Patient evaluation: medical evaluation form and laboratory tests
The information on medical history in Chapters 11 and 12 is not to be construed as a standard of care or guidelines, which may legally vary based on locale. In view of the relatively low prevalence rate of postoperative complications in the general population, limited evidence is available to guide clinicians in regard to possible increased risks of dental implant procedures associated with non-healthy patients.
The major difference between dental implant surgery and most of the other oral surgeries is that, in contrast with other surgeries, it does not treat an ongoing disease or a current infection, but treats an oral condition (edentulism). The implant failure may induce an unexpected infection that may have serious consequences in patients with poor health. Therefore, the famous precept of Hippocrates, primum non nocere, is particularly relevant to this type of elective surgery. Consequently, the medical history of candidates for implant therapy is mandatory and must be included in the medical records.
The medical history informs the surgeon on:
- the surgical risk (Chapter 12)
- the implant failure risk (Chapter 13).
A medical evaluation form is requested to obtain a written record for every individual patient (Appendix D). The past medical history and medication usage within the preceding 6 months are of particular importance. This form is not a blank check but rather a support for the medical interview. It is reviewed with the patient by the implant surgeon. Any health conditions/problems must be documented in the patient records (Chapter 21).
Dental implant surgery is not specific in terms of contraindications as compared to other intraoral surgeries. There are very few absolute contraindications. However, there are many risk situations that must be carefully evaluated.
As a rule of thumb, dental implant placement should be postponed in patients who have a disease that can be treated, until the patient is cured or stabilized. This is also true for oral c/>