RESUMO
Missing maxillary central incisors can impact a patient's psychological wellbeing and smile aesthetics. Comprehensive management of such cases requires a multidisciplinary team approach, often involving orthodontic, paediatric and restorative dental teams. This paper summarises the various management options for these complex patients.
Assuntos
Estética Dentária , Incisivo , Humanos , Adolescente , Criança , Sorriso , MaxilaRESUMO
OBJECTIVES: 1. Assess treatment outcomes and oral health related quality of lifeM (OHRQoL) of hypodontia patients after completing dental treatment at the Eastman Dental Hospital and compare it with British public norms. 2. Assess factors which have an association with patients' reported OHRQoL. METHODS: Hypodontia patients who finished their treatment completed a 16-item questionnaire (UK oral health related quality-of-life measure), a list of four questions about their satisfaction with treatment received and a clinical assessment using modified USPHS criteria. RESULTS: The sample included 52 participants; median age 28 years (range 16 - 61 years). All participants had completed treatment for at least 6 months (range 6-60 months). Clinical assessment revealed 4 of the participants had complications requiring treatment. The OHRQoL mean scores of the sample were statistically significantly higher than the mean scores of the British public norms for most age groups (P⟨0.05). Factors which revealed association with OHRQoL scores were: gender (P=.047) and satisfaction with dental aesthetics (P=.006). CONCLUSIONS: Hypodontia patients following treatment reported higher OHRQoL average scores compared to the British population. Higher OHRQoL scores were related to patients' satisfaction with dental aesthetics after treatment. Females tended to report higher OHRQoL scores than males.
Assuntos
Anodontia/cirurgia , Saúde Bucal , Qualidade de Vida , Adolescente , Adulto , Humanos , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Resultado do Tratamento , Adulto JovemRESUMO
UNLABELLED: As part of treatment planning, options are presented to patients by dentists. An informal discussion takes place involving a cost-benefit analysis and a treatment plan is agreed. Evidence-based dentistry takes into account the best available literature, clinical experience and patient factors to guide the dentist. Dentists exert considerable influence on which treatment modality is selected. This paper focuses on the importance of patient factors which lead to less than ideal, clinically acceptable, treatment plans that nevertheless give patient satisfaction over the long term. Though no universally accepted healthcare model exists for restorative dentistry, patients' decisions are most influenced by their relationship with their dentist over factors such as time, access and cost. Letters should be sent to patients clarifying the nature of all proposed options, including advantages and disadvantages, complications, success rates, biological and financial costs and what happens if no treatment is carried out. CLINICAL RELEVANCE: Many psychological and social determinants influence patients'values and decision-making when planning for restorative dentistry. These lead to a treatment plan agreed between the patient and the dentist. Often an element of compromise is considered acceptable to both parties when the evidence would suggest an alternative treatment to be preferable.
Assuntos
Dentística Operatória , Planejamento de Assistência ao Paciente , Participação do Paciente , Adulto , Anodontia/reabilitação , Atitude Frente a Saúde , Periodontite Crônica/terapia , Comunicação , Análise Custo-Benefício , Coroas , Tomada de Decisões , Implantes Dentários , Prótese Dentária Fixada por Implante , Restauração Dentária Permanente , Relações Dentista-Paciente , Dentística Operatória/economia , Odontologia Baseada em Evidências , Feminino , Humanos , Incisivo/anormalidades , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Técnica para Retentor Intrarradicular , Determinantes Sociais da Saúde , Fatores de Tempo , Fraturas dos Dentes/terapia , Dente não Vital/terapia , Resultado do Tratamento , Adulto JovemRESUMO
Traditional methods of achieving anchorage for orthodontic treatment are dependant on the presence of a sufficient number of teeth with adequate root support. With the success and predictability of osseo-integration, dental implants are being used frequently to obtain absolute anchorage. This case report illustrates the successful use of implants with a combined orthodontic-restorative approach to obtain anchorage in a partially dentate patient to correct a transverse cross-bite (scissor bite) relationship. The implants were subsequently restored to replace missing posterior teeth. The importance of a multi-disciplinary approach to planning and close liaison between the orthodontist, surgeon and restorative dentist during the treatment phase are discussed.
