“Begin with the end in mind" 以终为始

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From the course by The University of Hong Kong

口腔种植学（Implant Dentistry）

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The University of Hong Kong

口腔种植学（Implant Dentistry）

28 ratings

口腔种植学是口腔教育中较新的学科。虽然现在我们都有共识，种植⽛相关的理论知识，⽆论是治疗⽅案的规划，还是后期的随访和维护，对于每⼀个职业⽛医都⾮常重要。然⽽，在当下全球的口腔医学本科培养体系中，它的覆盖程度还远远落后于其重要性。在此背景下，香港大学口腔医学院联合⾹港⼤学的线上教育专业团队，历时⼀年有余，设计并制作了这门为期五周的⽹络公开课，旨在传播以循证医学为基础的，客观、全⾯的⽛种植学相关知识。这门课程⾯向全球，双语教学，完全免费。学员将在20 多位全球领先的种植学专家的带领下，完成五个模块，系统地学习⽛种植学。

From the lesson

种植牙和患者

患者选择和治疗计划是种植牙成功的基石。本模块中，我们将评估所有系统性，解剖学和行为上的风险，并帮助你设计综合治疗计划中的所有步骤，以满足患者的实际需求。

“Begin with the end in mind" 以终为始5:53

"Put first things first"要事第一2:23

制定治疗计划6:15

Meet the Instructors

Nikos Mattheos
Clinical Associate Professor in Implant Dentistry
The University of Hong Kong

Hello and welcome to this discussion

on treatment planning.

I welcome you to this discussion on treatment planning

under the title “Begin with the End in Mind”.

“Begin with the end in mind” is the second paradigm

of a book that is called,

The 7 Habits of Highly Effective People

by Stephen Covey.

And the first three habits

are well suited to delineate

the steps that we have to take in treatment planning.

These steps, the first three are:

that to “Be proactive”,

the second step is to “Begin with the end in mind”.

And the third step is to “Put first things first”.

We have these habits that are

normally constructed to be used in daily life,

but they can,

they can really be easily extrapolated

to the treatment planning situation.

If we have these three first paradigms

that bring us to the independence stage,

there is a fourth paradigm that is called,

“Think Win-win"

the fifth paradigm,

“Seek to understand, then to be understood”,

and the sixth paradigm, “Synergize”.

That will get you to the level of interdependence.

These four, five and six habits

we don't discuss in this content.

And we start out with our first paradigm,

“Be proactive”

What does that mean for treatment planning?

It means that we create a mission statement.

You can discuss that for a long time,

but then you come to probably,

a mission statement that is very reasonable

to establish and satisfy the patient's needs

for esthetics and function under healthy conditions.

These sentences have

three very essential words.

Namely, esthetics, and function, and health.

The key factors for reconstruction.

Now, if I have this mission statement,

I go to the second, to the topic of this lecture,

namely, “Begin with the end in mind”.

What does that mean in treatment planning?

It means that I ask the question,

how does this patient's dentition look like

when treatment is finished and she leaves the office?

So, in other words, I hope that she will be smiling

and at full function under healthy conditions.

Now in this instance here,

you have an edentulous patient,

and we could say that there are basically two options

of how this patient will look like.

Either they are going to be two locators,

placed under a full denture.

And that is, then, of course,

the end of the treatment.

And this will substantially improve the chewing function

of this particular patient.

But not everybody wants to have removable dentures.

Some people may want to have a fixed reconstruction.

And here, I have here a case

that starts out with a mutilated dentition

where about everything is wrong that can be wrong.

You see, there is periodontal disease,

you see the caries,

you see loss of function.

You see that this molar has completely lost its attachment,

and you have already a dentureless area.

If we now think about how he wants to look like,

we have to remind ourselves

that this patient is a very affluent patient

who wants absolutely a fixed reconstruction.

And yet, the circumstances for him

to end up with this are very slim.

Because, if we now take out all the teeth

that are really jeopardized in their health,

like all these front teeth,

we end up with almost an edentulous jaw in the maxilla.

And almost an edentulous jaw in the mandible.

So, we are at the same spot as the previous patient,

and yet, this patient does not want

a removable prosthetic.

So, immediately, we are going to look at

the anatomical structures

in order to have an idea of where we can place our implants.

We will use six implants here in the maxilla,

and we will use two to begin with in the mandible.

But then, we need do other,

do other implants in the mandible

that will allow us to construct

an extension bridge towards the canine.

So here, you have all the implants placed,

and now you have the fixed reconstruction.

So you see, the end was completely different,

even though the starting point was very similar.

So, in the end, we have two fixed bridges in the maxilla,

and we have three fixed bridges in the mandible.

And, we have these three in the mandible

because of the bending of the mandible

when maximal opening it.

And we have two in the maxilla

in order to minimize technical complications,

such as porcelain chippings.

So this was the second paradigm.

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