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What is dental implantation?
Dental implantation Is one of the most modern and reliable methods for restoring lost teeth. Its essence lies in the fact that part of the dental implant is introduced into the jaw bone instead of the damaged root ( remote) of the tooth and is firmly fixed there. The outer part of the implant is covered with a special crown or prosthesis, which ensures high strength of the entire structure, as well as a good cosmetic result.The advantages of this technique include quality and reliability.
At the same time, it should be noted that the complete installation of the implant can take from several months to six months, due to the slow fusion of the implanted part with the jaw bone tissue. Average lifetime of a dental implant ( using quality materials and correct installation technique, as well as with proper oral care) can reach 25 - 30 and more years.
What is the difference between prosthetics and dental implants?
Implantation and prosthetics are two completely different procedures for restoring or replacing damaged teeth. Prosthetics are used in cases where the tooth is only partially damaged, and its root is still firmly fixed in the gum. In this case, the doctor first prepares the damaged tooth ( removes damaged parts, removes nerve if necessary). Then he sharpens the rest of the tooth, and applies a metal or metal-ceramic prosthesis on it ( crown or so-called "bridge", which allows replacing several teeth at once). With proper care, the service life of such a prosthesis can reach several decades.The main difference between prosthetics and dental implantation is that in the second case, not only the upper part of the tooth is replaced, but also its root. Instead of a root in the gum ( into the jaw bone) a metal frame is implanted ( directly the implant), on which the so-called suprastructure is subsequently "put on" - a crown, a bridge, and so on. Further ( if necessary) the suprastructure can be replaced, while removing the implant itself from the bone is extremely difficult ( it will only be possible to do it promptly).
Indications for dental implantation
As follows from the above, indications for dental implantation can be various diseases and pathological conditions in which the entire tooth is absent or cannot be preserved ( including its root).Implantation of one or more teeth is indicated:
- With adentia. This term refers to the complete absence of teeth in the oral cavity. Usually, this condition can be observed in older people who have not sought qualified dental care for a long time, as a result of which all of their teeth have fallen out.
- If one or more teeth are missing in the mouth. If one tooth needs to be replaced, one implant is installed instead. If the patient lacks several adjacent teeth at once, a special plate can be implanted into the jaw, on which there will be 2 - 3 or more "teeth". This will speed up the treatment process, since there is no need to install each implant separately.
- With looseness and loss of teeth. The reasons for increased tooth mobility can be many, from diseases of the teeth themselves to pathologies of the jaw bone. As a rule, once a loose tooth will never return to its previous, normal standing, as a result of which the option of replacing it with an implant should be considered.
- If it is impossible to wear removable dentures. Some people may experience permanent oral discomfort while wearing removable dentures, and therefore may be advised to undergo implantation.
- If it is impossible to install permanent dentures. Even when wearing a high-quality crown, some of the underlying tooth can be destroyed. If this happens, the crown will no longer be able to hold in place, and it will be impossible to install a new one due to the lack of supporting dental tissue. In this case, the only treatment option will also be the implantation of an artificial tooth.
- In case of malocclusion. For some congenital or acquired anomalies of the upper or lower jaw there may be malocclusions that cannot be eliminated in any other way. In this case, the manufacture and installation of specially prepared implants can help solve the problem.
Is dental implantation indicated for periodontal disease and periodontitis?
Dental implantation is one of the main methods of treating periodontitis, while in case of periodontitis it can be used only in advanced cases, with the ineffectiveness of other therapeutic methods.Periodontitis is inflammatory disease tissues that surround the tooth and ensure its fixation in the jawbone. With this pathology, the destruction of the alveolar process of the jaw is noted ( in which the tooth is directly fixed), as well as the formation of abscesses around the tooth itself. As a result, it loosens and falls out. Dental implantation is indicated only after the treatment of periodontitis and the elimination of the causes of its occurrence.
Unlike periodontitis, there is no development of the inflammatory process during periodontal disease. This pathology characterized by slow destruction of the jaw bone tissue and damage to it alveolar processes, as a result of which the tooth root is exposed. An important feature is the fact that for a long time the tooth remains firmly fixed, does not stagger and does not fall out, and therefore to carry out implantation on early stages disease is inappropriate ( indicated drug and surgical treatment aimed at restoring bone tissue around the tooth). At the same time, it should be noted that with prolonged progression of the disease and without the necessary treatment, the tooth root can become bare ( protrude above the gum surface) by more than 50%. In this case, the appearance of tooth shakiness is possible, as well as the risk of its loss increases. If this happens, dental implantation will be the only possible treatment.
Is dental implantation performed for children?
It is not recommended to implant teeth in children under 18 years of age. The fact is that in the process of growing up a child, the jaw bones and the teeth themselves grow and change. The implant, which was installed in early childhood, would be too small for the patient after a while, as a result of which it would have to be reinstalled. It would be inappropriate and extremely traumatic to perform such a procedure. That is why in such cases, various options for dental prosthetics are first used, and after the child's growth stops, the issue of installing permanent implants is decided.Dental implantation alternatives
Dental implantation is quite reliable, but expensive and relatively laborious. If the patient is not ready for such a procedure, the damaged tooth can be "corrected" in other ways.An alternative to dental implantation can be:
- Classic prosthetics. In this case, a special crown is put on the prepared upper part of the tooth to protect the tooth from further decay. It should be noted that dentures can be removable ( the patient can remove them on their own whenever they wish) or permanent, which are firmly fixed to the remainder of the tooth and can only be removed by a specialist in a dental clinic.
