Schweitzer Fachinformationen
Wenn es um professionelles Wissen geht, ist Schweitzer Fachinformationen wegweisend. Kunden aus Recht und Beratung sowie Unternehmen, öffentliche Verwaltungen und Bibliotheken erhalten komplette Lösungen zum Beschaffen, Verwalten und Nutzen von digitalen und gedruckten Medien.
Best Practices in Implant Dentistry meets the need for a thorough, accessible guide to the knowledge and skills required to provide dental implant treatment. Aimed at all members of the dental team, from general practitioners to surgeons to nurses, this book begins with regulations, standards, and patients' safety before moving through well-organized sections on clinical aspects, including biomechanics, implant design, human factors, patient assessment, and implant maintenance. The growth of nanotechnology and digital workflows in the field of implant dentistry are also covered.
Best Practices in Implant Dentistry readers will also find:
Best Practices in Implant Dentistry is fully informed by the latest approaches and institutional guidelines. It is a must-have purchase for dental professionals at every level who work with implants, including dentists, dental nurses, and oral surgeons.
The Authors
Simon Wright MBE BDS MSc PGCTLCP FHEA FDTFEd (RCSEd) SMFGDP(UK)A FCGDent is Professor of Dental Implantology at the School of Health and Society, University of Salford, UK Clinical Director of ICE Postgraduate Dental Institute and Hospital, and Principal Partner at Glencairn Practice Group.
Cemal Ucer BDS MSc PhD (OMFS) MFDS RCS (Eng) FCGDent FDTFEd RCS Ed is a Specialist Oral Surgeon, Professor in Dental Implantaology at the School of Health and Society, University of Salford and Clinical Director at ICE Dental Postgraduate Institute and Hospital in the UK.
Rabia Khan BDS MSc Oral Path PhD Medicine PgC Oral Surgery PgC Med Ed PgC OELP PgDip Aes Med FCGDent FICD FPFA FAoME FHEA is Education Director and Research Lead at ICE Postgraduate Dental Institute and Hospital and Professor at the School of Health and Society, University of Salford, UK.
Foreword xi
Preface xiii
Acknowledgements xv
Chapter 1 Standards in Implant Dentistry 1
1.1 Introduction 1
1.2 Aims for Standards in Implant Dentistry 4
1.3 Key Features and Objectives of the Standards in Implant Dentistry 5
1.4 The Legal Standard of Care 7
1.5 The Clinical Standard of Care 7
1.6 Training Standards in Implant Dentistry Domains of Competence and Clinical Application 7
1.6.1 Level of Evidence 9
1.6.2 Grading System 9
1.7 Other Sources of Guidance in Implant Dentistry 11
References 12
Chapter 2 Assessment 13
2.1 Introduction 13
2.2 Dental History 14
2.3 Medical History 15
2.4 Intraoral and Extraoral Examination 16
2.5 Provisional Diagnosis 18
2.6 Investigations and Diagnostic Imaging 18
2.7 Definitive Diagnosis 20
2.8 Treatment Planning 20
2.9 Definitive Treatment Plan 24
2.10 Complexity 26
2.11 Preparation for Surgery 26
References 28
Chapter 3 Patient Management 29
3.1 Introduction 29
3.2 Medically Compromised Patient 31
3.3 Patient Information 35
3.4 Patient Education 40
3.5 Managing Expectations 41
3.6 Patient on Referral 43
3.7 Patient Records 44
3.7.1 Implant Pro 44
References 46
Chapter 4 Risk Management 49
4.1 Introduction 49
4.2 Human Factors 53
4.3 Definition of Success 55
4.4 Evidence- Based Treatment Planning Methodology 55
4.5 Treatment Objectives and Endpoints In Implantology 56
4.6 Patient- Related Systemic Factors 57
4.7 Patient- Related Local Risk Factors 58
4.8 Clinical- Related Risk Factors 61
4.9 Surgical Risk Factors 63
4.10 Strategies for Management of Risk Factors Relating to Human Factors 66
References 67
Chapter 5 Consent 69
5.1 Introduction 69
5.2 Valid Informed Consent 70
5.3 Patient Centred 70
5.4 Patient Information and Education 71
References 71
Chapter 6 Imaging 73
6.1 Introduction 73
6.2 Imaging in Treatment Planning 74
6.2.1 Conventional Techniques 75
6.2.2 Sectional or Three- dimensional Imaging Techniques 75
6.3 Imaging During Surgery 76
6.4 Imaging Post Treatment and Review 78
References 78
Chapter 7 Pain Control 81
7.1 Introduction 81
7.2 Acute Dental Pain 82
7.3 Preoperative Prophylaxis 82
7.4 Surgical Anaesthesia 83
7.5 Postoperative Pain 84
References 85
Chapter 8 Anxiety 87
8.1 Introduction 87
8.2 Patient Management 88
8.3 Preoperative Care, Administration and Postoperative Care in Anxiety Management 88
8.4 Communication and Professionalism 89
References 90
Chapter 9 Surgical Management 91
9.1 Introduction 91
9.2 Surgical Preparation 92
9.3 Bone and Soft Tissue Management 95
9.4 Implant Placement 98
9.5 Exposure and Temporisation 101
9.6 Organisation 101
References 102
Chapter 10 Restorative Approach 105
10.1 Introduction 105
10.2 Soft Tissue Management 106
10.3 Implant Abutment and Super Structure 108
10.4 Provisional Restoration 109
