What tests need to be passed for dental implants. Dental Implant Tests

My LJ friend didn’t have a pair of teeth, and after reading several articles from this blog, he decided to restore them with crowns on implants. Following the advice, he turned to a well-known network clinic, where the doctor, glancing briefly at him, said: "Kakie dela, we’ll do it right now!" and suggested that he immediately put the implants. To my friend, this approach seemed suspicious, so he decided to consult somewhere else. So he went to another clinic, where the doctor, looking into his mouth right in the corridor, issued a blank slider with a preoperative examination plan. The list included computed tomography, detailed blood and urine tests, a consultation with a cardiologist, therapist and endocrinologist, tests for tumor markers, etc.

Today I would like to talk with you about how to prepare for a dental implantation operation (osteoplasty or sinus lift), what preoperative examination is necessary, what indications and contraindications exist for a dental implantation operation.

In other words, today we’ll talk about what the patient must do to calmly and safely go through all stages of implant treatment without spending extra money, time and emotions.

The difference between the extreme photos is a week. The last photo was taken immediately after the seams were removed.

Let's start with contraindications and indications.

Indications for dental implantation.
The absence of one, several or all teeth (with the exception of wisdom teeth).

From this:

to this:

Any tooth of any location at any time can be prosthetized with a crown on the implant.

Contraindications

They can be divided into two types: absolute  (irresistible) and   relative (solvable). So, my friends, there are no absolute contraindications to the operation of dental implantation. Neither disease, nor bone deficiency, nor age, nor anything there are insurmountable contraindications for the installation of implants.

All contraindications to dental implantation are relative. That is, they can be eliminated.

VERY CAUTION, but it is possible to install implants for patients with diabetes mellitus of any type, with autoimmune diseases in remission, etc. Of course, we are talking about compensated forms of the disease and the patient's compliance with all doctor's recommendations.

Bone tissue deficiency has long been not an obstacle to dental implantation. The capabilities of modern surgical equipment allow you to recreate the desired volume of bone needed to install the implant in any area of \u200b\u200bthe dentition.

Smoking is also not a contraindication for dental implantation. Moreover, .

Perhaps the most serious contraindication is poor oral hygiene. But, we are adults, can we really not cope with this?

Preoperative examination.

This is the point where there is a misunderstanding not only between the doctor and the patient, but also between doctors in general. What examination should be done before the operation of dental implantation? Where to begin?

The main, most important, most important principle  preoperative examination is the principle of medical expediency. In other words, when prescribing one or another medical diagnosis, we must clearly know what we are doing this for and what we hope to find there.

Consultations of related specialists.

The most important doctor in implantology is an orthopedic dentist. The goal of our work is high-quality, reliable and aesthetic dentures based on implants. A dental implant is just the support of a prosthesis. How many such supports will be, where they will be located, in what position to stand - all this is determined by the design of the future prosthesis. To do this, you need an orthopedic doctor.

If the teeth are missing for a long time, then the patient often changes his bite, up to the impossibility of high-quality and aesthetic prosthetics. Therefore, in some cases, patients before implantation (as well as before prosthetics in general) require an orthodontic consultation and, possibly, orthodontic treatment.

It is highly recommended that before dental implantation (as well as before any other surgical operation in the oral cavity) undergo a professional hygiene session: using ultrasound and AirFlow, remove tartar and plaque, as well as receive recommendations on oral hygiene in order to maintain all this cleanliness.

Sanitation of the oral cavity.

Some doctors require that the oral cavity be completely sanitized before implantation. The requirement is fair, if you do not go too far.

Yes, there should be cleanliness in the oral cavity, the absence of acute and potentially dangerous inflammatory processes, such as chronic pulpitis, periodontitis or periodontitis in the acute stage, etc. BUT! If orthopedic treatment is planned on natural teeth (crowns or inlays), then it is better to postpone it to prosthetics on implants - it will turn out easier, better and cheaper.

Whoever says anything, but the presence of a tooth with a sluggish fibrous periodontitis in the implant area does not at all affect the condition of the implant. Even relatively large granulomas on adjacent teeth do not affect the outcome of the implantation operation.

Diagnostic Models and WaxUp.

We must not forget that the purpose of the implantologist's work is high-quality, durable and reliable prosthetics, and not the installation of implants. Implants are just the support of the prosthesis, not the prosthesis itself. Therefore, the size, number and location of implants depends, first of all, not on the imagination of the surgeon, but on the tasks that the orthopedic dentist sets before him.

