Implantation of teeth: the essence of the method, types, indications, contraindications, possible complications
Human teeth are completely deprived of the ability to regenerate( self-healing).Loss of teeth permanent bite leads to a change in facial features and violation of the masticatory function, which negatively affects the state of the digestive system and the whole body.For a long time, removable plate prostheses and permanent bridges with a number of disadvantages were made for restoration of the dentition.The breakthrough in dentistry was the massive introduction of the technique of installing dental implants.Contents: The purpose and essence of the implantation method of teeth The advantages of implantation Types of implantation of teeth Materials of dental implants Types of dental implants
The purpose and essence of the implantation method of teeth
Implantation allows quickly and reliably replacing missing teeth.In the jawbone, a titanium alloy implant fulfills the function of the root, and then the supragingival part of the structure-the abutment and the crown-is fixed on it.
Important: The procedure is performed using the general, local or combined anesthesia , so the intervention is absolutely painless.The type of anesthesia and drugs are selected strictly individually, taking into account the indications, scope of work and individual physiological and psychological characteristics of the patient.
The installation of implants can be coupled with bone plastic, which ultimately increases the reliability of the fastening of the metal element in the jaw.
Advantages of implantation
Undoubted advantages of the innovative technique are the :
- intervening exclusively in the area of the missing tooth;
- the ability to install elements immediately after tooth extraction;
- elimination of defects of any length( including with full adentium);
- prevention of natural resorption( resorption) of the alveolar bone after loss of its own tooth;
- construction reliability;
- full functional recovery;
- impeccable aesthetic qualities.
Traditional designs used in dental prosthetics( bridges) require the grinding of adjacent teeth, but this is not necessary to establish implants.The abutments and crowns installed on them never press on the gums, which prevents inflammation of the mucous membranes.Modern implants are almost never rejected by the body due to the unique alloys used for their manufacture.Their cost is comparatively high in comparison with bridges, but dental implants serve the patient up to several decades.In addition, a person gets the opportunity to eat any familiar food without experiencing any inconvenience.
Types of implantation of teeth
At present, the installation of dental implants can be carried out in two ways - classical or one-stage.
In the classical version, implantation of a metal dental implant is carried out 1-2 months after extraction of the tooth.The implantation process lasts about 3-4 months on the upper jaw and 2-3 - on the lower jaw.As the implant is firmly anchored in the bone, it is used to fix a single crown or as a reference point for the "bridge".
Simultaneous implantation makes it possible to solve the problem in almost one visit.After extraction of the diseased tooth, an implant, abutment and temporary crown are immediately installed.The express technique is less traumatic and psychologically more comfortable for the patient.
Note : The unique IMPLANT 3D technology, combining computer tomography and three-dimensional modeling, is now widely used.The system allows the most accurate placement of dental implants, taking into account the structure of the jawbone, the location of the nerves.Thanks to the technology of 3D, it became possible to conduct multiple implantation within the shortest possible time.
Materials of dental implants
Titanium is used to create implants, since this metal is not corroded and is characterized by biological inertness, that is, it does not provoke a rejection reaction.
The elasticity of this material is close to the elasticity of bone tissue, due to which the probability of damage to the jaw bones due to the load when chewing food is reduced to zero.
Important: , when choosing the material of an artificial tooth, it is recommended to give preference to all-ceramic crowns.They best imitate the real tooth and do not lead to a darkening of the gingival margin, which distinguishes them from metal-ceramic products.
Types of dental implants
The following types are distinguished in form:
- dental implants with steps;
- designs with cortical lining.
Endoossal( intraosteal) dental implants
- A dental implant of the root type, in fact, is a screw - "self-tapping".Such implants are used if the bone volume allows them to gain a foothold.Often requires preliminary osteoplasty.
- Plastic implants make it possible to fix them in the bone for a considerable length, which significantly increases the degree of stability of the prosthesis.Indications for the selection of models of this type is the narrow bone of the jaw, to implant into which the root-like implant is difficult.
- Combined implants are characterized by more solid dimensions and a rather complex shape.They combine the advantages of root-type and plate-like types and are indicated for defects in dentition that are of considerable length.
Other types of implants
In addition to intraosteal dental implants, there are:
- Subperiosteal( subperiosteal) designs are implanted between the bone and the periosteum if there is a pronounced thinning of the bone tissue.Strong retention and functionality is provided by a large area.
- Endodontic stabilized implants - are fixed through the apex( top) of the retained root of the tooth in order to strengthen and build it.During installation, the gingival mucosa is not damaged.The endodonto-endosseous technique is considered obsolete.
- Intralucleated implants are not implanted in bone, but retained in soft tissues.They serve to fix and stabilize removable dentures.
