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林保瑩醫師牙周開業的82法則（或二八法則）

生活中充滿著許多82法則的報導；最廣為人知的譬如在一國家中80%的財富在20%的人口裡，在公司裡80%的產能在20%的人手上，甚至個人80%的時間花在20%同樣的事情中……

在世界衛生組織( WHO ) 於2001年推動全民口腔保健觀念，呼應了日本1989年就的活動提出80歲時仍保有20顆牙的「80/20」，希望全世界一起來重視「保留自然牙」的觀念。

一直將牙齒最大保存與最適重建的理念為一己之重任，不從主流以東方智慧的少多原則「Less is More 」的林保瑩醫師，集結30年臨床觀察也發現有類似82法則現象，以下先以四種項目來探討林醫師牙周植牙美學專科【82法則】的心得竟同時適用於自然牙與植牙：

1、面臨被判定的牙周無救牙其實80%都可以保留，僅20%需拔除。

2、得了嚴重牙周炎或種植體周圍炎，80%都可以非手術治療，僅20%需進行手術

3、牙齦萎縮只是臨床現象且原因很多，不一定有症狀或美觀抱怨，80%都可以非手術方式處理，僅20%有症狀或美觀抱怨的需進行根覆蓋手術改善。

4、角化齦移植改善牙周質量與抗刷能力，但增補的組織常有3年消失50%的報導 ，或10年消失80%的觀察，而林醫師補的角化齦80%有10年80%存在率，即使另20%也有10年50%存在率。

“80/20 Rule” in my periodontal practice

In daily life, we are familiarized with the lesser 20% dominates the 80% in wealth distribution of a country, in capacity of workforce in a company and even in one’s recreation time allocation, etc. It’s quite a phenomenal coincidence in every day’s life.

In health care policy, WHO implemented an 80/20 goal which encourage all people should strive to retain 20 natural teeth at the age of 80.

However today, I happen to find the similar rates of two diverse treatment modalities also exist in my practice that interestingly contradict what the ordinary dental world would consider.

Firstly, the retention rate of periodontally hopeless teeth or implants in my practice is 80% rather than 20%. Secondly, the effectiveness of non-surgical treatment satisfies 80% of the patient with periodontitis or peri-implantitis rather than mostly needing to go for surgery to resolve disease. Thirdly, the non-surgical remedy for gingival or mid-facial implant recession are 80% rather than 20% needing for surgical root coverage procedures. Lastly, the 10-year retention of a grafted keratinized tissue around natural or implants are 80% rather than mostly underwent 50% of recession in first 3 years.

These findings were discovered in an over 30 years of perio/implant/esthetic specialty practice not abided by the current trends but by following the eastern disciplines utilizing “Less is More” principle. The practice of “Maximal preservation for dentiton and optimal reconstruction for defects” embraced the “patient centered eastern oriented” structure.