Otherwise, it turns out this is an implant, on which for several years no one can make a crown.

I always said that in order to become an implantologist, you need to be not so much a cool surgeon as a little orthopedist. In addition, to have well-developed spatial thinking and imagination. Because the most difficult thing in dental implantology is the selection and positioning of implants.

To put the implants in the correct position, you need to clearly understand what the prosthesis will be. For this there is wax-up, the so-called. "wax modeling".

We do it if the positioning of the implants is difficult. For example, cases of the absence of several teeth, atrophy of bone tissue or when planning a prosthesis of complex design.

According to wax models, you can not only clearly imagine and show the patient how the treatment will end, but also correctly position the implants, calculate their diameter and position:

From the figure it is clear that the larger the tooth, the larger the diameter of the implant is needed for prosthetics.

In addition, the implants of adjacent teeth must be parallel. Otherwise, the orthopedist will encounter difficulties, right up to "prosthetics is impossible":

I think we will devote a separate article to the positioning and selection of implants. Too complicated topic.

In general, my friends, an orthopedic consultation is an essential step in preparing for a dental implantation operation. And in difficult cases, it is necessary to do diagnostic models and wax modeling.

Long-term tooth loss leads to a number of serious changes in the dentition, namely:
  - redistribution of loads in the dentition
  - the movement of adjacent teeth, malocclusion
  - dystrophic changes in the temporomandibular joints and masticatory muscles
  - atrophy of bone tissue and mucous membrane in the area of \u200b\u200bmissing teeth

The doctor’s task is not only to “make beautiful,” but also to restore normal function, eliminating the consequences of tooth loss. To do this, you need to understand what happened to the dentitions after their "thinning". This purpose is served by the functional diagnosis of the dentition. Details about it can be found in this article.

Of course, in uncomplicated cases (single implants, the absence of problems with a bite, etc.), there is no urgent need for it.

Surgical template
If the positioning of the implants is difficult, then the orthopedist makes a special stencil template for the operation. The need for a surgical template is inversely proportional to the qualifications of the implantologist and directly proportional to the complexity of the implantology work.

Templates can be done in several ways. You can use special computer programs and a three-dimensional printer. For example, Implant-Assistant:

and as a result:

You can make a surgical template “manually” using diagnostic models and wax-up. As a template, you can use removable or temporary prostheses by drilling holes and installing the guide bushings in the right places. A lot of options. However, whether a template is needed in this case, or whether it is possible to do without it, is decided by the implantologist.

Perhaps this is the main study before the implantation operation, which must be carried out in 100% of cases. DO NOT proceed with implant surgery without computed tomography data. Otherwise, it can seriously harm the health of the patient.

For CT, special digital tomographs and special dental programs are used. Nevertheless, teeth are not the liver and not the kidneys, therefore, a special configuration of cross sections and high resolution are required.

Some doctors ignore CT scans, believing that targeted or even targeted shots are sufficient for implant planning. Perhaps in a very simple uncomplicated case this is enough, but these very simple cases are very rare.

First of all, you need to understand that aiming images and orthopantomography have a number of significant distortions, and their accuracy greatly depends on who took the pictures. Slightly changed the position of the sensor relative to the head - and that's it, the picture looks completely wrong. Therefore, relying on OPTG or radiovisiography, planning such complex work as implantation, is by no means impossible. Dangerously.

Computed tomography allows you to evaluate the configuration, volume and structure of bone tissue in the area of \u200b\u200bthe proposed operation. Sometimes, for greater accuracy, special radiopaque patterns are made, but, in my opinion, they are not necessary. For distracting attention and may be the cause of artifacts in the picture.

Blood tests, urine tests and other laboratory diagnostics.

In some clinics, there is a rule that all patients must undergo blood and urine tests before surgery. At the same time, these analyzes have no effect on the planning of surgical interventions - as yet no patient has been denied surgery. The question begs: why then are they needed?

In terms of trauma, effects on the body and the number of complications, dental implantation is much easier than tooth extraction. Sinuslifting and osteoplasty are easier and more comfortable than the complex removal of any resorcine six or eight. BUT we do not send the patient to undergo tests before each tooth extraction, right?

Everything has its own indications and contraindications. For example, we have a patient who says: "Well, I have such and such health problems, I have been seeing such and such a doctor." In this case, we are obliged to get advice from this doctor about the possibility of surgical intervention. And it is he, and not us, who should send the patient for testing if such a need arises.