- Tooth reimplantation. This technique is similar to classical implantation. First, the doctor carefully removes the damaged tooth, which is further processed in a special way ( that is, it is restored, restored) - pathological foci of caries and other damage are removed from it, various deformations and channels are sealed, enamel is restored ( outer surface of the tooth) and so on. After the end of the restoration process, the patient's tooth returns to its original place and is fixed to the jawbone, after which it can serve for many more years ( with proper care).
Limitations and contraindications for dental implantation
The procedure for installing an implant is rather complicated, time-consuming and involves certain risks, as a result of which, before starting its implementation, the doctor must make sure that the patient does not have any contraindications. Tooth implantation is contraindicated:
- With infectious diseases of the oral cavity. If the patient has stomatitis ( inflammation of the oral mucosa), gingivitis ( gum inflammation) or another similar infectious process, you should first start treating it, and only after the complete elimination of the focus of infection, proceed with tooth implantation. The fact is that during the implantation procedure, the implant will be implanted into the jawbone. If, at the same time, there is a focus of infection in the oral cavity, pathogenic microorganisms can enter the blood or bone tissue, causing the development of formidable complications.
- For severe diseases of the cardiovascular or respiratory system. During implantation, the patient may need to be anesthetized ( medication sleep), which can be dangerous if you have heart failure or respiratory failure.
- With diseases of the immune system. In some pathologies, the work of the immune system is disrupted, which normally performs a protective function ( protecting the body from the introduction of foreign bacteria, viruses, fungi and other dangerous particles). Since the implant is a foreign substance that comes into direct contact with the patient's blood, if the immune system is impaired, the patient may develop allergic reactions that can pose a threat to his health or even life.
- With mental disorders. Performing dental implantation requires a certain amount of cooperation and understanding from the patient. If the patient is inadequate and not responsible for his actions, he cannot carry out this procedure.
- For diseases of the blood coagulation system. Under normal conditions, this system is responsible for stopping bleeding in case of injury, injury, cuts, and so on. If its functions are impaired, the patient may experience prolonged, profuse bleeding even after minor cuts. Tooth implantation surgery is associated with damage to the oral mucosa, gums and jawbone, as a result of which the risk of bleeding during this procedure is increased. That is why, before starting its implementation, the doctor must make sure that the patient's blood coagulation system is functioning properly.
- For rheumatic diseases connective tissue. With systemic lupus erythematosus, scleroderma and other similar diseases, the processes of connective tissue development are disrupted, which are extremely important at the stage of implantation of the implant into the jaw bone. That is why, before dental implantation, it is necessary to achieve a stable remission of the patient's pathology.
- In the acute phase of tuberculosis. Tuberculosis is infection, in which lung tissue is most often affected. The acute phase of the pathology is characterized by the fact that a sick person secretes an infectious agent into environment along with exhaled air ( while coughing or simple breathing). Since during dental implantation, doctors will need to work in close proximity to the patient's airways, their risk of contracting tuberculosis increases. That is why tuberculosis should be treated first, and only after a stable remission is achieved ( subside acute manifestations disease and negative laboratory tests), dental implantation can be planned.
- For diseases of the temporomandibular joint. Diseases that make it impossible to open the mouth wide enough can create difficulties during tooth implantation surgery.
- With pronounced anomalies in the structure of the jaw. During the procedure, a metal implant of a certain length and size will need to be implanted into the jawbone. If the patient's anomalies do not allow this ( for example, bones that are too thin, deformed or fragile), dental implantation is contraindicated for him.
Dental implantation for anemia
The possibility of implantation depends on the severity of the anemia ( anemia), as well as on the speed of its development.Anemia is characterized by a decrease in the concentration of red blood cells ( red blood cells) and hemoglobin ( providing oxygen transportation to tissues and organs). With the development of anemia, the transport function of the blood is disrupted, that is, the cells of the body may begin to lack oxygen. Since a certain amount of blood loss is possible during tooth implantation ( usually no more than a few milliliters, but in the event of unforeseen complications, perhaps more profuse bleeding ), no doctor will take on a patient with severe anemia.
It should be noted that not only the severity of anemia is important, but also the speed of its development. So, for example, the normal hemoglobin level in men is 130 g / l, and in women - 120 g / l. If anemia developed slowly ( for example, if you are deficient in iron, vitamin B12 or other substances), the body manages to adapt to gradually changing conditions and does not experience a pronounced lack of oxygen. In such cases, you can perform the operation even when slightly reduced level hemoglobin ( but not less than 90 g / l). If anemia develops as a result of bleeding, the body does not adapt well to rapidly changing conditions, as a result of which it will be possible to perform dental implantation only after the cause of the anemia is eliminated and the normal hemoglobin level is restored.
Is dental implantation done during menstruation?
