Actual ethical topics of dental implantology

Abstract

Introduction: Despite of chosen professional branch, medicine imposes certain ethical principles in medical activity providing moral values of doctor’s daily activity behavior and attitude. In such a way, the professional ethics sets up a system of standards and rules of conduct, which reflect some social functions of medicine: doctor-patient, doctor-doctor and doctor-society relations... Stomatology - is a vast profession with high ethical standards, thus stomatologists must be able to face many difficult situations, being based on moral thinking and high ethical norms. During the working process in dentistry, between doctor - patient and other relations many “banal” conflicts have already appeared. These misunderstandings could be solved keeping up respecting certain established bioethical principles. Purpose and Objectives: to elucidate some values and principles of medical Bioethics, their impact on Dentistry and Implantology, making evident the scientific achievements in these fields of Stomatology and finally to solve bioethical problems. Materials and methods: published monographs, articles and statistical data. There were used sociological, historical - medical and bioethical methods. Results: Medicine - is a socio-human domain, in which a doctor has a big significance doing his job day by day: as a practician, as a psychologist, as a teacher and many others. In different medical fields doctor works with the people and for the people, he or she is called „ The right hand of the God”. In Dental Implantology the doctor has the same functions and this medical field has its special rules and risks. Many difficulties may appear caused by both sides: by the doctor or patient. On doctor’s side they may be: many risks in anaesthesiology caused by the lack of knowledge in this domain, the incompatibility of the patient and anaesthesiological substances, the risk to be infected with venereal diseases caused by inadequate and insufficient sterilization and also the superficial knowledge in this area, the guarantee of the final result for personal boost and reclamation (advertising), technological difficulties which are caused by the incompatibility between tissue and implant (tissue incompatibility). As we know there are 2 types of implants: the first method - „In one step” - when the tooth is implanted completely without osteointegration; in such a way all the risks are related to the patient. The second method is - „ In two steps” - the tooth implant is fixed into maxillary bone for osteointegration during 3-6 months. After this period of time the doctor must decide ifthis method is suitable for patient. In such a way only doctor assumes the highest risks concerning successftil final result. The secondary difficulties shown by the patients may be: infringement of doctor's prescriptions before and after the treatment, avoidance to respect personal hygiene and healthy conditions of social surroundings, the great wish of patients for implants without being concerned about contra-indications of this method of Implantology. According to all these facts presented above the large majority of risks are assumed by the doctor. As a solution to solve the main problems, to avoid the conflicts between both parts, to insure the stomatologist and patient against future complications, Bioethics offers some principles. One of them is to sign a special document (an agreement), which confirms that the patient accepts voluntarily the treatment after first-hand acquaintance with professional medical information. An “Informed Agreement” can help us to solve the problems which may appear between the doctor and patient. The lack of this agreement, as a starting point created by the freedom of patient’s self determination and doctor’s obligations to carry out patient’s wishes, established the arbitration for medical treatment, which in its turn may have penal consequences. Conclusions: In medicine will always exist the risks and successes concerning the treatment. Dental Implantology is a medical branch with high risks in which the doctor must pave the way for success and provide healthy conditions for each patient, but it may generate some embarrassing positions and conflicts by ethical nature. Bioethics as well as its moral values and principles can solve half of these problems, that’s why practicing this job - being a stomatologist - we must respect the principles of ethical code. Thanks to wisdom and high-level of professionalism many people can smile and they may be happy again and again.