And the fact that some dentists ask all patients for detailed blood, urine and tear fluid tests, but they don’t remember the quantitative indicators in the norm, they don’t know how to interpret them correctly .... this, excuse me, is complete crap and pulling money.

Conclusion

I did not expect the article to turn out to be so voluminous - apparently almost two weeks of absence from LJ have an effect. I think you need to make a brief summary. So:

Mandatory stages of preparation for an implantation operation are:
  - orthopedic consultation
  - CT scan

Optionally, according to the results of a consultation with an implantologist and orthopedist, the following are prescribed:
  - diagnostic models, wax modeling
  - consultations of related dental specialists, oral rehabilitation
  - professional oral hygiene
  - functional diagnostics of the dentition
  - manufacturing of a surgical template

Strictly according to indications are assigned:
  - laboratory tests of blood and urine
  - consultations of specialists of a non-dental profile - cardiologist, general practitioner, endocrinologist, rheumatologist, etc.
  - electrocardiogram

moreover, the first and last paragraph appoints a non-dentist of the corresponding specialty.

Absolutely not needed:
  - electroencephalography
  - metal tolerance tests
  - MRI
  - dynamic CT or MRI
  - Laboratory tests of cerebrospinal fluid and prostate secretion.

And finally, successful treatment and the result is the merit of two people, a doctor and a patient. And not just one doctor.

Be healthy!

Sincerely, Stanislav Vasiliev

Installing a dental implant requires a serious approach. This is why proper preparation for dental implants is important. The doctor needs to know the maximum information about the patient’s health status. A person who is planning a dental implant will also be able to psychologically prepare for this procedure.

In dental practice, dental implants are common. This does not prevent many people from experiencing a genuine fear of the term “dental implant” even today. The reason for this is a lack of knowledge. The person is in doubt and does not trust the dentists performing the implantation.

Let's try to consider the questions that patients pose themselves.

Preparation before dental implantation

To bring back an attractive smile, you don’t need to sacrifice your own comfort. Anyone can safely restore their teeth thanks to modern techniques.

It is required that the person be ready for the upcoming surgery. The dentist needs to collect certain information. That is why a comprehensive examination is prescribed before the procedure. It consists in:

X-ray of the dentition. It allows the dentist to understand the problem and choose the best treatment tactics.

Computed tomography. It makes it possible to find out in what condition the bone tissue is. The tomogram allows you to choose the optimal type of implant.

Important and the general condition of the body. A qualified doctor pays attention to his individual characteristics and prescribes additional examination methods, in accordance with them. It is desirable that the patient be completely healthy before implanting a tooth. Due to this, it will be possible to minimize any unpleasant consequences.

Preparation of the oral cavity is an important component

When you mean dental implantation, operation preparation  includes sanitation of the oral cavity. What is meant:

1. If caries is found, it should be treated. The dentist performs root canal filling to the end of the root in the presence of caries with a complicated course. If all these therapeutic measures do not give a result, resort to surgical intervention. This is the removal of the apex of the root of the tooth, the elimination of granulomas, if present.
2. There are two possible treatment options for the detection of periodontitis: therapeutic and surgical. When the space between the teeth is inflamed, in some cases it is necessary to treat dental deposits under the gums by treating the gingival pockets.
3. Implantation is prohibited when periodontal disease and periodontitis are detected in advanced form. If you want to carry out the procedure, first try to heal the tissues around the teeth. It is unlikely that an implant can be installed if preparation for implantation is poor.

Features of orthopedic training

This stage is considered if the patient has orthopedic structures or prostheses that have to be replaced. If you have such designs, it is better to replace them before proceeding with implantation. An important point is the compatibility of materials. If this feature is not taken into account, various complications are possible, including the formation of galvanic cells. Suppose corrosion is inevitable when there is a combination of a titanium implant and a nickel-plated metal product. That is why dentists prefer materials with similar properties.

Preparation for dental implant after removal  can be carried out effectively if the person has been instructed in oral hygiene. He must know how to care for implant prostheses correctly. If for certain reasons a person is not able to maintain oral hygiene, the doctor has the right to refuse implantation. The same applies to the installation of fixed orthopedic structures. It is much more efficient to put removable dentures in this situation.

Why is preparation for implantation required?