It is not recommended to install an implant or other surgical interventions during menstrual bleeding, as this may adversely affect general state and women's health, as well as lead to the development of complications.Dental implantation during menstruation can be complicated:
- The development of anemia. During menstrual bleeding, a woman normally loses about 50 - 150 ml of blood ( sometimes up to 200 ml, which depends on the individual characteristics of the organism). At the same time, with the development of any pathologies or complications, bleeding may be more pronounced, as a result of which blood loss can reach 500 ml or more. In this case, severe anemia may develop, requiring urgent treatment... That is why dental implantation ( as well as any other surgical interventions) during menstruation is undesirable.
- Stress. During your period female body experiences stress, which is manifested by increased arousal nervous system, hormonal changes and so on. Stress can be exacerbated by implant placement surgery, which can lead to increased nervousness, nervousness, nervous breakdown and other psychological disorders.
- Disorders of the blood coagulation system. As mentioned earlier, the coagulation system stops bleeding. During menstruation, there is an increased activation of blood coagulation factors, which is protective ( prevents profuse blood loss). If at the same time perform dental implantation ( during which damage to the tissues of the gums, jaw and oral mucosa also occurs), this can further enhance the activity of the blood coagulation system, thereby increasing the risk of developing related complications. The most dangerous complication in this case may be the formation of blood clots ( blood clots) directly in the vascular bed. Such blood clots can block blood vessels, thereby disrupting the delivery of blood and oxygen to certain tissues and organs ( including to the heart, lungs, brain and so on).
Can dental implants be performed during pregnancy or while breastfeeding?
During pregnancy, dental implantation is prohibited, as this can lead to the development of complications that pose a danger to the health and life of the mother and fetus.Dental implantation during pregnancy can be complicated by:
- The toxic effect of medications. The implantation procedure is extremely painful, and therefore can only be performed using anesthesia ( anesthesia, pain relief). Anesthesia is associated with the introduction into the woman's bloodstream of a number of drugs that can penetrate the placenta ( nourishing organ) into the bloodstream of the fetus and disrupt its development. This can lead to intrauterine abnormalities or even intrauterine fetal death. It is also worth noting that painkillers prescribed to the patient after the implantation can also have a toxic effect.
- Allergic reactions. Allergy is an over-expressed reaction of the immune system, manifested by general malaise, itchy skin, a marked decrease in blood pressure, an increase in body temperature, and so on. Allergies can occur both during pain relief and in response to the introduction of a foreign substance ( implant) into the jawbone. Development of severe allergic reaction can lead to impaired blood supply to the fetus, thereby causing damage to its organs ( primarily the brain) or even his intrauterine death.
- X-ray damage to the fetus. In preparation for implantation, you must perform x-ray examination, that is, take a picture of the jaw and teeth ( sometimes not one, but several at once). Exposure to radiation can adversely affect the process of laying and developing the organs of the embryo or fetus, which will lead to the occurrence of intrauterine developmental anomalies.
- The development of infectious complications. During pregnancy, there is a weakening of female immunity, which is necessary for the normal development of the fetus. In such conditions, the ingress of even a small number of pathogenic microorganisms into open wound can lead to the development of a severe infection, which will require complementary treatment (in particular, the appointment of antibiotics, which are contraindicated during pregnancy, as they can damage the fetus).
Features of dental implantation in type 1 or type 2 diabetes
If the patient has initial form diabetes mellitus, which has not yet led to the development of complications, and the patient himself is taking the prescribed treatment, dental implantation is not contraindicated for him. At the same time, with long-term progressive forms of the disease, as well as with the development of complications from internal organs and systems, it will be extremely difficult or even impossible to perform the implantation procedure.Diabetes mellitus is a disease in which some cells of the human body cannot normally metabolize glucose ( sugar, which is a source of energy for them). This leads to dysfunction of many organs and systems, which is accompanied by the development of severe complications.
To date, type 1 diabetes mellitus ( insulin dependent) and 2 types ( insulin independent). In the first case, the cause of the disease is a violation of the production of the hormone insulin, which is normally produced by the pancreas. With its lack, glucose cannot enter the cells, which leads to an increase in the concentration of sugar in the blood. The introduction of insulin from the outside helps to solve this problem, which was the reason for the name of this form of the disease.
In type 2 diabetes, the cause of the disease is damage to cells in the body that cannot interact with insulin, as a result of which glucose cannot penetrate into them. It also leads to high blood sugar levels, although insulin production is not impaired. In this case, various drugs are used for treatment, which help to lower sugar levels, thereby preventing the development of complications.
As mentioned earlier, diabetes mellitus affects many organs, including the blood vessels. Due to insufficient supply of glucose, the walls of small blood vessels are damaged, as a result of which the vessels are destroyed. Over time, this leads to insufficient blood supply to the affected organs. Against the background of impaired oxygen delivery, the processes of cell division are disrupted ( regeneration), and the risk of developing infections ( due to insufficient supply of cells of the immune system to the affected tissue). If such complications develop, it will be impossible for the patient to implant a tooth. The fact is that after the implant is installed, it must grow into the bone tissue of the jaw. However, due to a violation of blood supply, this process will proceed extremely slowly and "sluggishly", as a result of which the implant will not take root as it should. Moreover, due to a violation of the blood supply to the oral mucosa, the risk of wound infection during the procedure increases, which is fraught with the development of a dangerous purulent infection.
