Dental implantation is a long-term procedure for the installation of artificial teeth, which is carried out by a special doctor - an implantologist. There are main types of dental implants, each of which has its own characteristics and is suitable in a particular clinical case.
During the operation, the root of the tooth is replaced by an implant. For its manufacture, titanium or zirconium is used. An implant is a support for a prosthesis or crown.
Dental implantation has several indications. Dentists distinguish 5 main scenarios that lead patients to them:
- One broken tooth, neighboring teeth are healthy and do not require grinding.
- Absence of 2-3 teeth in a row, adjacent teeth require preparation.
- The loss of the last tooth in the row, turning the adjacent tooth is not needed. Other methods of prosthetics in this case are difficult.
- Absence of a large number of teeth. In this case, prostheses are used, which are supported by implants. This is the best option when the patient cannot use a removable structure.
- Allergy to the main component of a removable prosthesis or the appearance of a gag reflex on it.
In the video, the dentist talks about the indications for implant placement:
Relative contraindications for dental implant surgery:
- acute periodontitis;
- rapid abrasion of the dentition;
- bite problems;
- bruxism;
- anatomical features.
In the presence of absolute contraindications, it is forbidden to install dental implants. These pathologies include:
- pathology of the circulatory system;
- diabetes;
- chronic diseases of the oral cavity;
- problems with the musculoskeletal system.
After implantation of a tooth, some complications may occur: swelling, bleeding, pain, fever, inflammation. If the condition worsens, the patient is advised to consult with the attending physician.
Classification of types of implantation
Dentists distinguish three main types:
- intraosseous;
- subperiosteal;
- intramucosal.
Intraosseous or endosseous implantation is a natural method of installation. Manipulations are carried out in the tissue, which guarantees the functioning of the artificial material. For implantation of teeth by the endosseous method, a certain height of the alveolar process is required. With its insufficiency, osteoplasty is indicated: the doctor builds up bone tissue, improves its quality.
Intraosseous implant model
Root-shaped products are used for intraosseous implantation. Lamellar analogues are installed less often.
Installation can be done in two different ways:
- one-stage method: installation of the implant and abutment with a temporary crown in 1 day;
- two-stage method: installation of the implant in 1 day, installation of the abutment and permanent crown after 4 months.
In special cases, basal implantation is practiced. Such an installation is made in the bicortical layer of the bone tissue, and is necessary for a temporary solution to the problem with the teeth.
There are only two main indications for basal implantation:
- insufficient amount of bone tissue;
- inability to grow bone tissue.
The video simulated the process of basal implantation:
Endodonto-endoosseous is an outdated method that helps preserve the tooth root. This technique is used when it is necessary to strengthen mobile teeth. It is practiced for periodontitis, fractures of dental elements. In the latter case, the pin is inserted into the tissue through the defect itself.
Subperiosteal implantation of the tooth is performed at a low height of the alveolar process. For the operation, subperiosteal implants are used, presented in the form of a metal frame with supports. The procedure consists of one or two stages.
Subperiosteal implantation
Intramucosal implantation is performed if it is necessary to improve the fixation of a removable prosthesis. For manipulation, special intramucosal products are used, consisting of two parts:
- the first part is located on a removable prosthesis;
- the second part fixes the prosthesis on the oral mucosa.
Intramucosal implantation
With intramucosal implantation, the tooth implant is fixed in a small hole in the gums. A prosthesis is put on top, which can later be removed for oral hygiene. To carry out such a manipulation, the thickness of the mucosa is measured - it must be more than 2.2 mm.
The transosseous technique is performed using curved 2-pin staples. The last elements are mounted on the chin. The height of the bone tissue is more than 6 mm, and the thickness is more than 3 mm.
The laser technique involves the use of a laser beam for incisions during the operation. This procedure takes a small amount of time and is less painful for the patient. At the same time, the beam has an antibacterial effect, and after the operation, surgical sutures are completely absent. A significant disadvantage of laser technology is its high cost.
The video simulated the process of laser implantation:
If necessary, the doctor prescribes an express operation, during which an implant and a dental crown are installed immediately in one visit. To carry out such a procedure, the patient must completely lack general contraindications.
It is allowed to carry out a minimally invasive intraosseous manipulation, which is carried out in a transgingival way. The gum is not cut. To make a hole for the implant in the bone, a special drill is used.
The video simulated the process of transgingival implantation:
How dental implants are done
Now let's talk about how the installation of a dental implant. Specialists distinguish the following stages of dental implantation:
- preparatory;
- tissue extension;
- implant placement;
- installation of the structure;
- prosthetics of the problem area of the jaw.
Preparatory stage
All of the above methods of dental implantation require the preparation of the patient for the upcoming procedure. The duration of the preparatory stage is from several days to 2 months. Preliminarily, the doctor assesses how ready the patient is for the upcoming treatment and predicts how well the implant will take root.