It allows you to divide patients into those who are shown implantation, and those who are suitable for traditional methods of orthopedic care. Not only neglect of health is a contraindication. Excessive consumption of coffee, smoking are social contraindications.

What if the implant does not take root?

The probability of rejection is minimal. It does not exceed 1% of 100. Sometimes rejection is the result of an incorrect approach to treatment, when the material and dimensions of the implant were chosen incorrectly. Sometimes the patient himself is to blame for such a development of events. Suppose, during an implantation operation, he did not sufficiently observe hygiene, as a result of which inflammation of tissues of an infectious nature developed.

Preparation before dental implantation  will come to naught if the patient has exacerbated chronic diseases. The engraftment and individual intolerance of the individual components will also hinder.

That's why it matters preparation for dental implants. The presence of an experienced doctor in combination with the patient following all the recommendations leads to a successful implantation.

What to do before implantation?

• It is forbidden to eat and drink 2 hours before implantation. But excluding breakfast is completely not recommended. Strength will definitely come in handy for you, so a light snack will even benefit.
• It is allowed to take sedatives an hour before the operation. The drug is chosen by the doctor individually, when the patient experiences strong mental excitement before manipulation. What you should not do is use alcohol as a way to get rid of stress. It is forbidden to use it.
• Dental brushing is required 30 minutes before implantation.
• A good dream and a positive attitude are almost half the success, because in this way you protect yourself from gloomy thoughts. Go to bed early on the eve of the operation, preferably a day before it.

Speaking about preparation for implantation, a specialist should definitely pay attention to the mucous membrane of the oral cavity. The following parameters are important:

• Thickness;
• Mobility.

Anatomical formations of the dentofacial system and their location relative to each other are also important. In addition, the implantologist looks at the features of bone tissue, its structure and size, the anatomical features of the jaw.

Preparation for dental implantation. Video.

How to avoid pain?

An individual selection of painkillers is the prerogative of the attending physician. If planned dental implants, preparation for surgery  makes it possible to choose anesthesia to exclude pain. Quality painkillers are available to patients today. In combination with modern equipment, they allow the implantation of teeth without pain.

Age restrictions

There are no strict restrictions. Even elderly patients whose age exceeds 70 years old have good results. As for adolescents, the success of engraftment is determined by the characteristics of the bone tissue. For boys it is recommended to install implants from 19 years old, while for girls it is possible to carry out the procedure from 17 years old.

Dental implant design and selection

It is determined by:

1. The condition of the dentition;
2. The width of the jaw bone;
3. The height of the bone jaw tissue.

First of all, two factors influence the outcome of implantation:

1. Surgical technique;
2. Proper preparation of the material.

How long will implants last?

Life as such is absent with respect to dental implants. But it is fair to assert in relation to those that were installed correctly. If the implant takes root well, a person will use it all his life. He will not have to worry about the life of the implants.

How to achieve this:

• Adhere to general hygiene rules;
• Minimize jaw injuries
• Avoid mechanical factors;
• Professional cleaning combined with regular cleaning at home.

All this will extend the life of the implants, will serve as a guarantee of oral health.

Bone grafting, bone tissue extension, targeted bone regeneration, sinus lift for dental implants

One-Stage ( single phase) basal dental implantation

Immediate dental implantation according to the immediate loading protocol ( without gum cut) - (video)

How to behave in the postoperative period ( what can and cannot be done after dental implants)?

Possible complications, consequences and side effects of dental implants

Where ( in which clinics or dental clinics) Can I have a dental implant in the Russian Federation?

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Specialist consultation required!

What is dental implantation?

Dental implantation  - This is one of the modern and reliable methods of restoring lost teeth. Its essence lies in the fact that part of the dental implant is inserted into the jawbone instead of the damaged root ( remote) tooth and is firmly fixed there. The external part of the implant is covered with a special crown or prosthesis, providing 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 is worth noting 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 bone tissue of the jaw. The average life of a dental implant ( when using high-quality materials and the correct installation technique, as well as with proper oral care) can reach 25-30 years or more.

What is the difference between prosthetics and dental implants?

Implantation and prosthetics are two completely different procedures for the restoration or replacement of damaged teeth. Prosthetics are used when 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 grinds the rest of the tooth, and a metal or ceramic-metal prosthesis is applied to it ( a crown or the so-called "bridge" that allows you to replace several teeth at once) With proper care, the service life of such a prosthesis can reach several tens of years.