Is dental implantation done for oncology?
Oncological ( tumor) diseases in themselves are not a contraindication to dental implantation. At the same time, it should be noted that the presence of a malignant tumor requires its immediate treatment, as otherwise the risk of complications and patient death increases. That is why, when a cancer is detected, first of all, it should be cured, and after that, dental implantation should be planned.It is contraindicated to perform dental implantation:
- In the presence of tumors in the oral cavity, face, head, neck. During the operation, damage to the tumor is possible, which can lead to its metastasis ( the progression of the disease, accompanied by the spread of tumor cells to other tissues and organs).
- In the presence of metastases. The presence of metastases in distant tissues and organs indicates that the tumor is progressively developing. At the same time, there is a rapid dysfunction of many internal organs and systems, which often leads to the death of the patient.
- During radiotherapy. Radiotherapy can be used to treat certain cancers. Its essence lies in the effect on the tumor tissue of certain doses of radiation, which leads to the death of tumor cells. At the same time, it is worth noting that irradiation can disrupt the division of normal cells in the human body, as a result of which the wound healing processes, including the process of bone tissue overgrowth of the implant, will slow down.
- With chemotherapy. Chemotherapy is the use of medications for the treatment of tumors. Chemotherapy also disrupts the processes of cell division in various organs, as a result of which it is impossible to implant the implant at this time.
Dental implantation for hepatitis
In itself, the presence of hepatitis is not a contraindication to dental implantation. At the same time, the development of complications associated with this disease can create certain difficulties that make it impossible to perform the procedure.Hepatitis is an inflammatory liver disease that develops as a result of infection with specific viruses, against the background of alcohol abuse, intoxication of the body, and so on. With an exacerbation of the disease, the patient has an increase in body temperature, general weakness, indigestion, nausea, vomiting, and so on. It is forbidden to perform dental implantation in such conditions, as this can lead to depletion of the body's compensatory capabilities and to the development of complications. At the same time, after adequate treatment and achievement of remission ( subsiding of acute manifestations of the disease) implantation can be performed without any major problems.
The situation is much worse in chronic, long-term progressive hepatitis. In this case, against the background of a chronic inflammatory process, most of the liver cells can be affected, which will lead to the development of complications ( in particular to cirrhosis of the liver). This will be accompanied by dysfunction of many other organs and systems, in particular the blood coagulation system. The fact is that many coagulation factors are formed precisely by liver cells. When they are destroyed, the concentration of these factors in the blood will decrease, as a result of which the patient will have a tendency to bleed even after minor tissue damage. It will be impossible to perform dental implantation in such conditions, since if bleeding occurs, it will be extremely difficult for doctors to stop it, as a result of which the patient may lose a lot of blood.
Are dental implants performed for HIV infection?
HIV is a human immunodeficiency virus that can enter the body through sexual contact, as well as through blood transfusion, with repeated use of syringes by different people (which is common among people who abuse drugs) and so on. When it enters the human body, this virus infects the cells of its immune system, as a result of which, over time, the body becomes less resistant to the development of various infections. Ultimately ( without the necessary treatment) the patient dies due to the development of many infectious complications from various organs.It should be noted that the process of affecting the human immune system proceeds very slowly, taking whole years or even decades. On initial stages disease, as well as with the correct treatment, there are enough cells of the immune system in the patient's body to resist infections. It is not forbidden for such patients to perform dental implantation, but they must definitely inform the doctor about their pathology. In this case, the doctor will work extremely carefully so as not to become infected with HIV, and will also pay special attention to the prevention of infectious complications during surgery and in the postoperative period ( he may prescribe stronger antibiotics for a longer time).
If HIV has infected most of the cells of the patient's immune system, his body's resistance to infections is extremely low. In this case, even simple, usually harmless bacteria ( which constantly live in the human oral cavity) can get into the wound and cause the development of severe systemic infectionwhich can cause death of the patient. Dental implantation in such patients is strictly contraindicated.
Dental implantation in old age
Old age is not a contraindication for tooth implantation. If the patient does not have the previously listed contraindications ( diseases of the cardiovascular, respiratory and other systems, diabetes mellitus, malignant tumors and so on), one or more teeth can be implanted. The peculiarities of the procedure in the elderly include slowing down the regeneration processes ( recovery) bone tissue. As a result, after the implant is installed, it may take longer for it to firmly anchor in the bone and begin to function normally.Preparation before dental implantation
For the implantation procedure to take place as quickly, efficiently and safely as possible, the patient must be properly prepared for it. Preparation includes a full examination of the patient, as well as his observance of certain rules, which the attending physician will tell him about. Which doctor is involved in dental implantation?
For dental implantation it is necessary make an appointment with a dentist... It is worth noting that today in dentistry there are many more narrow specialties, each of which deals with the solution of certain issues. In addition, it is the stamatologist who, if necessary, can refer the patient to other specialized specialists, if their consultation is necessary for the dental implantation procedure.To perform a tooth implantation, the patient may need a consultation:
- Orthopedic dentist. This specialist directly involved in the determination of indications and contraindications for implantation, helps the patient to choose the most appropriate method of implantation, and is also directly involved in the process of installing the implant and in postoperative treatment the patient.
