4 Protocols for Predictable Aesthetic Dental Restorations
inaccuracies. This usually results in underesti-
mating disease severity, and necessitates more
complex and costly treatment later. The aim of
risk assessment is to tailor treatment plans
individually according to a patient’s dental
profile, thereby moving away from a ‘repair
model’ to a ‘wellness model’. This will discour-
age disease recurrence and encourage long-term
oral health.
Many studies have cited that the two major
dental diseases, caries and periodontal disease,
are preventable. This assertion is based on iden-
tifying and reducing risk, and implementing
appropriate preventive measures.
4
For example,
the diagnosis of severe periodontal disease does
not imply a high risk of periodontal disease.
Diagnosis assesses current clinical findings, while
risk assesses or predicts future disease patterns.
This is because traditional diagnosis is two-
dimensional (2D) (clinical examination and radi-
ographs), which indicate disease severity. The
third dimension, risk assessment, is omitted. A
three-dimensional (3D) diagnosis for periodontal
disease incorporates the following (Fig. 1.7):
! Clinical examination and findings
! Radiographic assessment
! Risk prediction
Using a 2D diagnosis, all patients will be pre-
scribed the same treatment, irrespective of risk.
However, when individual patient risks are
incorporated in a 3D diagnosis, the treatment
plan differs for each patient, even though the 2D
diagnosis is identical. Periodontal risk factors are
crucial when considering implants or aesthetic
prostheses. For low-risk patients, simple
Figure 1.4 CT scan showing insufficient bone for endosseous implant placement (image courtesy of Dr Alan Sidi, UK).
inaccuracies. This usually results in underesti-
mating disease severity, and necessitates more
complex and costly treatment later. The aim of
risk assessment is to tailor treatment plans
individually according to a patient’s dental
profile, thereby moving away from a ‘repair
model’ to a ‘wellness model’. This will discour-
age disease recurrence and encourage long-term
oral health.
Many studies have cited that the two major
dental diseases, caries and periodontal disease,
are preventable. This assertion is based on iden-
tifying and reducing risk, and implementing
appropriate preventive measures.
4
For example,
the diagnosis of severe periodontal disease does
not imply a high risk of periodontal disease.
Diagnosis assesses current clinical findings, while
risk assesses or predicts future disease patterns.
This is because traditional diagnosis is two-
dimensional (2D) (clinical examination and radi-
ographs), which indicate disease severity. The
third dimension, risk assessment, is omitted. A
three-dimensional (3D) diagnosis for periodontal
disease incorporates the following (Fig. 1.7):
! Clinical examination and findings
! Radiographic assessment
! Risk prediction
Using a 2D diagnosis, all patients will be pre-
scribed the same treatment, irrespective of risk.
However, when individual patient risks are
incorporated in a 3D diagnosis, the treatment
plan differs for each patient, even though the 2D
diagnosis is identical. Periodontal risk factors are
crucial when considering implants or aesthetic
prostheses. For low-risk patients, simple
Figure 1.4 CT scan showing insufficient bone for endosseous implant placement (image courtesy of Dr Alan Sidi, UK).