The main difference between prosthetics and dental implants 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 ( in the jaw bone) implanted metal frame ( directly 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 from the bone is extremely difficult ( this can only be done in an operational way).

Indications for dental implants

As follows from the foregoing, various diseases and pathological conditions can be indications for dental implants in which the entire tooth is absent or cannot be saved ( including its root).

Implantation of one or more teeth is indicated:

• With an adentia.  This term refers to the complete absence of teeth in the oral cavity. Typically, this condition can be observed in older people who have not applied for qualified dental care for a long time, as a result of which they lost all their teeth.

• In the absence of one or more teeth in the mouth.  If you need to replace one tooth, one implant is installed instead. If the patient does not have several adjacent teeth at once, a special plate can be implanted in the jaw, on which there will be 2 - 3 or more “teeth”. This will speed up the treatment process, as there is no need to install each implant separately.
• With looseness and loss of teeth.  There can be many reasons for increased tooth mobility, from diseases of the teeth themselves to pathologies of the jaw bone. As a rule, once a loosened tooth will never return to its previous, normal state, as a result of which the option of replacing it with an implant should be considered.
• If it is impossible to wear removable dentures.  When wearing removable dentures, some people may experience permanent discomfort in the oral cavity, and therefore they can be recommended to perform implantation.
• If it is impossible to install permanent prostheses.  Even when wearing a quality crown, part of the tooth underneath can be destroyed. If this happens, the crown will no longer be able to stay in place, and it will be impossible to establish 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.  With some congenital or acquired abnormalities of the upper or lower jaw, malocclusion may occur, which cannot be eliminated otherwise. 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 treatment of periodontitis, while with periodontal disease can only be used in advanced cases, with the ineffectiveness of other therapeutic methods.

Periodontitis is an inflammatory disease of the tissues that surround the tooth and ensure its fixation in the jawbone. With this pathology, the destruction of the alveolar process of the jaw ( in which the tooth is directly fixed), as well as the formation of ulcers around the tooth itself. As a result of this, it loosens and falls out. Dental implantation is indicated only after treatment for periodontitis and elimination of the causes of its occurrence.

Unlike periodontitis, with periodontal disease there is no development of the inflammatory process. This pathology is characterized by slow destruction of the bone tissue of the jaw and damage to its alveolar processes, resulting in exposure of the root of the tooth. 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 it is not advisable to carry out implantation in the early stages of the disease ( medication and surgical treatment aimed at restoring bone tissue around the tooth is indicated) At the same time, it is worth noting that with prolonged progression of the disease and without the necessary treatment, the tooth root can be exposed ( protrude above the gum surface) more than 50%. In this case, the tooth may become unstable, and the risk of tooth loss will also increase. If this happens, tooth implantation will be the only possible treatment.

Is dental implantation performed for children?

Dental implants are not recommended for children under 18 years of age. The fact is that in the process of growing up the child, the jaw bones and the teeth themselves grow and change. An implant placed in early childhood would have turned out to be too small for the patient after some time, as a result of which it would have to be reinstalled. Performing such a procedure would be impractical and extremely traumatic. That is why in such cases, various options for prosthetics are first applied, and after the child stops growing, the question of installing permanent implants is decided.

Dental implant alternatives

Tooth implantation is a fairly reliable, but expensive and relatively time-consuming method. If the patient is not ready for such a procedure, the damaged tooth can be “fixed” in other ways.

An alternative to tooth implantation may be:

• Classical prosthetics. In this case, a special crown is put on the prepared upper part of the tooth, which protects the tooth from further destruction. It is worth noting that dentures can be removable ( the patient can take them off at will whenever he wishes) or permanent, which are firmly fixed to the rest of the tooth and can only be removed by a specialist in a dental clinic.
• Reimplantation of a tooth.  This technique is similar to classical implantation. First, the doctor carefully removes the damaged tooth, which is subsequently specially treated ( that is, restored, restored) - pathological foci of caries and other injuries are removed from it, various deformations and channels are sealed, and enamel is restored ( the outer surface of the tooth) etc. After the restoration process is over, the patient’s tooth returns to its previous position and is fixed to the jawbone, after which it can last for many more years ( with proper care).

Limitations and contraindications for dental implants

The procedure for installing the implant is quite complicated, time-consuming and involves certain risks, as a result of which, before starting the procedure, 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 disease) or another similar infectious process, you should first treat it, and only after the complete elimination of the focus of infection, proceed with implantation of the tooth. The fact is that during the implantation procedure the implant will be implanted in the jawbone. If at the same time there will be a focus of infection in the oral cavity, pathogenic microorganisms can enter the blood or bone tissue, causing the development of formidable complications.

