Hello and welcome to this discussion on treatment planning. I welcome you to this discussion on treatment planning under the title “Begin with the End in Mind”. “Begin with the end in mind” is the second paradigm of a book that is called, The 7 Habits of Highly Effective People by Stephen Covey. And the first three habits are well suited to delineate the steps that we have to take in treatment planning. These steps, the first three are: that to “Be proactive”, the second step is to “Begin with the end in mind”. And the third step is to “Put first things first”. We have these habits that are normally constructed to be used in daily life, but they can, they can really be easily extrapolated to the treatment planning situation. If we have these three first paradigms that bring us to the independence stage, there is a fourth paradigm that is called, “Think Win-win" the fifth paradigm, “Seek to understand, then to be understood”, and the sixth paradigm, “Synergize”. That will get you to the level of interdependence. These four, five and six habits we don't discuss in this content. And we start out with our first paradigm, “Be proactive” What does that mean for treatment planning? It means that we create a mission statement. You can discuss that for a long time, but then you come to probably, a mission statement that is very reasonable to establish and satisfy the patient's needs for esthetics and function under healthy conditions. These sentences have three very essential words. Namely, esthetics, and function, and health. The key factors for reconstruction. Now, if I have this mission statement, I go to the second, to the topic of this lecture, namely, “Begin with the end in mind”. What does that mean in treatment planning? It means that I ask the question, how does this patient's dentition look like when treatment is finished and she leaves the office? So, in other words, I hope that she will be smiling and at full function under healthy conditions. Now in this instance here, you have an edentulous patient, and we could say that there are basically two options of how this patient will look like. Either they are going to be two locators, placed under a full denture. And that is, then, of course, the end of the treatment. And this will substantially improve the chewing function of this particular patient. But not everybody wants to have removable dentures. Some people may want to have a fixed reconstruction. And here, I have here a case that starts out with a mutilated dentition where about everything is wrong that can be wrong. You see, there is periodontal disease, you see the caries, you see loss of function. You see that this molar has completely lost its attachment, and you have already a dentureless area. If we now think about how he wants to look like, we have to remind ourselves that this patient is a very affluent patient who wants absolutely a fixed reconstruction. And yet, the circumstances for him to end up with this are very slim. Because, if we now take out all the teeth that are really jeopardized in their health, like all these front teeth, we end up with almost an edentulous jaw in the maxilla. And almost an edentulous jaw in the mandible. So, we are at the same spot as the previous patient, and yet, this patient does not want a removable prosthetic. So, immediately, we are going to look at the anatomical structures in order to have an idea of where we can place our implants. We will use six implants here in the maxilla, and we will use two to begin with in the mandible. But then, we need do other, do other implants in the mandible that will allow us to construct an extension bridge towards the canine. So here, you have all the implants placed, and now you have the fixed reconstruction. So you see, the end was completely different, even though the starting point was very similar. So, in the end, we have two fixed bridges in the maxilla, and we have three fixed bridges in the mandible. And, we have these three in the mandible because of the bending of the mandible when maximal opening it. And we have two in the maxilla in order to minimize technical complications, such as porcelain chippings. So this was the second paradigm.
