Mazurat R D, Love W B, Pesun I J
Department of restorative dentistry, faculty of dentistry, University of Manitoba, Winnipeg.
J Can Dent Assoc. 1994 Sep;60(9):814-8.
Prosthetic planning is critical to the success of the diagnostic phase of implant therapy and is used to establish fixture numbers, position and the optimal occlusal scheme, based on the design of the definitive prosthesis. The prosthetic needs of the patient, anticipated functional and parafunctional forces, restoration fabrication and serviceability are all considered. A clear picture of the intended rehabilitation is provided to the surgical team and expedites the consultation between implant team members. Comprehensive diagnostic planning using mounted diagnostic casts and diagnostic wax-ups will provide definite parameters for fixture number, position and alignment, and permit the fabrication of radiographic and surgical templates as the treatment sequence progresses. Patients need to be informed of the time and expense involved in the diagnostic phase of implant therapy prior to the initiation of the planning process. The practitioner conducting the selection and planning phase is entitled and should expect financial remuneration commensurate with the time and effort required to achieve the objectives of this phase of implant therapy. The Planning Process Using mounted diagnostic casts and diagnostic wax-ups: 1. Establish fixture numbers and position; 2. Establish the optimal occlusal scheme; 3. Design the definitive prosthesis; 4. Fabricate a surgical template. Design Principles--Summary 1. The location and number of fixtures dictates the prosthetic design and influences restorative success. 2. A restoration must be designed to distribute forces to the fixtures without overloading the bone, and therefore be able to withstand anticipated functional and parafunctional loading. 3. Design for optimal function and esthetics with a regard for patient comfort and maintenance.
修复体规划对于种植治疗诊断阶段的成功至关重要，它用于根据最终修复体的设计确定种植体的数量、位置和最佳咬合方案。需要综合考虑患者的修复需求、预期的功能和非功能力、修复体制作以及耐用性。向手术团队清晰展示预期的修复情况，可加快种植团队成员之间的会诊。使用上架诊断模型和诊断性蜡型进行全面的诊断规划，将为种植体的数量、位置和排列提供明确参数，并随着治疗进程制作放射影像模板和手术模板。在开始规划过程之前，需要告知患者种植治疗诊断阶段所需的时间和费用。进行选择和规划阶段的从业者有权获得并应期望得到与实现种植治疗此阶段目标所需时间和精力相称的经济报酬。使用上架诊断模型和诊断性蜡型的规划过程：1. 确定种植体数量和位置；2. 确定最佳咬合方案；3. 设计最终修复体；4. 制作手术模板。设计原则——总结1. 种植体的位置和数量决定修复体设计并影响修复成功。2. 修复体的设计必须能将力分散到种植体上，避免骨组织过载，因此必须能够承受预期的功能和非功能负荷。3. 设计要兼顾最佳功能和美观，同时考虑患者舒适度和维护。