• In severe diseases of the cardiovascular or respiratory system.  During implantation, the patient may need to be anesthetized ( drug sleep), which can be dangerous in the presence of heart failure or respiratory failure.
• With diseases of the immune system.  For some pathologies, the immune system, 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 in direct contact with the patient’s blood, if the immune system is impaired, the patient may develop allergic reactions that can be dangerous for his health or even life.
• With mental disorders.  Performing a tooth implant requires a certain amount of cooperation and understanding from the patient. If the patient is inadequate and is not responsible for his actions, he cannot carry out this procedure.
• With diseases of the blood coagulation system.  Under normal conditions, this system is responsible for stopping bleeding during injuries, injuries, cuts, and so on. If its functions are disturbed, the patient may experience prolonged, heavy bleeding even after small cuts. A tooth implantation operation is associated with damage to the mucous membrane of the oral cavity, gums and jawbone, resulting in an increased risk of bleeding with this procedure. That is why, before starting its implementation, the doctor must make sure that the patient's blood coagulation system is functioning properly.
• With rheumatic diseases of connective tissue.  With systemic lupus erythematosus, scleroderma, and other similar diseases, the development of connective tissue is disrupted, which is extremely important at the stage of implantation in the jaw bone. That is why, before implanting teeth, a stable remission of the patient’s pathology must be achieved.
• In the acute phase of tuberculosis.  Tuberculosis is an infectious disease in which the lung tissue is most often affected. The acute phase of the pathology is characterized by the fact that a sick person releases the pathogen into the environment along with exhaled air ( during coughing or simple breathing) Since doctors will need to work in close proximity to the patient’s respiratory tract during tooth implantation, their risk of contracting tuberculosis increases. That is why tuberculosis should be treated first, but only after achieving stable remission ( abatement of acute manifestations of the disease and negative laboratory tests) You can plan dental implants.
• In diseases of the temporomandibular joint.  Diseases that make it impossible to open the mouth sufficiently wide can create difficulties during the operation to implant a tooth.
• With severe anomalies in the structure of the jaw. During the procedure, a metal implant of a certain length and certain sizes will need to be implanted in the jawbone. If the patient's abnormalities do not allow this ( for example, with too thin, deformed or weak bones), implantation of teeth is contraindicated for him.

Dental implants for anemia

The possibility of implantation depends on the severity of anemia ( anemia), as well as 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 loss of blood is possible during tooth implantation ( usually no more than a few milliliters, but if unforeseen complications develop, more heavy bleeding is possible), not a single doctor will take a patient with severe anemia for surgery.

It is worth noting that not only the severity of anemia is important, but also the speed of its development. So, for example, 130 g / liter is considered a normal hemoglobin level in men, and 120 g / l in women. If anemia developed slowly ( for example, deficiency of 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 with a slightly reduced hemoglobin level ( 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 dental implants can be performed only after eliminating the cause of anemia and restoring the normal level of hemoglobin.

Do dental implants do during menstruation?

It is not recommended to carry out the installation of an implant or other surgical interventions during menstrual bleeding, as this can adversely affect the general condition and health of the woman, as well as lead to the development of complications.

Dental implants 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 body) At the same time, with the development of any pathologies or complications, bleeding can 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. This is why dental implantation ( as well as any other surgical interventions) during menstruation is undesirable.
• By stress.  During menstruation, the female body experiences stress, which is manifested by increased excitation of the nervous system, hormonal changes, and so on. An operation to install an implant can increase stress, which can lead to increased nervous excitement, nervousness, nervous breakdown, and other psychological disorders.
• Blood coagulation disorders.  As mentioned earlier, the coagulation system stops bleeding. During menstruation, increased activation of blood coagulation factors is noted, which is protective ( prevents heavy blood loss) If at the same time to perform dental implantation ( during which there is also damage to the gum tissue, jaw and oral mucosa), this can further enhance the activity of the blood coagulation system, thereby increasing the risk of developing complications associated with this. The most dangerous complication may be blood clots ( blood clots) directly in the vascular bed. Such blood clots can clog vessels, thereby disrupting the delivery of blood and oxygen to certain tissues and organs ( including the heart, lungs, brain, and so on).

Can I have a dental implant 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.

