PROSTHODONTICS - American College of Prosthodontists

December 2005, Supplement, Volume 14, Number 4 837. Physically impaired prosthesis placement skills8. Unsatisfactory existing soft tissue retention caseB. Therapeutic goals1. Restored facial form2. Protect exposed mucous membranes3. Restored esthetics4. Improved patient self-esteem5. Improved patient confidence in retention of prosthesis6. Improved quality of life7. Improved compromised surgical resultC. Risk factors affecting quality of treatment (severity factors that increase risk and the potential forknown complications)1. Size and location of the defect2. Possible surgical tissue contours3. Possible radiation sequela4. Psychosocial factors5. Patient’s age6. Patient’s expectations and motivation7. Patient’s compliance8. Tissue reaction to penetrating materials9. Soft-tissue depth and movement at penetration side10. Bone availability, quality, and depth at receptor sites11. Previous radiation therapy and bone residual vascularity12. Superstructure design and ease of maintenance13. Dexterity, visual acuity, and motor skills in placement of prosthesis14. Soft-tissue reaction at penetration site over timeD. Standards of care1. Review medical history (includes radiation ports, type, amount, etc.)2. Surgical removal of impending tissue remnants3. Appropriate consultation and referrals for alternative treatment modalities4. Prosthesis compatibility with existing tissues5. Accurate impression, superstructure design with correct prosthesis construction, retention modalities,and coloration6. Post-treatment maintenance of prosthesis7. Education of patient8. Knowledge of osseointegration theory, principles, and techniques9. Referral of adjunctive care as indicated (HBO)E. Specialty performance assessment1. Favorable outcomesa. Improved psychosocial attitude, self-esteem, and confidenceb. Improved facial symmetryc. Improved estheticsd. Improved organ function (i.e., airflow, directional hearing, etc.)e. Protection of exposed mucous membranes2. Known risk and complicationsa. Unrealistic patient expectationsb. Loss of prosthesis usec. Change in color and appearance of prosthesisd. Loss of prosthesis marginal integrity with usee. Tissue irritation at implant penetration sitef. Tissue changes requiring modification or refabrication of prosthesisg. Loss of mechanical retention2010 CDEL Re-recognition of the Specialty Report 123 of 279