2020 Volume 33 Issue 2 Pages 142-149
The purpose of prosthetic treatment is to try to improve the main complaint of the patient and achieve recovery of the form and function that have been lost. To do so, comprehensive dental treatment should be provided. However, it is not always possible to provide all patients with the treatment that the dentist considers ideal. It is also impossible to completely eliminate the causes of collapse or the risks, even if comprehensive treatment is provided. Therefore, the most important point is to diagnose while predicting the causes of collapse based on various factors, and to reflect the risks in the treatment policy. While the risks are roughly classified into environmental factors, biological factors and composite factors, the environmental and composite factors that are variable need to be understood by the patient sufficiently to ensure stability after the treatment.
The major hindrances to long-term durability after prosthetic treatment are infection and force. Damages caused by force, in particular, must be taken into consideration, especially after installing an implant prosthesis. The types of force can be roughly classified into pathogenic occlusion, parafunction, excessive force, and dietary habit. Even though they may all be categorized as forces, which factors caused adverse effects and resulted in collapse must be analogically inferred, since there are differences among patients. Treatment is then provided to improve these factors by using measures that are practical and feasible while always taking into account the priorities. It is recommended that the treatment policy should be determined with consideration of various elements, including the values, economic background and age of the patient.
No effective and sustainable measures against forces that are highly harmful have been identified. Even so, it is necessary to steadily and repeatedly communicate and share the risks with the patient.
We must face our patients while keeping in mind that there is one diagnosis and diverse treatment policies.