- Dentist-surgeon. This specialist is engaged in the extraction of teeth, as well as the treatment of other diseases of the dentoalveolar system that require surgical intervention. His consultation may be needed both before implantation ( to remove the remnants of damaged teeth, instead of which implants will be installed), and after the end of the procedure ( in case of the development of purulent complications, in which surgical treatment is indicated).
- Dentist therapist. Consultation or treatment with this specialist may be required if the patient has caries ( a source of infection in the oral cavity), periodontitis ( inflammatory lesions of tissues that fix the tooth) and other pathologies in which the implantation is contraindicated.
- Dental technician. This specialist is directly involved in the manufacture of dental implants and prostheses.
Patient examination before dental implantation
During the first consultation, the doctor determines the indications and contraindications for implantation, and also informs the patient about the features of the upcoming procedure.The initial examination of the patient by the dentist includes:
- Conversation with the patient. During the conversation, the doctor clarifies what problems are bothering the patient, how long he has been suffering from dental diseases, whether he has visited dentists before, and so on.
- Examination of the oral cavity. During the first consultation, the doctor carefully examines the patient's oral cavity and teeth, on the basis of which he determines whether he needs implantation or should resort to other methods of treatment.
- Informing the patient about possible treatments. After the examination, the doctor must tell the patient about all possible treatment options for his existing disease, as well as about their features, possible complications and so on.
- Identification of possible contraindications. At the very first consultation, the doctor should ask the patient if he has any diseases for which implantation is contraindicated.
- Informing the patient about the implantation procedure. The doctor must tell the patient everything about the chosen treatment method, including the technical features of the procedure, the method of pain relief, the duration of treatment, the duration of postoperative recovery, possible consequences, complications, cost of the procedure, and so on. If during the consultation the patient has any additional questions, the doctor must also answer them.
What tests should be taken before dental implantation?
Before performing the procedure, a series of tests should be taken, on the basis of which the doctor will determine whether the patient can have an implant installed.Before dental implantation, you may need:
- General analysis blood. This analysis contains data on the concentration of hemoglobin and red blood cells in the blood ( their decrease may be a sign of anemia, in which implantation is contraindicated). Also, based on a general blood test, it is possible to detect the presence of an infection in the body ( this may be indicated by an increase in the concentration of leukocytes of more than 9.0 x 109 / l), which is also a contraindication to the operation.
- Blood chemistry. A biochemical blood test may contain data on the functioning of the liver, kidneys, heart and other internal organs. Violation of their functions can also be a reason for canceling or postponing the dental implantation procedure. Moreover, during the biochemical analysis, the concentration of glucose in the blood is determined, which makes it possible to identify patients with diabetes mellitus.
- General urine analysis. Common urinalysis detects infections genitourinary systemas well as functional kidney disease.
- Analysis for viral hepatitis. As mentioned earlier, infection with certain viruses can be the cause of hepatitis. Determination of markers of hepatitis B and C viruses is of diagnostic value before dental implantation, since they can lead to chronic course diseases and liver damage. Also, the doctor performing the operation can become infected with these viruses if, during the procedure, he contacts the patient's blood ( for example, if his glove breaks or is pricked with a needle).
- HIV test. This analysis is carried out for several reasons. First, if the doctor knows that the patient has HIV, he will take additional measures to prevent the development of infectious complications during and after surgery. Secondly, during the operation, he will be very careful not to get infected himself. Thirdly, the analysis is performed before any surgical intervention in order to ensure the safety of the doctor. The fact is that after the operation, the HIV-infected patient can sue the doctor, saying that it was during the implantation that he was infected with this virus. Laboratory confirmation of the presence of HIV in a patient before surgery will prevent this scenario.
- Pregnancy test. Is not mandatory researchhowever, it is best for a woman to make sure she is not pregnant before planning for implantation. The fact is that in some cases, the total duration of tooth implantation can be several months ( after the first stage, a certain break is made, and then the second stage of the operation Toothache is performed. What to do?
- Dentist (dentist, orthodontist) - what kind of doctors are they and what do they treat? When should you contact him? What awaits the patient at the appointment?
Of all modern methods restoration of teeth, implantation can be safely called the most progressive at the moment. Moreover, this technique demonstrates tremendous reliability and efficiency, as evidenced by international statistics. At the same time, it should be remembered that this procedure has not only indications, there are also contraindications to dental implantation, respectively, before starting it, you should carefully think over and weigh all the pros and cons.
Indications
It is impossible to install dental implants without specific indications, experts always warn about this. These include:
- A defect of a single character in the dentition, in the presence of which the doctor must do everything possible to healthy teeth in the neighborhood were not adversely affected.
- The absence of several teeth in a row, running in a row. This situation literally forces the dentist to use one of the options for using implants to solve the problem.
- Absence of end teeth in a row. In this case, simpler and more affordable ones are practically excluded, since it is not possible to find support for prostheses, for implants there is no such problem.
- The patient has no teeth. Not the most obvious case, but it is the only one possible for those who are not ready to constantly get out of their mouths.
- Rejection of prostheses by the body. In this situation, there is simply no other alternative, and to restore teeth, you will have to resort to implants.
In addition to the above, it should also be noted that when performing this operation, there is no need to remove the nerves.
