人工植牙的醫療糾紛─歐美觀點

人工植牙已成當代牙科醫療的顯學，但隨之而來的醫療糾紛卻也愈來愈多。植牙糾紛可歸責於牙醫者包括不當的醫療行為、不足的醫療訊息告知以及不實的病歷記載。不當的醫療行為主要包括植牙手術技術不良導致感染、神經受損、鼻竇炎或鼻穿孔、補骨失當、植入位置不當、致命大出血等。假牙糾紛多因美觀或咬合不滿意、螺絲鬆脫或斷裂、治療費用、設計不當導致牙周破壞等。醫師應在術前仔細評估缺牙區是否為植牙的適應症，履行告知後同意之程序，將重要的訊息如治療的過程、成功率、潛在的風險和可能造成的傷害或副作用、其他可供選擇的治療方式充分告知，並執行符合當時醫療水準的植牙手術，且將過程詳實記載於病歷中。

關鍵字

人工植牙；醫療過失；醫療訴訟；告知後同意

並列摘要

Current trend of dentistry is dental implantation. However, implant litigation is increasing simultaneously. Liability on the part of the dentist could be summarized as treatment-related, information-related and documentation-related malpractice. Infringement of the obligation to make correct diagnosis, treatment planning and treatment procedure will result in infection, nerve damage, sinusitis, improper implant placement or life-threatening hemorrhage. With lack of esthetic result or screw loosening, legal action or liability claims will also be taken by the patient. Dentists must provide the patient with information to make informed decision. Obligation to take due care before, during and after surgery ought to be mandated for all clinicians.

並列關鍵字

implant dentistry ； medical malpractice ； liability lawsuit ； informed consent

參考文獻

Branemark PI, Breine U, Adell R, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. Scand J Plast Reconstr Surg, 3:81-100, 1969.

Figgener L, Kleinheinz J. Implant dentistry at the focus of liability lawsuits. Int J Oral Maxillofac Implants, 19:382-386, 2004.

Lambert PM, Morris HF, Ochi S. Positive effect of surgical experience with implants on second stage implant survival. J Oral Maxillofac Surg, 55:12- 18, 1997.

Morris HF, Manz MC, Tarolli JH. Success of multiple endosseous dental implant designs to second stage surgery across study sites. J Oral Maxillofac Surg, 55:76-82, 1997.

Rozovsky FA. Consent to Treatment: A Practical Guide. 4th ed, Aspen Publishers, New York, pp.2- 3, 2007.

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人工植牙的醫療糾紛─歐美觀點

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