Indications for implantation
Often people believe that the absence of one or two dental units is not a serious problem if it is not a frontal group, that is, it is not associated with aesthetic disadvantages.This opinion is fundamentally wrong.After tooth extraction, the adjacent ones gradually shift, and the gaps between them become larger.The consequence of this is a stuck food residue, worsening hygiene and, over time - caries and periodontitis.
The bone structure in the area of the lost tooth ceases to receive a physiological load, which leads to its decrease.The absence of several dental units in a row often causes some distortion of the facial features - the patient's lips are lowered and the cheeks sag.
Thus, indications for implantation include:
- absence of one or more teeth;
- complete jaw adentium.
Note: with significant bone resorption in the area of the lost tooth( if extraction was performed for a long time) shows bone plastic or so-called.Sine-lifting, if it is a question of the anterior section of the upper jaw.
Contraindications to implantation
This type of surgical intervention has a number of absolute and relative contraindications.
Note: dental implants do not implant patients under 22 years of age, as the process of growth and formation of jaw bones may not be completed.To restore the functional and eliminate aesthetic disadvantages young people are shown the traditional methods of denture prosthetics.
Absolute contraindications for implantation include:
- systemic pathology of connective tissue;
- recently suffered myocardial infarction;
- diabetes mellitus( decompensated form);
- chronic renal and / or hepatic insufficiency;
- Mental illness;
The list of relative contraindications to implantation includes:
- diabetes mellitus( compensated form);
- marked nicotine dependence;
- bruxism( nocturnal grinding of teeth);
- the period of pregnancy and breastfeeding of a child.
With bruxism, the restoration of the dentition with implants is possible if the patient undertakes to wear special protective caps before bed.
Stages of implantation
The installation of dental implants today is not much more difficult than caries treatment.It can be carried out simultaneously or include several successive stages.
Before this dental procedure, the patient is examined.In some cases, laboratory blood test data and advice from other specialists are needed.It is necessary to sanitize teeth and achieve remission of old inflammatory processes, if any.It is recommended to carry out professional cleaning of teeth several days before surgery.
The total duration of manipulations for the installation of a dental implant is on average 20-30 minutes.The duration varies slightly depending on the chosen technique.
Intervention in most cases is performed under local( conductive) anesthesia.The need to install a large number of titanium elements immediately requires general anesthesia( anesthesia).
In the first stage, by means of a drill and special drills in the jawbone, a bed is formed, where an artificial root is then installed.
The second stage requires checking the strength of the fixation of the implant in the bone.If it is held securely, then you can attach the abutment and the temporary crown.She will not participate in the act of chewing, but will hide the cosmetic defect, which is especially important when the teeth of the front group are absent.
Complete fusion of a dental implant with bone tissue( osteointegration) is achieved in a few months.On the lower jaw, the artificial tooth can be placed in the abutment after 3-4 months, and on the upper - 5-6 months after the operation.
Complications with implantation
During the implantation operation, complications such as:
- may occur, bleeding when a large vessel is injured;
- bone perforation( with intervention on the upper jaw there is a risk of perforation in the maxillary sinus).
In the postoperative period:
- intensive pain syndrome;
- insolvency or divergence of imposed seams;
- infection of injured mucosa;
- development of inflammation in the area of intervention.
During implant implantation, complications can occur in the form:
- periimplantitis( inflammation of tissues around the prosthesis);
- implant rejection.
When installing the supragingival part of the structure( abutment):
- pushing the implant into the maxillary( maxillary) sinus;
- bone growth over the root of the implant.
Note : most of the possible complications develop due to violation of the rules of implantation.Their probability does not exceed 1-2%.
Recommendations for patients who underwent tooth implantation
As with any other surgical procedure in dentistry, after the implantation, minor puffiness and a mild local pain syndrome may occur.Negative effects take place over several days.
To reduce pain and inflammation, it is possible to recommend non-steroidal anti-inflammatory drugs in tablets.From hot food for one day after the operation you need to abstain.It is necessary to exclude from the diet solid products until the completion of the osseointegration.For some time, it is necessary to take antibiotics prescribed by the dentist for preventive purposes.
It is extremely important to pay special attention to oral hygiene, since infection can provoke a rejection reaction.It is recommended to use a special brush with one set of bristles and dental floss( flosses) for high-quality cleaning of the interdental spaces.It is advisable to refuse the use of ultrasonic brushes.
After installing the implants, the dentist will certainly recommend the patient to use the oral irrigation device, a device that cleans interdental spaces by spraying a powerful fluid jet.Warm liquid is supplied from a special container through the nozzle under pressure from 2 to 10 atmospheres, while the water supply mode can change and its pressure can be adjusted.Jets remove the remains of food, clean the dentogingival pockets and massage the gums.If the irrigator is used after implantation, instead of ordinary water in a container, it is better to pour special solutions that have a therapeutic and preventive effect.
Important : the irrigator can only be used after the implant has been fully implanted.
More detailed information on the process of dental implants can be obtained by viewing this video review:Vladimir Plisov, dentist