Contraindications
Implantation, by its nature, is one of the operations that cannot be performed only on the basis of the patient's wishes; it is necessary to take into account both the indications and contraindications for implantation. Contraindications can be different, for example, absolute ones include:
- heart diseases;
- diabetes mellitus and other disorders in the functioning of the endocrine system;
- diseases of the central and peripheral nervous system;
- tumors;
- low rates of blood clotting;
- renal failure;
- alcoholism and drug addiction;
- age less than 22 years;
- mental illness;
- an allergic reaction to the materials and components used;
- immune pathologies.
In the situations described above, implantation becomes impossible, however, there are times when contraindications may be relative. They do not exclude the very possibility of installing implants, but the operation must be preceded by a certain preparation, for example, a revision of the nutritional system, treatment of diseases, psychological preparation. Relative contraindications include:
- severe stress;
- endocrine diseases;
- poor quality food;
- sexually transmitted diseases;
- the presence of other implants in the body.
There are also situations when local contraindications prevent implantation, that is, certain diseases of the oral cavity, which should first be cured before starting this procedure. These include the following:
- jaw defects;
- grinding teeth;
- malocclusion;
- high level of tooth wear;
- small volume of bone tissue;
- insufficient quality oral hygiene.
Finally, there is also a group of general contraindications, which can either completely exclude the very possibility of installing implants, or make it feasible if certain conditions are met:
- intolerance to anesthesia;
- diseases of those organs that may be under the influence of implantation;
- using certain types of drugs, such as antidepressants;
- nervous disorders;
- exhaustion of the body;
- stress;
- poor oral hygiene.
Possible complications
Technically, implantation does not belong to the number of surgical operations that pose a danger and threat to the patient, but various complications can arise during the installation of implants, in particular:
- the appearance of pain, which is a completely natural reaction of the human body to the appearance of a foreign element inside it, pass painful sensations usually fairly quickly, in just a few days;
- swelling, which also goes away very quickly, especially if cold is used to facilitate healing;
- bleeding that lasts no more than 3 days under normal conditions;
- temperature rise over several days;
- divergence of seams, although this is extremely rare, indicating mechanical problems or the onset of inflammation;
- the process of inflammation of the tissues located around the implant, due to the penetration of infection.
All these problems usually arise due to the natural reaction of the body and last no longer than 3-4 days, if during this period deterioration is observed, then you should immediately consult a doctor for help.
Modern methods of implantation can reduce the risks of surgical operations. In particular, or "all for 6", as well as other protocols with immediate loading, when the prosthesis is placed immediately, are carried out only after careful preparation, pre-made computed tomography and 3D treatment planning.
How do you know if there are any contraindications?
No such procedure can begin if the doctor has not thoroughly examined the patient, examined him and studied his medical records. Carrying out this examination assumes that in its process the collection of all information about the state of the body, in particular, the oral cavity, will be performed.
It is important to know: It is imperative to perform an X-ray and collect a number of tests to find out if there are possible contraindications.
How much does implantation cost?
Despite the fact that dental implants have a large number of contraindications, they are very popular in modern dentistry... Therefore, if you have indications for dental implantation, then you should familiarize yourself with their prices.
The cost depends on what type of product is installed and by what method. For example, it will have a price of 35,000 rubles. and higher. And laser, due to its specificity, will be slightly more expensive, by about 30%.
Expert opinions
Aleksandrov Vladimir Nikolaevich, surgeon-implantologist
“I must emphasize that in this area there is a steady tendency towards a decrease in the number of contraindications every year. Today, an absolute and uncontested ban is very rare, in the overwhelming majority of situations, implantation is possible after certain preparatory measures have been taken. There are no special age restrictions, except, of course, the childhood period of human development, just patients with potential contraindications require more serious control and attention to themselves. "
Konareva Svetlana Nikolaevna, chief physician dentistry
“Implantation is now the most popular and demanded operation among our patients. At the same time, we have to admit that not all of them, alas, adhere to our recommendations after the completion of the procedure, using hard brushes, not following a diet and touching the seams while brushing their teeth. As a result, this leads to complications and problems that have to be solved later, but already spending time, money and nerves. "
For a conscious choice of treatment method you should always consider all possible options. If it is necessary to restore a missing tooth, first of all, you should turn to the least complex and most gentle methods, such as dentures that require minimal preparation, or removable dentures.
Need covering adjacent teeth or the need for other restorations is an argument in favor of a standard bridge. Implantation is worth considering in following cases:
If there are three between the teeth: a bridge in such a situation is impossible without a significant change in the size of the abutment teeth.
In the absence of key abutment teeth (for example, a canine), which complicates the design of the bridge.
When complete absence abutment teeth, for example, with congenital partial edentulous or long terminal defect.
With a large defect in the dentition, when the supporting teeth are not enough for a bridge of the appropriate size.
When changing existing restorations is more complicated and expensive than implantation.
In case of a controversial condition of the key abutment teeth, for example, in the presence of pin and stump tabs.
When the adjacent teeth are completely healthy.
General contraindications for implantation
As for others methods of dental treatment, there are general contraindications for implantation associated with somatic and mental illness... Specific contraindications for implantation include the following conditions:
Patients with uncontrolled diabetes mellitus are more likely to have complications and an increased risk of implant rejection in the long-term postoperative period.