Tooth implantation during pregnancy can be complicated:

• Toxic effect of medicines.  The implantation procedure is extremely painful, and therefore can only be performed using anesthesia ( anesthesia) Anesthesia is associated with the introduction 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 to fetal death. It is also worth noting that the painkillers prescribed to the patient after implantation may have a toxic effect.
• Allergic reactions.  Allergy is an overly pronounced reaction of the immune system, manifested by general malaise, skin itching, 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) in the jawbone. The development of a severe allergic reaction can lead to a violation of the blood supply to the fetus, thereby causing damage to its organs ( primarily brain) or even intrauterine death.
• Damage to the fetus by x-rays.  In preparation for implantation, it is necessary to perform an X-ray examination, that is, take a picture of the jaw and teeth ( sometimes not just one, but several) Exposure to radiation can adversely affect the process of laying and developing the organs of the embryo or fetus, which will lead to intrauterine developmental abnormalities.
• The development of infectious complications.  During pregnancy, weakening of female immunity is noted, which is necessary for the normal development of the fetus. Under such conditions, even a small number of pathogenic microorganisms entering the open wound can lead to the development of a severe infection, which will require additional treatment ( in particular, the appointment of antibiotics, which are contraindicated during pregnancy, as they can damage the fetus).

It is also not recommended to carry out implantation of teeth during breastfeeding, as the medicines introduced into the mother’s body can be excreted in breast milk and enter the baby’s body, provoking the development of allergic and other dangerous reactions.

Features of dental implants in type 1 or type 2 diabetes

If the patient has an initial form of diabetes mellitus, which has not yet led to the development of complications, and the patient accepts the treatment prescribed for him, dental implantation is not contraindicated. 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 procedure for implantation.

Diabetes mellitus is a disease in which some cells of the human body cannot normally absorb glucose ( sugar, which is their source of energy) This leads to impaired functions 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 deficiency, glucose cannot penetrate into 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 the body's cells, which cannot interact with insulin, as a result of which glucose cannot penetrate into them. It also leads to an increase in blood sugar, although insulin production is not impaired. In this case, various drugs are used for treatment that contribute to lowering sugar levels, thereby preventing the development of complications.

As mentioned earlier, with diabetes, many organs are affected, including blood vessels. Due to the 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, cell division processes 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 have developed, it will be impossible for the patient to have a tooth implanted. The fact is that after installing the implant, it should 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 does 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 is increased, which is fraught with the development of a dangerous purulent infection.

Do dental implants do oncology?

Oncological ( tumor) The diseases themselves are not a contraindication to dental implants. At the same time, it is worth noting that the presence of a malignant tumor requires its immediate treatment, since otherwise the risk of developing complications and death of the patient increases. That is why, when detecting a cancerous tumor, first of all, it should be cured, and after that, dental implantation should be planned.

To perform dental implantation is contraindicated:

• 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 ( disease progression, 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 suggests that the tumor is progressively developing. At the same time, there is a rapid violation of the functions of many internal organs and systems, which often leads to the death of the patient.
• During radiotherapy.  Radiotherapy can be used to treat certain neoplastic diseases. 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 of the human body, as a result of which wound healing processes will slow down, including the process of implant fouling with bone tissue.
• With chemotherapy.  Chemotherapy is the use of medications to treat 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 implants for hepatitis

Hepatitis alone is not a contraindication to tooth implantation. At the same time, the development of complications associated with this disease can create certain difficulties that make the procedure impossible.

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 tooth implantation in such conditions, as this can lead to depletion of the compensatory capabilities of the body and to the development of complications. At the same time, after adequate treatment and remission ( abatement of acute manifestations of the disease) implantation can be performed without any serious problems.

Things are much worse with 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) This will be accompanied by a violation of the functions 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 implant a tooth under such conditions, since in the event of bleeding, it will be extremely difficult for doctors to stop it, as a result of which the patient may lose a lot of blood.

Do dental implants work for HIV?

HIV is a human immunodeficiency virus that can enter the body through sexual contact, as well as blood transfusion, with repeated use of syringes by different people ( common among drug abusers) etc. 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 is worth noting that the process of damage to the human immune system is very slow, taking whole years or even tens of years. At the initial stages of the disease, as well as with the correct treatment, the cells of the immune system in the patient's body are enough to resist infections. Such patients are not forbidden to perform dental implants, however, they must inform the doctor about their pathology. In this case, the doctor will work extremely carefully so as not to get infected with HIV, and will also pay special attention to the prevention of infectious complications during surgery and in the postoperative period ( perhaps he will 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 small. In this case, during the operation, even simple, usually safe bacteria ( who constantly live in the human oral cavity) can get into the wound and cause the development of severe systemic infection, which can lead to death of the patient. Dental implantation in such patients is strictly contraindicated.

