable prosthodontics. In order to develop an appropriate level of expertise in implant prosthodontics, the clinician must have a firm foundation in conventional fixed and removable prosthodontics. Therefore, topics such as occlusal schemes used for the various types of implant prostheses, as well as designing proper resistance and retention form into customized abutments where the prosthesis is to be retained with cement, the principles of smile design and esthetics, and other topics pertinent to the fundamentals of prosthodontics are emphasized and discussed as needed.