Der Oberkiefer, unsere Problemzone.
Oder: Warum ist die Zahnmedizin eigentlich so teuer? So wirklich teuer oft?
Wenn es in der Implantologie beziehungsweise beim implantatgetragenen Zahnersatz Probleme geben kann, dann im Oberkiefer. Diese Probleme können auftreten, wenn Patienten mit einer gewissen Restbezahnung, deren Lebensdauer sich dem Ende zu neigt, zu einer Beratung kommen, um sich über spätere Möglichkeiten einer Implantatversorgung zu informieren. Ebenfalls bereits zahnlose Menschen mit einer bestehenden Totalprothese im Oberkiefer, die sich einfach eine Alternative zu der sie psychisch belastenden Prothese wünschen, sind oft Fälle, wo es schwierig sein kann, eine gute dauerhafte Lösung für sie zu finden. Was ist hier das Problem? Es ist das vorhandene Knochenangebot, das oft zu wünschen übrig lässt, sprich, es ist einfach zu wenig an Knochen vorhanden. Das ist bei manchen Menschen einfach von Natur aus so, dass sie nicht mit Unmengen an Knochen gesegnet sind, und bei anderen Menschen hat sich binnen kürzester Zeit der Knochen nach Zahnverlust oder durch vorher bestehende Entzündungen massiv zurückentwickelt. Das geht oft echt schnell, unglaublich schnell! Und wir brauchen einfach ein gutes Fundament in Bezug auf die Höhe und vor allem in Bezug auf die Breite des Knochens. Bei unzureichendem Fundament hat ein gesetztes Implantat einfach eine klare Prognose: das Implantat wird Probleme machen, Entzündungen hervorrufen und am Ende wird man das Implantat einfach, meistens komplett schmerzfrei, verlieren. Das ist absehbar, das weiß der Behandler schon beim Einbringen des Zahnimplantats. Und das wäre eigentlich gemein gegenüber den Patienten. Aber das wird natürlich nicht gemacht sowas. Aber leider schaut auch ein schlechtes Implantat am Röntgen, was ja immer zur Kontrolle nach dem Eingriff gemacht wird, oft sehr gut aus. Fazit ist: Viele Implantate werden in deutlich zu wenig Knochen gesetzt. Eine Geschichte dazu: Vorige Woche kam eine nette 54-jährige Patientin in Begleitung ihres Gatten zu mir. Sie hatte eine bestehende 25-jährige Kronen-Brückenversorgung im Mund , aus Ungarn. Ungarn macht mir nix, wirklich nix, da ich ja auch nach Ungarn fahre. Klarerweise schaut aber diese alte Versorgung nach dieser langen Zeit einfach nicht mehr optimal aus, weil das Zahnfleisch und damit der Kieferknochen, der die Zähne hält, zurück gegangen ist. Die Optik ist nicht mehr schön, da man deutlich den Grenzverlauf zwischen der Brückenversorgung und dem Rest des eigenen Zahnes sieht, einzelne Teile der Versorgung bewegen sich leicht und die Schleimhaut um die Zähne ist da und dort etwas geschwollen, verfärbt und leicht entzündet. An sich funktioniert der Zahnersatz noch ganz gut und verursacht keine nennenswerten Beschwerden, aber sie leidet absolut nachvollziehbar unter der deutlich reduzierten Ästhetik in der Oberkieferfront. Frauen wollen schöne Zähne, das ist Fakt! Diese Region ist wichtig für Menschen, weil das die Region ist, die die Mitmenschen unbewusst zuerst wahrnehmen und sich ebenfalls unbewusst binnen Bruchteilen einer Sekunde ein Urteil über das Gegenüber bilden. So ist nämlich der Mensch programmiert. Schau auf die Frontzähne und du weißt, wer dein Gegenüber ist beziehungsweise was du von ihm halten sollst. Das war schon in der Steinzeit besonders bei der Partnerwahl wichtig. Besonders in dieser Zeit war für Frauen wichtig sich einen starken Mann auszusuchen, der imstande war die Familie zu ernähren. Starke Männer hatten alle Zwistigkeiten mit anderen Männern in der Sippe schadlos überstanden und deshalb keine Zähne verloren. Zusätzlich waren starke Oberkieferzähne ein Zeichen dafür, dass der Mann erfolgreich in der Jagd, und damit in der Beschaffung von besonders wertvollen Nahrungsmitteln, sprich Fleisch, war, weil ja eine ausreichende Ernährung zu starken Zähnen und natürlich zu sehr guter allgemeiner Gesundheit führte. Nur mit solchen Männern wollten Frauen sich paaren, einfach damit die Ernährung, der Erhalt und der Schutz der Familie gewährleistet war. Deshalb schauen Frauen immer noch unbewusst auf zu allererst auf die Zähne, als zentralen Teil des Gesichtes. Männer, das müsst ihr einfach wissen! Passt auf eure Zähne auf oder lasst diese vom Zahnarzt optimieren, ihr werdet sehen, dass dann das Liebesleben und die Partnerwahl deutlich einfacher werden wird. Das war echt ein cooler Tipp von DDr.Jahl, der erste Tipp im Blog.