Dental implantation in old age

Elderly age is not a contraindication to tooth implantation. If the patient does not have the previously listed contraindications ( diseases of the cardiovascular, respiratory and other systems, diabetes, malignant tumors and so on), one or more teeth can be implanted. The features of the procedure in the elderly include a slowdown in regeneration processes ( recovery) bone tissue. As a result, after the implant is installed, it may take more time for it to firmly fix in the bone and begin to function normally.

Preparation before dental implantation

In order for the implantation procedure to occur as quickly as possible, efficiently and safely, the patient must be properly prepared for it. Preparation includes a full examination of the patient, as well as compliance with certain rules, which the attending physician will tell him about.

Which doctor is involved in dental implants?

To perform dental implantation, it is necessary make an appointment with the dentist. It is worth noting that today in dentistry there are many narrower specialties, each of which deals with the solution of certain issues. In addition, it is the stomatologist who, if necessary, can refer the patient to other relevant specialists if their consultation is necessary for the dental implantation procedure.

To perform a tooth implant, a patient may need a consultation:

• Orthopedic dentist.  This specialist is directly involved in determining the indications and contraindications for implantation, helps the patient choose the most suitable implantation method, and also directly participates in the implant placement process and in the postoperative treatment of the patient.
• Dentist surgeon.  This specialist is engaged in tooth extraction, as well as in the treatment of other diseases of the dentition, requiring surgical intervention. His consultation may be needed as before implantation ( to remove the remains of damaged teeth, instead of which implants will be installed), and after the procedure ( in the case of purulent complications in which surgical treatment is indicated).
• Dentist  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 tooth-fixing tissues) and other pathologies in which implantation is contraindicated.
• Dental technician.  This specialist is directly involved in the manufacture of a dental implant and prosthesis.

Examination of the patient 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 specifies what specific problems the patient is concerned about, how long he has suffered 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 whether other treatment methods should be resorted to.
• Informing the patient about possible treatment methods.  After the examination, the doctor should tell the patient about all possible treatment options for his disease, as well as about their features, possible complications, and so on.
• Identification of possible contraindications.  At the first consultation, the doctor should ask the patient if he has any diseases in which implantation is contraindicated.
• Informing the patient about the implantation procedure.  The doctor should tell the patient everything about the chosen method of treatment, including the technical features of the procedure, the method of anesthesia, the duration of treatment, the duration of postoperative recovery, possible consequences, complications, the cost of the procedure, and so on. If during the consultation the patient has any additional questions, the doctor should also answer them.

If, after examining the oral cavity and talking, the patient agrees to the operation, the doctor appoints him additional laboratory and instrumental examinations, which must be done before the operation.

What tests should be done before dental implants?

Before performing the procedure, a series of tests should be taken, on the basis of which the doctor will determine whether the implant can be installed for this patient.

Before implanting teeth, you may need:

• General blood analysis.  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, you can detect the presence of infection in the body ( this may indicate an increase in the concentration of leukocytes over 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 may also be the reason for the cancellation or transfer of the dental implantation procedure. Moreover, during biochemical analysis, the concentration of glucose in the blood is determined, which allows to identify patients with diabetes.
• General urine analysis.  A general urine test reveals infections of the genitourinary system, as well as functional kidney diseases.
• Analysis for viral hepatitis.  As mentioned earlier, the cause of hepatitis can be infection with certain viruses. The definition of hepatitis B and C virus markers is of diagnostic value before dental implants, since they can lead to a chronic course of the disease and liver damage. Also, the doctor performing the operation can become infected with these viruses if during the procedure it comes into contact with the patient’s blood ( for example, if his glove breaks or he pricks with a needle).
• HIV test.  This analysis is carried out for several reasons. Firstly, 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 observe increased caution so as not to become infected himself. Thirdly, the analysis is performed before any surgery, 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.  This is not a mandatory study, but before planning an implantation, a woman is better to make sure that she is not pregnant. 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 is performed
• Dentist (dentist, orthodontist) - what kind of doctors are they and what are they treating? When should I contact him? What awaits the patient at the appointment?