A successful operation can be predicted if the patient has a sufficient amount and good quality of bone. In this case, its density is also taken into account. Taking into account this criterion, doctors distinguish 4 types of bone tissue:
- homogeneous compact;
- dense spongy bone surrounded by a thick layer of compact mass;
- dense spongy bone surrounded by a thin layer of cortical mass;
- mobile spongy bone surrounded by a thin layer of cortical mass.
The indicator under consideration varies in different anatomical regions and may differ in different areas. Based on the value of this indicator, treatment tactics are built. The product may not take root if the patient is diagnosed with low or high bone density. The risk group also includes patients with low cortical thickness.
In the absence of obvious contraindications to the installation of the implant, the doctor examines the condition of the oral cavity. For this, an orthopantomogram and computed tomography are prescribed. With the help of panoramic images, hidden pathologies are revealed, the size and quality of the bone are studied. Based on the data obtained, the doctor determines the future location of the dental implant.
In the video, the dentist-surgeon talks about the features of preparing for dental implantation:
After this manipulation, the mouth is sanitized. If there are bad teeth, they are treated. The terms of therapy are unlimited, it all depends on the condition of the teeth and gums. If the teeth are not treated before the operation, the risk of inflammation of the tissues around the installation site increases several times.
At the preparatory stage, it is recommended to take tests for sugar and HIV. With a compensated level of sugar, the implantation of an artificial mechanism will not occur. Diseases of the immune system are not absolute contraindications for the installation of an implant, but if the value of the indicators differs from the norm, the operation is postponed until normalization.
Installation process
If dental implants are installed according to the classical method, in most cases the doctor will build up the bone tissue. The duration of the procedure is several hours. It will take 3 months for the artificial bone tissue to take root.
Against the background of a long absence of teeth, the jaw bones decrease. If the tooth was removed several months ago, then the patient is advised to increase the bone. The size of the bone tissue also decreases if there is no load on it. To securely fix the delivered implants, it is recommended to return the bone tissue to its former size. For replanting, synthetic or bone material is used.
The third stage of the operation is the direct implantation of the implant into the jaw. The procedure is carried out in different ways. Terms of implementation - from several days to a year. Implantation is carried out in stages:
- gum incision;
- the creation of a bed in the bone;
- plug installation;
- gum stitching.
The installation of the implant takes several hours. But it takes several months for it to heal and grow together with the bone. Complete fusion of the bone with the artificial element occurs after six months. Modern methods of implantation reduce the rehabilitation period to 1-2 months.
With an abbreviated method, manipulation is carried out through a puncture inside the jaw. After such a procedure, the patient is advised to follow a diet with a soft consistency of food and switch to solid foods gradually. Such a safety measure will ensure high-quality splicing of the product with the bone.
Abutment installation and prosthetics
At the next stage, an abutment is installed - a metal product that connects the implant and the prosthesis. This procedure only takes a few minutes. 2 weeks before the manipulation, the doctor installs the gum shaper.
Abutment model
Then the abutment is installed. Dental implantation of teeth is completed by making an impression for the crown. To make an express operation, constructions already combined with the abutment are used.
The next stage of the operation is prosthetics. Any technology provides for crown prosthetics as the final stage. To do this, prostheses are fixed on implants, which can be presented in the form of a single crown or a solid structure for the entire dentition. The procedure of implantation of teeth with their subsequent prosthetics takes several hours. At the same time, prosthetics themselves are carried out only if they have taken root well and the abutment has already been mounted. The procedure can be performed after fusion with the bone or 2-3 days after its installation. It depends on what type of implant is used.
rehabilitation period
The success of the operation depends on the patient's compliance with the doctor's recommendations. After the operation, the doctor explains the principles of oral care, talks about the rules of hygiene and daily cleaning of the jaw and mouth with antiseptics. Otherwise, bacteria accumulated on the mucous membrane can cause inflammation.
It is especially important to monitor the stitches that the doctor will put on the gum. The purpose of postoperative treatment is the prevention of the infectious process in this area, the acceleration of wound healing. For this, the patient is prescribed medication and a special regimen is prescribed.
If the patient needs to insert a dental implant or perform a sinus lift, then antibiotics must be taken in the postoperative period. Treatment with these drugs lasts a week. Antibiotic therapy is not indicated if only one implant has been placed with minimal surgical intervention. Along with antibiotics, antifungal agents are taken to prevent the occurrence of fungal infections.
Antihistamines reduce swelling and inflammation. The appointment of these drugs should be dealt with by the doctor on an individual basis, taking into account the characteristics of each patient. Some patients may be prescribed non-steroidal anti-inflammatory drugs.
All patients who underwent implantation are recommended to take a complex of vitamins and ascorbic acid. If antibiotics were prescribed in the postoperative period, the patient is prescribed calcium supplements. It will accelerate the formation of a strong bond between the bone and the artificial product. In addition, you need to follow a diet rich in calcium.
Stage of abutment installation and after rehabilitation
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