Nach diesem kurzen Ausflug zurück zu der Dame, die sehr gepflegt und attraktiv war. Sie hat einfach sehr viel Wert auf ihr Äußeres und ihre Erscheinung gelegt. Sie war Angestellte im Verkauf eines Modegeschäftes und sie tat das gerne. Klarerweise waren die finanziellen Ressourcen nach oben hin irgendwo begrenzt, aber sie war durchaus bereit und sich dessen auch bewusst, dass sie gutes Geld in die Hand nehmen musste. Das wissen ja die Leute, dass gute Zähne, oder schöne Zähne, einfach gutes Geld kosten, das ist jedem klar. Ihr Wunsch waren feste Zähne, also nix zum Rausnehmen, und sie wusste und spürte, dass keiner der vorhandenen Zähne ernsthaft zu erhalten war oder für eine zukünftige Versorgung zu verwenden war. Das spüren Menschen, einfach auch deshalb, weil sie die unbefriedigende Situation bereits lange beobachten und sich Gedanken machen, bevor sie sich beraten lassen. Zusätzlich wird natürlich vorab Dr.Google konsultiert, der ganz schön viele Lösungen binnen Sekundenbruchteilen für die Suchenden findet. Gewiss war ich nicht der erste zu Rate gezogene Arzt, aber das alles stellt kein Problem dar. Sie meinte auch, dass es für sie klar ist, dass eine Prothese für sie keinesfalls in Frage komme. Es müssen feste Zähne auf Implantaten sein! Nach einem insgesamt echt netten Gespräch, und nach dieser Vorgabe wegen der Prothese einigten wir uns darauf ein 3D-Röntgen zu machen, um einfach einen Befund über Zähne und vor allem über den verfügbaren Knochen zu haben. Sie war bereits über die ungefähren Kosten, und die sind ja nicht unbeträchtlich, einer „All on 4“-Behandlung informiert, da alles auf meiner Homepage zu finden ist. Information ist wichtig für die Menschen, das ist mein Credo. Je mehr Information, desto besser. Und, vor allem: Patienten haben ein Recht auf Information, genug mit dieser Geheimniskrämerei zu Lasten leidender Menschen, die Hilfe brauchen. Nach 10 Minuten war die Untersuchung fertig und die Dame mit ihrem Mann wieder bei mir zur geplanten Besprechung, die ich in vielen Fällen live mache. Live heißt, dass ich im Beisein der Patientin das Programm am PC öffne und es vorher noch gar nicht angesehen habe, um zu wissen, was möglich oder eben nicht möglich sein wird. Alles also live, unvorbereitet, ungeschönt und ungeschnitten. Im Beisein der Patientin öffne ich nun also das Planungsprogramm und schaue mir die Kiefer, den Knochen und die Zähne einmal genau an………
To be continued .. Teil 3 folgt in Kürze
Teil 1: Blog: Der See, das Haus, Zahnimplantate und Patienten
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