Korsch Michael, Robra Bernt P, Walther Winfried
Dental Academy for Continuing Professional Development, Karlsruhe, Germany.
Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany.
Clin Oral Implants Res. 2015 Apr;26(4):e47-e50. doi: 10.1111/clr.12329. Epub 2014 Jan 20.
Implant counseling and information must enable the patient to make his/her own independent decision (informed consent). However, there are indications that patient counseling and information often provides incomplete information.
In 40 implant counseling and information sessions, all questions raised by the patients were documented during the session. The patient's decision for or against implant therapy was recorded 3 months later. The influence of the patient's age and gender, the type of insurance, the number of questions asked by the patient, the number of required implants, and the need for augmentation on the patient's decision were determined.
Sixty-five percentage of the patients decided in favor of implant-prosthetic therapy. One significant factor influencing the patient's decision was the need for augmentation. Fifty-four percentage of the patients who decided in favor of the implant intervention needed augmentation. Eighty-six percentage of the patients who refused the intervention could have been treated only in conjunction with pre-implantological augmentation. The need for augmentation was associated with a higher mean number of questions per counseling and information session (3.7 vs. 2.3) (n.s.). Patients who had opted for implant treatment asked significantly fewer questions (2.5) than patients who refused the treatment (4.4). The patient's age and gender, the type of insurance, or the number of implants required had no influence on decision-making.
Patients who ask many questions rather tend to refuse the implant treatment. The need for augmentation was also associated with a significantly higher percentage of implant refusal. These results suggest that patients with an indication of augmentation require particularly detailed and comprehensive counseling and information.
种植体咨询和信息提供必须使患者能够做出自己的独立决定（知情同意）。然而，有迹象表明，患者咨询和信息提供往往不完整。
在40次种植体咨询和信息提供过程中，记录患者在咨询期间提出的所有问题。3个月后记录患者对种植治疗的支持或反对决定。确定患者的年龄和性别、保险类型、患者提出的问题数量、所需种植体数量以及植骨需求对患者决定的影响。
65%的患者决定接受种植修复治疗。影响患者决定的一个重要因素是植骨需求。决定接受种植干预的患者中有54%需要植骨。拒绝干预的患者中86%只有在进行种植前植骨的情况下才能接受治疗。植骨需求与每次咨询和信息提供的平均问题数量较多相关（3.7对2.3）（无统计学意义）。选择种植治疗的患者提出的问题（2.5个）明显少于拒绝治疗的患者（4.4个）。患者的年龄和性别、保险类型或所需种植体数量对决策没有影响。
问问题多的患者往往倾向于拒绝种植治疗。植骨需求也与种植拒绝率显著较高相关。这些结果表明，有植骨指征的患者需要特别详细和全面的咨询和信息。
