Association with maxillary impalnt retainet overdentures.

Indeed, whne the time

needed for postplacement adjustment and repairs was considered, each
remoyable implant-supported prosthesis averaged four times as many
postplacement adjusment and twice as many repairs as did the fixed implant
supported prostheses. In this content, ball-retained-overdentures needed more
repairs and adjusments than bar-retained overdentures.
Decision making in Treatment Planning
In prosthetic treatment planning for older adults the choice of and
prognosis for treatment are determined partly by the patients situation and
partly by the clinicians background and evaluation of the situation (Table 4-7).
For example, patients with higher educational level are more likely to choosea
more sophisticated solution that takes comfort and esthetics into account.
Previous personal or family experiences with fixed or removable prostheses are
important for the patients actual choice. The patients commitment to conserve
and maintain remaining teeth, as well as his pr her ability to maintain
appropriate oral hygiene, are important for the prognosis of the dentition. Finally,
the patients economic situation is often a seriously limiting factor in the choice
of treatment.
When proposing a realistic treatment plan, the clinician considers the
patients demand and the oral and dental situation. Quite often, however, other
factors intervene (see Table 4-7). Contohnya seorang dokter gigieducational level
and skill often, and should, limit the choice; those with the limited experience in
prosthodontics are likely to propose ea simpler solution so the prosthesis can be
corrected and remodeled if its fit is not optimal. Also it is normal to choose
teknik dan treatment solution with which one has had good personal experience.
As a dentist is is important to be commited to ones clinical work and to strive for
excellence. However, when treating older adults, it is particularly important to
put the patient first, not only with regard to dental and prosthetic treatment, but
as a human being. The implies among other rhings that clinican takes the
patients socio-economic situation into consideration and proposes a treatment
the patient will and can afford to pay; the clinician never should propose an
expensive and sophisticalted teratment which in biologically unfounded.
Some patient-related guidelines such as oral hygiene, degree of
coo[eration, periodontal status, tooth loss, and expected adaptive capacityto a
prothesis may be used in choosing between different prosthetic treatment
modabilities (Table 4-S).
In a patient with good oral hygiene and a high level cooperation, there is a
multitude of treatment alternatives, to those listen in the above table. However,
if the patient neglects oral hygiene in spite of repeated instructions, a
nondefinitive treatment solution should be designed. A removable partial denture
ca be transformed and extended if some teeth have to be romeve , and a fixed
partial denture might be constructed in the future, if oral hygiene improves.
Similiarly, an overdenture can be transformed into a conventional complete
denture if cooperation remains poor, and attachment can be placed or

combination of fixed and removable partial denture constructed id f the degree

of cooporation improves. In patients with poor oral hygiene who likely to show
poor adaptation to removable dentures, it may be better not to replace the
missing teeth so as not to advance the destruction of the remaining teeth.
Eventually, an acid-etched partial denture may be used to replace one or two
missisng anterior teeth.