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CHAPTER 2

Patient-related factors for material selection

1.2.1 Introduction

In this chapter:

■ Patient demands

■ Esthetic requirements – prerequisites

■ Amount and quality of tooth substance

■ Amount and quality of soft tissues

■ Occlusal and functional requirements

The selection of the restorative material is a crucial step within the rehabilitation of patients with fixed restorations, as the material is of high importance for the esthetics and the long-term performance of the fixed tooth- and implant-supported restorations. The restorative team, ie, the dentist and dental technician, need to be aware of the indications, advantages and limitations of all restorative materials in order to select the most appropriate alternative for the specific patient situation ( Part I, Chapter 1).

Today, the selection of the material also includes the selection of the fabrication technology and, consequently, the efficiency (time, costs) and efficacy (predictability of outcomes) of the treatment.

In this chapter, the clinically relevant patient-based factors for the material selection will be discussed.

1.2.2 Patient demands

The thorough evaluation and definition of the patient expectations at the beginning of the treatment is possibly the most important Part of a prosthetic rehabilitation.The patient demands for dental improvement can focus on the following factors:

■ esthetics

■ occlusion and function

■ intraoral health.

A patient may have only one priority or may desire to improve several or all of these factors with the proposed treatment. Esthetics is probably the most complex patient demand for a prosthetic rehabilitation when considering the material selection. Some esthetic prosthetic materials exhibit low stability (see Part I, Chapter 1), feldspathic ceramics being a good example. Besides good esthetics, the restoration has to withstand the conditions of the oral environment for long-term periods. With this in mind, the selection of material for esthetic rehabilitation needs to include such parameters as the position in the jaws (anterior, posterior), occlusal and functional scheme, expected occlusal forces, and quality of substrate for adhesive cementation (abutment tooth, implant abutment).