10.5 Restorative Design and Materials 110
10.6 Clinical Procedures 112
10.7 Aesthetics 112
10.8 Occlusion 114
10.9 Patient Notes 116
References 116
Chapter 11 Postoperative 119
11.1 Introduction 119
11.2 Pain Control 119
11.3 Infection 120
11.4 Suture Removal 121
11.5 Review and Follow- Up 121
References 122
Chapter 12 Maintenance 123
12.1 Introduction 123
12.2 Recall Interval 123
12.3 Radiographic Review 124
12.4 Clinical Examination 125
12.5 Oral Hygiene and Patient Education 127
12.5.1 Host Susceptibility 127
12.5.2 Prosthetic Design 128
12.5.3 Patient Factors 128
References 128
Chapter 13 The Digital Workflow in Implant Dentistry 129
13.1 Introduction 129
13.2 Components and Steps of the Digital Implant Workflow 130
13.2.1 Digital Diagnostic Impression 130
13.2.2 Cone Beam Computed Tomography 131
13.2.3 Digital Implant Treatment Planning 131
13.2.4 The Digital Surgical Guide 132
13.2.5 Fabricated Temporary Prosthesis 133
13.2.6 Guided Implant Surgery 133
13.2.7 Digital Implant Impressions 135
13.2.8 Customised Prosthesis Fabrication 135
Reference 136
Chapter 14 Complications 137
14.1 Introduction 137
14.2 Patient Management 137
14.3 Documentation 139
14.4 Diagnosis 139
14.5 Surgical Complications 140
14.6 Restorative Complications 141
14.7 Peri- Implant Disease 143
14.7.1 Supplemental Treatment 145
14.7.2 Systemic Antibiotics 145
14.7.3 Non- surgical 146
14.7.4 Surgical 146
14.7.5 Modifying Factors 147
14.7.6 Summary of Peri- implant Disease 147
References 148
Chapter 15 Regulation and Legislation 151
15.1 Overview of Regulation and Legislation 151
References 153
Chapter 16 Team Management 155
16.1 Introduction 155
References 158
Chapter 17 Clinical Audit 159
17.1 Introduction 159
17.2 Decontamination 160
17.3 Treatment 160
17.4 Continuing Professional Development and Skill Assessment 161
17.5 Equipment and Devices 161
References 162
Chapter 18 Communication 163
18.1 Overview of Communication 163
18.2 Patient Education 165
18.3 Communication Barriers 165
18.4 Informed Consent 165
18.5 Interprofessional Communication 166
18.6 Conclusion 166
References 166
Chapter 19 Human Factors 167
19.1 Introduction 167
19.2 Threat and Error Management 168
19.3 Team Resource Management 168
19.4 Checklists 169
19.5 Reporting 170
19.6 Standard Operating Protocol 171
19.7 Additional Information 171
References 171
Chapter 20 Technical Procedures 175
20.1 Introduction 175
20.2 Communication 175
20.3 Restorative Design 176
20.4 Materials 176
20.5 Disinfection 177
References 178
Chapter 21 Education and Training 179
21.1 Introduction 179
21.2 Personal Development Plan 180
21.3 Mentoring 180
21.4 Qualifications, Competence and Courses 181
References 182
Appendix A 183
Appendix B: Standard Operating Procedures 187
Index 219
Dental implant treatment has become routinely available in the UK for the management of tooth loss to restore dental function and aesthetics [1]. Currently, implant treatment is provided by dentists from different backgrounds and training, ranging from general dental practitioners to specialists in oral and maxillofacial surgery. Apart from guidance by the Faculty of General Dental Practice UK (FGDP(UK)) in Training Standards in Implant Dentistry (2016) [2] that set the standards for training in implant dentistry for dentists who wish to practise dental implant treatment, there are no specific national guidelines in this field. Nevertheless, it should be noted that Training Standards in Implant Dentistry has been adapted by the General Dental Council (GDC) to set the training standards for acquiring clinical competence in this field of dentistry.
Delivery of satisfactory dental implant treatment and its long-term success and maintenance require complex and invasive surgical and restorative procedures using a variety of highly specialised products, biomaterials and equipment. These interact with the host tissues both biologically and mechanically [3]. Satisfactory delivery of dental implant treatment also requires a well-trained team of dental professionals, therefore dentists who provide dental implant treatment have a legal and ethical duty to develop and maintain up-to-date evidence-based knowledge and competence in the field. The treatment provided should involve the use of evidence-based techniques and products, with the exception of a clinical trial consented to explicitly by the patient. The patient is entitled to, and expects, that the members of the dental team have the right skills, and that the products they use are safe and proven [3]. The patient is also entitled to have adequate information and advice on the alternative techniques, products, risks and outcomes, as well as the experience and scope of practise of the clinician proposing to carry it out before autonomously deciding to commence treatment [4].