Patients who received radiation therapy, may have low bone vascularization in the irradiated area.
Progressive periodontitis is an obvious risk factor for implantation.
Smoking: Individuals who smoke more than 20 cigarettes a day are at risk of implant rejection, and the longer they smoke, the higher the risk. Quitting smoking for at least a short period (several weeks) before and after surgery can have a beneficial effect, but smokers with long experience for many years after quitting this habit still have a greater risk of rejection than non-smokers.
Age of the patient: implantation is possible only after the end of the growth of the facial skeleton: in women - after 18 years, in men - after 21 years. There is no upper age limit for implantation.
Patients with persistent bruxism often have complications during implantation, but this factor applies equally to other methods of restoring the integrity of the dentition.
Many the patients have unrealistic expectations about the outcome of treatment and this can be critical given the cost and complexity of implant treatment. It is very important to carefully draw up a treatment plan and understand what the patient expects in order to avoid mistakes in choosing a method. Removable denture may have a better appearancethan a complex implant-supported design.
Choosing between implantation and bridges
In some cases, this choice is obvious, since alternative options are not possible, for example, in the situation depicted in the figure, where, with the loss of the central incisor, there are three between adjacent teeth. However, in most cases, the doctor is still forced to make a decision, choosing from several possible options. At the same time, the patient must also participate in the selection process and receive all the necessary information so that his consent to treatment is truly informed.
Information about the method of treatment must include the approximate life of the restorations, the likelihood of failure, the duration and cost of the treatment. Even if the doctor assumes that the patient will not be able to afford the implantation, or if he is not personally involved in the installation of implants, this method of treatment should still be offered and discussed, and the patient should be referred to the appropriate clinic.
Video lesson how tooth implantation is carried out, what are the prices, stages and its types
If you have problems with viewing, download the video from the pageDental implantation is an operation that involves implanting an artificial root into the bone tissue. Implants allow you to completely restore not only the aesthetics of the smile, but also the functionality of the teeth. They are used as a support for a crown or removable denture.
The construction itself consists of a titanium screw and an abutment on which the crust is put on. For the product to take root, not only the qualifications of the master and the quality of the dental implant are important, but also the patient's fulfillment of all requirements during the recovery period.
Dental implantation is performed only when necessary. It is determined by the doctor after a complete diagnosis and collection of the patient's anamnesis. The implantation of artificial roots is carried out with the following indications:
- Single defect in the dentition;
- The need to create a support for removable prosthetics;
- Complete adentia;
- The desire to make the smile more aesthetic.
All contraindications for such a procedure can be divided into absolute and relative. In the first case, the operation is prohibited. Dental implantation should be completely abandoned in the following clinical situations:
- Bruxism;
- Open tuberculosis;
- Serious pathologies of the cardiovascular system;
- Low protective functions organism;
- Deviations in the work of the hematopoietic organs;
- The presence of a malignant tumor;
- Sexually transmitted diseases;
- Diabetes mellitus 1 degree.
Relative contraindications may indicate that there is a risk of an adverse outcome. However, the operation can be performed if all precautions are taken. These contraindications include:
- Diabetes mellitus 2 degree;
- A predisposition to an allergic reaction;
- Osteomyelitis;
- Pathological bite;
- Precancerous condition of the tissues of the oral cavity;
- Infection.
Relative contraindications include the period of bearing a child. If the situation permits, implantation is best done.
Advantages and disadvantages
Dental implantology is a direction that has many advantages. After the operation, the aesthetic appeal of the smile is fully restored. This procedure is less traumatic and reliable. After the implant is placed, the patient can speak and eat normally.
Despite great amount advantages, implantation of implant structures has the following disadvantages:
- There is a risk of implant rejection (less than 5%);
- A large number of contraindications;
- Duration of the procedure;
- High price.
The implant may not take root due to the individual characteristics of the patient, for a reason proper care behind oral cavity, due to the use of low-quality material or due to its incorrect installation. In especially advanced cases, the duration of the procedure can be up to six months. The cost of installing an implant is much higher than a simple prosthetics.
Types of implants
There are different models of implant structures. Each of them is designed for a specific clinical case. The following varieties are distinguished:
- Classic;
- Short;
- Mini implants;
- Intramucosal;
- Basal;
- Zygomatic.
The classic type of root implants is presented in the form of an elongated cylinder or dental root. Their length is 6-7 mm. Such products can be used in almost all clinical situations. In areas with a minimum amount of bone tissue, short implants of 3-6 mm are installed. Their stability and reliability is ensured by their large width.
Elongated basal products are inserted directly into the basal bone. They take root best in diabetic patients and smokers. Zygomatic varieties are placed in the zygomatic bone. They are used with a minimum amount of bone tissue. They serve as an excellent fixation for a bridge or fixed prosthesis.
Mini-implants are used to create temporary support for prosthetics or as additional reinforcement for placing braces.
Intramucosal models are not fixed in the bone tissue, but in the mucosa. Most often they are used for fixing removable dentures in the elderly.
Implantation methods
The result of the manipulation depends not only on the type of implant chosen, but also on the technology of the implantation. There are several methods for carrying out such a procedure, each of them has its own advantages and disadvantages. Implantation techniques do not require prior turning healthy teethwhich are located in the neighborhood.
