Protocols in classification of partially edentulous patients

Abstract

This paper shall discuss the importance of protocol application in modern dentistry. Literature data that include recommendations and consensuses in dental practice point out to their presence in available literature, printed papers, reviewed journals and supplements in the form of expert group conclusions. It should be noted that the protocols most commonly rely on valid postulates of different branches of medicine, supported by specific conditions of the environment in which they are implemented. Additionally, in our settings, applicable dentistry protocols are the result of requirements that institutions and practices should fulfill according to renewable accreditation, as well as following recommendations given in the good clinical practice guidelines with different binding obligations levels. Certain protocols offer therapeutic modalities categorized into classes intended to help users to select appropriate treatments. The second part of this paper shall address one such protocol which classifies partially edentulous patients. The emphasis is on the partial edentulism classification recommended by The American College of Prosthodontists (ACP), which relies on four diagnostic criteria essential for therapeutic decision. Edentulous areas location and extent, abutment teeth health, occlusion model, and residual ridge characteristics represent the parameters which have defined the four classes of partial edentulism of different complexity. In this way, comprehensive approach to the clinical status of the patients has, for the first time been offered to the dental practitioners assuring, among others, higher uniformity of professional attitudes in selection of therapeutic modalities.

U radu se diskutuje o značaju primene protokola u savremenoj stomatologiji. Literaturni podaci koji obuhvataju preporuke i konsenzuse u stomatološkoj praksi govore o njihovoj prisutnosti u dostupnim knjigama, štampanim radovima u recenziranim časopisima, i dodacima časopisa kao zaključci ekspertskih grupa. Treba primetiti da su protokoli najčešće oslonjeni na validne postulate različitih medicinskih grana, pomognuti specifičnim uslovima sredine u koju se implementiraju. Dodatno, u našim uslovima, protokoli u stomatologiji su rezultat zahteva koje institucije i prakse moraju da ispunjavaju shodno obnovljivoj akreditaciji, kao i poštovanja preporuka koje su date u vodičima dobre kliničke prakse različitog nivoa obaveznosti. Pojedini protokoli nude terapijske modalitete koji se kategorizuju u klase, pomažući korisnicima u izboru pravog tretmana. O jednom od takvih protokola koji klasifikuje krezube pacijente govori drugi deo rada. Akcenat je na primeni klasifikacije krezubosti koju je preporučio Američki koledž protetičara, a koja se oslanja na četiri dijagnostička kriterijuma, bitna za terapijsku odluku. Lokalizacija i veličina bezubih polja, stanje zdravlja zuba nosača, model okluzije i karakteristike rezidualnog grebena su parametri koji su definisali četiri klase krezubosti različite složenosti. Tako je, prvi put, stomatološkoj praksi ponuđen ozbiljan, sveobuhvatni pristup kliničkom statusu bolesnika, koji obezbeđuje, između ostalog, i uniformnije stručne stavove u izboru terapijskih modaliteta.