Kaj nova pravila obveznega zdravstvenega zavarovanja pomenijo za zobne vsadke

Objavil/a Capo Info, dne 2018-10-25 ob 11:52:48

Zdravstveno zavarovanje za zobne vsadke po novem brez večjih sprememb, a vseeno omogoča vrhunsko storitev pri slovenskih dentalnih strokovnjakih

 

V medijih se je po sprejetju novih pravic v okviru obveznega zdravstvenega zavarovanja večkrat pojavila novica, da so pacienti upravičeni do plačila vstavitve zobnih vsadkov. A v podjetju Dentalia, ki je ponudnik enih najbolj kakovostnih zobnih vsadkov na svetu, v sodelovanju s slovenskimi zobozdravniki in dentalnimi strkovnjaki ugotavljajo, da novosti iz obveznega zdravstvenega zavarovanja niso tako revolucionarne kot se na prvi pogled zdi. S tem pa se strinja tudi mag. David Debevc, dr. med., dr. dent. med. specialist maksilofacialne kirurgije in otorinolaringologije.

»Sprejetje novih pravic v okviru obveznega zdravstvenega zavarovanja je bilo že nekaj časa pričakovano, vendar je ob tem treba poudariti, da nova odločitev bistvenih sprememb za zavarovance na področju zobnih vsadkov ne prinaša. Zobno–protetična rehabilitacija s pomočjo zobnih vsadkov je bila že doslej omogočena bolnikom, ki so izpolnjevali določene kriterije oziroma indikacije,« je prepričan kirurg David Debevc.

»V zadnjih letih je Zavod za zdravstveno zavarovanje Slovenije (ZZZS) odobril povračilo stroškov vstavitve implantatov v primerih, ko zavarovani osebi na noben način ni bilo mogoče zagotoviti ustrezne zobnoprotetične rehabilitacije v skladu s Pravili obveznega zdravstvenega zavarovanja. V praksi je to pomenilo, da so zavarovanci ZZZS predložili prošnjo in mnenja specialistov maksilofacialne ali oralne kirurgije in specialista protetike. Izvedenec je nato v skladu s postavljenimi indikacijami presodil, če se lahko odobri plačilo na osnovi tretjega odstavka 259. člena Pravil. V tem členu je zapisano, da lahko ZZZS izjemoma odobri osebni medicinski pripomoček, zdravilo ali živilo oziroma celotno ali delno povračilo stroškov, ki niso pravica. Indikacije za odobritev so po novem zapisane v 30. členu Pravil,« pojasnjuje David Debevc.

 

Kakšne so torej indikacije oziroma kdaj so pacienti upravičeni do plačila vstavitve implantatov?

Sogovornik pravi, da so pacienti upravičeni do plačila vstavitve zobnih vsadkov po operaciji v zgornji ali spodnji čeljusti zaradi rakavega obolenja. Prav tako so upravičeni bolniki z oligodontijo oziroma prirojeno odsotnostjo vsaj šestih stalnih zob. Tudi bolnikom s prirojeno anomalijo kosti ali razcepom kosti (shiza) obvezno zavarovanje krijestroške  vstavitev zobnih vsadkov. Najpogostejša indikacija pa je napredovala atrofija – resorpcija kosti zgornje ali spodnje čeljusti. A resorpcija mora po Lekholm-Zarbovi klasifikaciji dosegati stopnjo D ali E (slika 1). V navedenih primerih je oskrba s klasično totalno protezo zaradi slabih anatomskih pogojev nesmiselna, ker ne omogoči ustreznega funkcionalnega rezultata. Število zobnih vsadkov, ki omogočajo izdelavo z vsadki podprte proteze je omejeno na dva v spodnji čeljusti in štiri v zgornji.

 

Pošiljanje prošnje na ZZZS za zdravljenje z implantati po novem ni bo več potrebno

Po novem 30. člen Pravil odpravlja potrebo po pošiljanju prošnje na ZZZS, pojasnjuje David Debevc in dodaja: »V primerih, ko bodo zavarovanci izpolnjevali pogoje (presodila bosta kirurg in protetik), se bo izvedlo ustrezno zdravljenje, ki bo v celoti krito s strani ZZZS. Določbe, ki se nanašajo na pravico do zobnih vsadkov bodo stopile v veljavo eno leto po uveljavitvi Pravil, to je 13. oktobra prihodnje leto.«

Pričakovano število zavarovanih oseb pri katerih bo potrebna tovrstna oskrba je po mnenjustroke nekaj čez 500 letno, ocenjuje kirurg David Debevc: »Najmanjši delež predstavljajo bolniki po operaciji shize in posamezniki z oligodontijo. Največji delež na drugi strani predstavljajo bolniki z napredovalo atrofijo kosti. Če so pacienti že več let brez svojih zob in nosijo totalno protezo, ki zaradi slabih kostnih pogojev nima več dobre retence, bi svetoval pogovor z izbranim zobozdravnikom. Ta naj presodi ali je smiselna podložitev – reparatura stare proteze, izdelava nove ali napotitev k specialistu protetike. Če bodo napoteni k specialistu, se bo slednji na osnovi kliničnega pregleda in rentgenske slike čeljusti odločil o upravičenosti do vstavitve zobnih vsadkov, na katere se sidra totalna proteza,« svetuje strokovnjak.

 

Kljub pričakovanemu povečanju števila kandidatov, indikacije ostale enake

Čeprav se pričakuje, da se bo z uveljavitvijo določbe povečalo število zavarovanih oseb, ki bodo uveljavljali pravico do takšne oskrbe, saj bo bo prepoznanih več pacientov, ki bodo izpolnjevali kriterije, je treba poudariti, da se indikacije z novim 30. členom Pravil niso spremenile od dosedanje prakse, je prepričana tudi Janja Debeljak iz podjetja Dentalia. Podjetje Dentalia je namreč partner najboljših in najzanesljivejših zobozdravnikov v Sloveniji, saj že več desetletij skrbijo za to, da imajo zobozdravniki vso potrebno opremo za svoje delo, ki je najbolj kakovostna. Še posebej pa so ponosni na njihov najboljši sistem zobnih vsadkov na svetu (znamke Straumann group), ki ga v Sloveniji uporablja več kot 150 klinik.

 

Slovenski zobozdravstveni strokovnjaki so zagotovilo za najboljšo možno osrkbo

Glede materialov, do katerih so pacienti upravičeni, če koristijo omenjeno pravico iz obveznega zdravstvenega zavarovanja, je standardni material zobnih vsadkov in zobno-protetičnih pripomočkov na vsadkih določen za zobni vsadek iz titana in titanove zlitine, ki vsebuje 85 odstotkov titana, pojasnjuje Janja Debeljak. Pri prevlekah in mostičkih na zobnih vsadkih pri oligodontijah in shizah sta določena porcelan in kobalt – kromova zlitina. Za protezo pridejo v poštev akrilat in ulita kovinska baza iz kobalta – kromove ali podobne zlitine.

Tako Janja Debeljak iz Dentalie kot kirurg David Debevc se strinjata, da je sodelovanje specialista protetike in kirurgije zagotovilo, da bodo vsi, ki so do tovrstnega zdravljenja upravičeni, deležni najboljše možne oskrbe. Nenazadnje imamo v Sloveniji vrhunske zobozdravnike, kirurge in druge zobne strokovnjake. Paciente to lahko navdaja z optimizmom.

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Objavil/a 2018-10-25 11:52:48 (Oct 25, 2018)
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