Two-stage implantation
This method is considered a classic in dental implantology. It is great for almost any clinical situation. Both conventional tapered implants and short ones can be installed. The main difference between the two-stage technique is that it allows the product to gradually take root in the bone. This approach is more gentle for the patient's body and ensures successful engraftment.
Initially, the doctor prepares the bone bed for the installation of cylindrical or screw implants. To do this, muco-periosteal flaps are removed and a small depression is created in the tissue itself. A guide channel is installed in the bone, which then expands. After preparation of the bone bed, an implant is screwed into it, on top of which a plug is installed. All mucoperiosteal flaps are returned to their place, and the wound is sutured. The whole procedure takes about 1 hour.
The healing period can last from 3 months to six months. The second stage of implantation is the installation of the support head. To do this, incisions are made on the mucous membrane, the plug is removed and the gum former is mounted, which is then replaced with a support head.
The disadvantage of this technique is that it does not allow you to instantly restore a lost tooth. However, in this case, engraftment occurs better, and the risks of developing complications are much less.
One-step procedure
This method involves the installation immediately on the implanted implant. Not all types of products are suitable for such an operation, since some of them cannot provide the required level of stability.
One-stage implantation occurs in the following way:
- On the day of tooth extraction, the implant, abutment and temporary crown are installed.
- For six months, the process of gum formation and engraftment of the product takes place.
- After final healing, an abutment is made according to the individual characteristics of the patient and a permanent crown is installed.
This procedure has many names: express, instant, instantaneous implantation. The essence of the technique is that both tooth extraction and the installation of a temporary crown are carried out in one visit to the doctor.
Laser and basal technology
Some doctors consider the laser method of manipulation a separate speciesbut it is actually a simple addition to the two-step technique. In this case, the gum is not cut with a scalpel, but with a laser. Therefore, the operation is bloodless, and the risks of developing an inflammatory process are minimized.
The peculiarities of the basal implantation are that instead of the usual tapered products, long basal ones are installed. They are screwed into the bone and the prosthesis is immediately inserted.
Basal technology provides for one-stage manipulation. Its advantages include the following nuances:
- Installation of an implant immediately after tooth extraction;
- Low trauma;
- Installation of a temporary prosthesis on the day of implantation of the device;
- The dentition looks aesthetically pleasing immediately after manipulation;
- No need to carry out sinus lifting and other additional procedures that provide;
- The restoration of chewing function occurs in a short time.
Due to the fact that the implant is installed in a dense basal bone, its stability and reliability increases several times. A permanent prosthesis is installed one year after successful engraftment. It is recommended to use metal-ceramic crowns as a prosthesis.
All-on-4 method
The peculiarity of this technique is that it allows you to install a prosthesis for the entire jaw on 4 implants. To do this, 2 products are implanted at a right angle, and the other two - at an angle of 30-45 degrees on the sides. Most often, this method is used for elderly patients or with a minimum amount of bone tissue.
The advantages of this implantation are as follows:
- prosthetics will take 4 to 5 days;
- no need for bone augmentation;
- reliable fixation of the prosthesis with screws;
- correct distribution of the load on all implants.
The cost of this type of implantation is much lower than the installation of an implant for each tooth separately. This is a great opportunity to restore teeth if they are completely lost. The habituation period is as short and comfortable as possible.
Stages of the procedure
The implantation process takes place in stages. Sometimes it takes a long time to complete the procedure. The exact duration of the manipulation depends on the individual characteristics of the patient's body and the complexity of the clinical situation.
The first step is planning. The doctor conducts a complete diagnosis. For this, X-ray and computer studies are carried out. If necessary, dental treatment is performed.
The next stage is itself surgical intervention... An artificial root is screwed into the bone. If necessary, the doctor can carry out additional manipulations that will help eliminate degenerative processes in the tissues.
The operation itself lasts from 30 minutes to several hours. It provides for the following algorithm:
- the introduction of anesthesia;
- implantation of an artificial root;
- suturing the wound.
The sutures are removed 7-10 days after the intervention. In some cases, additional surgery is performed to place the healing cap. After a few weeks, it will be removed and an abutment will be placed in its place.
The final stage of the surgical intervention is the installation of the crown, removable structure or bridge. As a result of all the manipulations, the patient receives full-fledged teeth that perform their chewing functions and have an attractive appearance.
The engraftment period is important. Due to the good biocompatibility of titanium, osseointegration is about 96%. The result of the operation is assessed by the doctor using a root mobility test. In this case, the patient should not experience painful sensations.
Complications and preventive measures
In some cases, postoperative complications may occur. These include canal perforation, suture failure, or implant fracture. If pain and inflammation occur, you should consult a specialist.
- during the first days after implantation, ice should be applied to the cheek every 3 hours;
- the mouth must be rinsed with antiseptic solutions;
- the gum should be treated with a special dental paste;
- the toothbrush should have soft bristles.
To avoid trauma to the mucous membrane, you must temporarily switch to soft food. Medical support for dental implantation is mandatory. The doctor prescribes the intake of antihistamines, antibacterial and anti-inflammatory drugs.