Dental implant treatment is mainly an elective dental treatment option that requires complex and invasive procedures, followed by a need for meticulous life-long maintenance. Patients' understanding of the nature and the mechanics of treatment, as well as their expectations regarding a realistic result, can often be lacking Figure 1.1. Thus, as in all elective surgery, dental implant treatment requires a higher standard of patient education and documentation, as well as meticulous attention to detail throughout every stage of treatment, from assessment and planning to delivery of treatment and maintenance phases.
These dynamic standards are intended to be good practice guidelines that could be applied to any clinical practice to promote safety and quality of care, rather than didactic or prescriptive rules that dictate how treatment should be delivered. Training Standards in Implant Dentistry is intended for the whole dental implant team. It covers all stages of treatment from assessment and surgery to maintenance phases. In this context, greater responsibility rests with the most experienced member of the team, particularly within the domains of professionalism, communication, leadership and management [2].
FIGURE 1.1 Diagrammatic representation of dental implants in jaw.
The standard of implant dentistry refers to the expectations and requirements that dental professionals must meet when providing implant treatment to patients. This standard is established to ensure that dental implants are placed safely, effectively and with the best possible outcomes for the patient. The standard of implant dentistry is constantly evolving with new research and developments in implant technology and techniques [5].
The standard of implant dentistry encompasses several areas, including the application of knowledge, skills and competence, professionalism, teamwork, safety and the quality of treatment equipment and products, and the provision of adequate information, communication and consent to patients. Dental professionals must gain adequate training and experience appropriate to each level of complexity of implant treatment offered, and recognise and work within the limits of their competence. They must update their knowledge and skills regularly through structured continuing professional development (CPD) in implant dentistry and take care and prudence in applying their knowledge and skills to deliver the treatment satisfactorily as planned [6].
Dental professionals must also seek and act on feedback from patients, colleagues and their team using specific outcome measures, audit results and treatment outcomes regularly, and use these to improve any shortcomings in their dental implant practice. They must follow best practice guidelines and keep up to date with evidence-based developments in materials and procedures to ensure safe, predictable and effective treatment outcomes. The techniques, treatment and products used must be safe and predictable, and unproven products or techniques should be avoided unless carrying out clinical trials with explicit patient information and consent.
When providing implant treatment, dental professionals must work closely with patients and other colleagues in formulating patient-centred, evidence-based treatment plans to ensure that the desired expectations of the outcome can be achieved effectively for each patient. They must carry out a full risk assessment and consider the anatomical, functional, psychological and financial needs of the patient when formulating a treatment plan for each individual patient. They must also discuss the relative indications, advantages and disadvantages of the alternatives and provide adequate information, communication and consent to patients [7]. This includes informing patients of the expected prognosis of the proposed treatment with specific reference to the possible impact of each patient's individual systemic and local risk factors on the intended outcome, discussing the likely impact of the patient's dental and medical history, systemic condition and vulnerabilities on the prognosis of the proposed treatment, and providing itemised and transparent financial information.
Implant dentistry is a well-established and rapidly growing field in the United Kingdom, and there are a number of standard practices and guidelines that are followed to ensure the safety and success of implant treatments. Here are some of the key training standards in implant dentistry in the United Kingdom:
Implant dentistry in the United Kingdom is subject to strict regulations and standards to ensure the safety and success of treatment. Dentists who practise implantology must have the necessary qualifications and training, and must adhere to established guidelines for patient selection, treatment and follow-up care.
The key aim of Training Standards in Implant Dentistry is to provide good practice guidelines on the knowledge, clinical competence and skills required of dentists who provide dental implant treatment to enhance the national standards of quality and safety of care (Figure 1.2).
Training Standards in Implant Dentistry incorporates general principles from the GDC guidance to dentists, FGDP good practice guidelines as well as Committee of Postgraduate Dental Deans and Directors (COPDEND) curriculum for Dental Foundation Training.
FIGURE 1.2 Educational requirements and constraints.
Dateiformat: ePUBKopierschutz: Adobe-DRM (Digital Rights Management)
Systemvoraussetzungen:
Das Dateiformat ePUB ist sehr gut für Romane und Sachbücher geeignet – also für „fließenden” Text ohne komplexes Layout. Bei E-Readern oder Smartphones passt sich der Zeilen- und Seitenumbruch automatisch den kleinen Displays an. Mit Adobe-DRM wird hier ein „harter” Kopierschutz verwendet. Wenn die notwendigen Voraussetzungen nicht vorliegen, können Sie das E-Book leider nicht öffnen. Daher müssen Sie bereits vor dem Download Ihre Lese-Hardware vorbereiten.Bitte beachten Sie: Wir empfehlen Ihnen unbedingt nach Installation der Lese-Software diese mit Ihrer persönlichen Adobe-ID zu autorisieren!
Weitere Informationen finden Sie in unserer E-Book Hilfe.
