植牙 VS 杜牙根 (二) Root canal treatment part 2

上回講到在杜牙根與植牙成功率相約前提下，還有甚麼因素要考慮呢? 
Checklist :

1.對病人自己本身，天然牙齒的重要性:

    a) 生活質量 (Quality of Life):
        在這個研究當中Gatten (2011)，發現了兩者對病人的生活質量沒有太大分別，雖然有部份病人覺得植牙好像跟真牙感覺不一樣。另外多數病人都傾向選擇保存真牙。

    b) 感覺回饋 (Sensory feedback) :
       植牙好像跟真牙感覺不一樣，部分原因可能是因為植牙是沒有牙周韌帶(periodontal ligament)，所以無法提供一些神經感覺給大腦去做反饋( Feedback)。例如，病人使植牙時比較難感覺是否用得太大力，而有機會導致負荷過重的情況發生(overloading)。當然，講緊的是全口沒有牙齒的情況會較明顯，而部分缺失牙齒仍然有其他牙齒提供回饋，影響較少。



    c) 影響將來治療:
       植牙跟牙骨連結在一起，將來是無法移動的。換言之，會影響到將來治療，如箍牙。    

     d) 可能的負面心理效果:
         很多病人會覺得剝一隻少一隻，另外他們也未必能夠接受口腔裏有假的東西。
        
     e) Medical history (病歷): 
       如果比較難止血，糖尿病，吸煙等，都會對植牙有不同程度的影響，甚至不適合植牙。


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Last time I mentioned that under the premise of the similar success rate of root canal treatment and dental implants, what other factors should be considered?

Checklist:


1. To the patient himself, the importance of natural teeth:


    a) Quality of Life:

        In this study, Gatten (2011) found that the two did not have much difference in the quality of life of patients, although some patients felt that dental implants did not feel like real teeth. In addition, most patients tend to choose to save real teeth.


    b) Sensory feedback:

       Dental implants seem to feel different from real teeth, partly because dental implants do not have periodontal ligaments, so they cannot provide some neural sensations to the brain for feedback. For example, it is more difficult for a patient to feel that they are using too much force when implanting a tooth, and there is a chance that it will cause an overload. Of course, it is important to note that the situation of no teeth in the entire mouth will be more obvious, and some missing teeth will still have other teeth to provide feedback, which has less impact.





    c) affect future treatment:

       Dental implants are linked to the bones and will not move in the future. In other words, it will affect future treatments, such as bracing.


     d) Possible negative psychological effects:

         Many patients feel that one is missing, and they may not be able to accept that there is something fake in their mouth.

        

     e) Medical history:

       If it is difficult to stop bleeding, diabetes, smoking, etc., it will have different degrees of impact on dental implants, and it is not even suitable for dental implants.

Source:

1. J Endod. 2011 Jul;37(7):903-9. doi: 10.1016/j.joen.2011.03.026. Epub 2011 May 17.Quality of life of endodontically treated versus implant treated patients: a University-based qualitative research study.Gatten DL1, Riedy CA, Hong SK, Johnson JD, Cohenca N.