NMDA Journal Summer 2020

New Mexico Dental Journal, Summer 2020 14 Case Selection to Optimize Success in Implant Dentistry By Steven Holbrook, DMD Implant Dentistry has become the standard of care in the replace- ment of missing teeth. One of the most important aspects of suc- cessful implant dentistry is case selection. There are many facets involved in case selection. This arti- cle will outline an approach to the process of case selection that should help optimize success in implant dentistry. There are several guiding principles that I try to keep inmind as I begin the process of diagno- sis, treatment planning, and case selection. Ste- ven Covey reminds us that wemust begin with “First Things First” so it is vital that we complete a thorough examination prior to providing treatment for our patients. Our examination provides us with the information that we need to complete our diagnosis and begin the pro- cess of treatment planning and case selection. As we begin to prepare our treatment plan, it is vital that we remember to “begin with the end inmind.” Wemust have an idea of our patient’s desires and begin to shape their expectations as we continue this process with them. Burton Melton said that, “Implant dentistry is a pros- thetic discipline with a surgical component.” It is important to remember that patients want teeth and not titanium screws. So, implant placement should be planned froma pros- thetic perspective andwith the patients’ needs and desires inmind. Carl Misch said, “An axiomof implant treat- ment is to provide the easiest cost-effective treatment that will satisfy the patient’s needs and desires.” There are somany options for treatment in implant dentistry, some of which are quite complex. If we can simplify the treat- ment and satisfy the patient’s expectations then we will have provided an excellent service for the patient. John Kois reminds us that as we prepare the treatment plan, “The patients pre- senting anatomymay determine the esthetic outcome of the case.” There are limitations as towhat wemay accomplish with dental treat- ment andwe do need to keep this inmind as we discuss the findings of our examination with our patient. One of themost important and overlooked components of a comprehensive examination is the patient interview. This is accomplished at the beginning of the examination process and consists of a conversation between the doctor and patient. The dentist needs to develop an idea of what the patient values. How important is their dental and overall health to them?What has been their experience with dental treat- ment in the past? Howdo they feel about den- tal treatment? Do they suffer fromanxiety related to dental treatment or their health in general? Are they willing tomake a commit- ment to improving their dental and overall health? Themost important thing that we can do during this process is listen to our patients, pay attention towhat they are saying, take notes so they knowwhat they are saying is important to us. It is important for the doctor to take the time to identify what the patient desires to achieve with dental treatment and to get a feeling for the patient’s expectations. The dentist can determine what the patient perceives to be their problems and concerns. The dentist can identify what they consider to be barriers to treatment. Spending this time gives the dentist