Are Our Patients in Favour of Implantoprosthetic Rehabilitation?

Temeljem dvanaestogodišnjeg iskustva možemo odgovoriti potvrdno. Drugo je pak pitanje jesu li bolesnici, unatoč svakodnevnim promidžbama pojedinih stomatoloških ordinacija u medijima, dovoljno obaviješteni o stvarnim mogućnostima takve rehabilitacije. Usporedimo li podatak o množini pregledanih bolesnika upućenih za ugradnju usatka s množinom onih kojima su usadci ugrađeni, tada ćemo utvrditi da je samo u 30% slučajeva postavljena indikacija za takvu vrstu rehabilitacije. A kada utvrdimo da dio naših bolesnika odustane zbog financijskih razloga, zbog duljine trajanja takva postupka, pa zbog lokalnih i općih kontraindikacija, tada je navedeni postotak osjetno manji. Danas je u Europi na tržištu 253 različitih implantoloških sustava, a u njemačkim stomatološkim ordinacijama ugradi se u godini 250.000 usadaka, bez obzira na činjenicu što zdravstveno osiguranje ne podmiruje troškove takva liječenja. Teško da ćemo se uskoro moći mjeriti s takvim zemljama, no ipak moramo težiti takvoj edukaciji naših studenata, doktora stomatologije i specijalista da mogu postaviti indikacije i sudjelovati u različitim fazama navedene rehabilitacije i poslije u održavanju usatka te protetske nadgradnje. Bolesnicima ne smijemo obećati neostvarivo, moramo izbjegavati kompromisna riješenja, često na bolesnikov nagovor. Temelj je uspjeha planiranje i timski rad u koji je uključen i zubni tehničar. S druge pak strane u naših bolesnika nije dovoljno razvijena svijest o održavanju higijene usne šupljine, a još manje navika redovitih kontrola nakon implantoprotetske rehabilitacije. Prikazat ćemo nekoliko bolesnika motiviranih za implantoprotetsku rehabilitaciju u kojih zbog različitih kontraindikacija nije učinjena implantacija pa su pacijenti opskrbljeni klasičnim protetskim radovima. S druge strane prikazat ćemo da katkada i u bolesnika koji dolaze s dotrajalim protetskim radovima i parodontopatijom implantoprotetska rehabilitacija daje dobre rezultate.Based on 12-year experience we can answer affirmatively. Another question is whether patients, in spite of the daily promotions in the media by some dental surgeries, are sufficiently familiarised with the realistic possibilities of such rehabilitation. If we compare data on the number of examined patients referred for construction of an implant with the number of those in whom implants had been constructed, it can be concluded that only 30% of the cases showed indication for such rehabilitation. As a number of our patients give up because of financial reasons, the duration of the procedure, or because of local and general contraindications, the aforementioned percentage is considerably smaller. In Europe today there are 253 different implantological systems on the market, and in German dental surgeries 250 000 implantations are performed each year, regardless of the fact that the public health insurance does not cover the costs of such treatment. Although we shall never be able to compare ourselves with such countries, we have to aspire to educate our students, dentists and specialists in order to enable them to define indications and participate in the various phases of such rehabilitation, and later in the maintenance of implants and prosthetic restorations. We must not give unrealistic promises to patients, and compromising solutions should be avoided, often in spite of the patient’s contrary insistence. The basis of success is in the planning and teamwork, in which the dental technician is also included. On the other hand, our patients are not sufficiently conscientious regarding the maintenance of oral cavity hygiene, and still less the habit of regular check-ups after implantoprosthetic rehabilitation. We will present several patients motivated for implantoprosthetic rehabilitation, in whom, because of different contraindications, implantation was not carried out, and the patients were supplied with classical prosthetic devices. We will also demonstrate that occasionally implantoprosthetic rehabilitation leads to good results in patients with worn out prosthetic devices and periodontopathy