口腔种植学是口腔教育中较新的学科。虽然现在我们都有共识，种植⽛相关的理论知识，⽆论是治疗⽅案的规划，还是后期的随访和维护，对于每⼀个职业⽛医都⾮常重要。然⽽，在当下全球的口腔医学本科培养体系中，它的覆盖程度还远远落后于其重要性。 在此背景下，香港大学口腔医学院联合⾹港⼤学的线上教育专业团队，历时⼀年有余，设计并制作了这门为期五周的⽹络公开课，旨在传播以循证医学为基础的，客观、全⾯的⽛种植学相关知识。这门课程⾯向全球，双语教学，完全免费。学员将在20 多位全球领先的种植学专家的带领下，完成五个模块，系统地学习⽛种植学。
“Begin with the end in mind" 以终为始
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来自 The University of Hong Kong 的课程
口腔种植学 （Implant Dentistry）
27 个评分
从本节课中
种植牙和患者
患者选择和治疗计划是种植牙成功的基石。本模块中，我们将评估所有系统性，解剖学和行为上的风险，并帮助你设计综合治疗计划中的所有步骤，以满足患者的实际需求。
与讲师见面
Nikos MattheosClinical Associate Professor in Implant Dentistry
The University of Hong Kong
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.
