There is a wide variety of information about dental implants. From the reviews of some patients it follows that the procedure is quick and almost painless. Others argue that the procedure was multi-stage, very painful, and the adaptation period was long. What is the truth of all this? Why, for some, implantation is just a simple dental prosthetics, and for others, a complex operation? How is the installation of dental implants?
The implantation procedure is a serious and lengthy work. This will require the professionalism of the doctor and the responsibility of the patient. The general plan for implantation is formed by the dentist and depends on the condition of the bone tissue, as well as the general condition of the whole organism. This plan includes several key steps:
- Preparatory
- Surgical
- orthodontic
Depending on the state of health and the method of implant placement, some of the stages can be shortened to a minimum, while others can increase to a maximum. For example, for some patients, the implantation procedure will take several weeks, while others will have to be patient for a year.
One of the factors that influence the diversity of reviews is the view. The implant is called metal. It serves as a kind of substitute for the root of the tooth. After insertion into the gum, an abutment is installed on its surface, and only then an artificial tooth is fixed.
Information: Some manufacturers produce the post and abutment in one single piece. In this case, the abutment installation step is skipped.
The type of implant is selected individually, and depends on the characteristics of the jawbone (its size and quality). Implants are of the following types.
Intraosseous constructions
Intraosseous implantation is a kind of replacement of a natural tooth root with a screw, a visible blade or a cylindrical pin. Such pins can be made from ceramic materials, but more often from titanium. During the implantation operation, the product is placed in the bone tissue below the gums. After the product has taken root, a holder (abutment) is installed on it, and then an artificial crown is fixed to it.
For the installation of intraosseous structures, a minimum of 2 stages is required. At the first stage, the pin is coated with hydroxyapatite and implanted into the bone. Hydroxyapatite is an inorganic mineral that is an important component of bone tissue and tooth enamel. Its use helps prevent negative reactions of the body to the implant. Also, hydroxyapatite promotes the rapid natural growth of bone tissue in the area of the implanted pin. When the pin is processed and installed, the gum is sutured.
Until the next stage, you will have to wait for the time it takes for healing and tissue regeneration (an average of 5 months). Next, the second stage follows - fixing the holder to the implant.
Subperiosteal constructs
This type of product differs in the method of installation. Subperiosteal implants are fixed under the gum but over the bone. The most common type of product is presented in the form of a metal frame with holders for artificial teeth. It is fixed on the jaw bones and is completely hidden by the gums. Outward on the surface of the gums only the holders themselves protrude.
The use of subperiosteal products is recommended in cases of insufficient jaw volume, which is a contraindication to the installation of intraosseous structures. This design is also distinguished by its high cost, which is determined by the need for individual manufacturing. The product should ideally fit the width and length of the jaw arch. Otherwise, the product will not fit, and installation will entail a lot of problems.
Transosseous structures
Transosseous products are used very rarely and only on the lower jaw. This is due to a very complex installation procedure, which will require extensive surgical intervention in the dentition.
During the operation, a massive metal bracket is attached to the lower jaw. The design of this bracket has pins that pierce through the jawbone, as well as holders for future artificial crowns.
To install such a massive structure, the surgeon makes an incision in the chin area. The duration and complexity of the operation does not guarantee a greater success rate. The patient may be left with another post-operative surprise - a post-surgical scar on the chin.
Mini designs
For patients who are not suitable for the usual implantation procedure, the installation of mini-products is recommended. A contraindication to the usual procedure may be poor bone density or violations in the formation of the structure of the jaw itself.
Unlike conventional products - compact size. In all other respects, the systems are similar to intraosseous structures. Most often, such products are used for implantation in narrow areas of the jaw and for the restoration of premolars.
The standard dimensions of a mini-implant are twice as thin as conventional products. This gives the design its own advantages. For example, the volume of surgical intervention is reduced, and this has a positive effect on the healing process, which is less painful and faster.
The main stages of implantation
We have already figured out that the process of installing a tooth implant depends on the type of implant itself. Now let's look at the main stages and what the procedure for installing a dental implant consists of.
Preparatory stage
The terms of the preparatory stage can vary from a couple of days to two months. This procedure includes:
- Collection of information on the general medical and dental condition of the patient's body;
- Definition of contraindications to the procedure;
- Complete sanitation of the oral cavity (professional cleaning, filling, treatment of existing diseases);
- The state of bone tissue is determined;
- Computed tomography and orthopantomogram are prescribed;
- Complete examination of all body systems and internal organs;
- Blood tests are given (general, blood, hepatitis, sugar, HIV and syphilis);
- The presence of chronic diseases will require additional consultation of relevant specialists.
During the examination, the specialist in parallel draws up a subsequent action plan.
Surgical intervention
The process of surgical intervention will depend on the type of implant chosen, but there are basic rules:
- Complete disinfection and anesthesia of the oral cavity is carried out.
- The surgeon cuts the gum and forms a bone bed for the implanted screw of the appropriate size.
- A plug is fixed on the installed screw, after which the gingival mucosa is sutured.
The procedure takes up to one hour, but the healing process can take up to a year.
Holder installation
The next procedure is the second stage of the surgical intervention, which is valid only after the pin has completely engrafted. The operation takes place on a small area of the mucosa and has less trauma.
- The surgeon makes an incision in the gum to open the implant. After that, a special gum shaper is screwed to it, which will protrude slightly in the oral cavity.
- The shaper is removed after 3–5 days, and an abutment is placed on the surface of the post.
Orthodontic process
May last several hours.
The installation of implants allows you to use any design of prosthetics in the future. These can be single crowns in the form of an artificial tooth or a full-fledged design that will allow you to create the entire row of teeth.
The orthodontic process includes: taking casts, making the desired model in the laboratory, making artificial crowns according to the received model. After that, the crowns are fixed on the holders.
The stage of surgery may vary. It depends on the chosen method of implant placement.
Implant placement methods
Intraosseous constructions are more often installed according to the method described above, but many patients have heard of such implantation as transgingival and express implantation. Advertising says that these 2 methods are performed without surgical intervention in the jawbone, but is this true? How safe are these methods, and what can be considered a publicity stunt?
Express implantation (non-surgical method of pin installation)
This procedure can be carried out only immediately after extraction of the diseased tooth from the jaw. In recent years, this type of implantation has gained great popularity. Up to 40% of all procedures performed fall on this method of implantation, but to carry it out, you will need a high professionalism of the doctor and the availability of special equipment in the clinic.
How is this method considered non-surgical? This procedure got its name due to the finished hole in the gum, which was formed at the site of the extracted tooth. Additional manipulations of the scalpel are often no longer required, and it is no longer necessary to cut the gum. Therefore, surgical intervention on the part of implantation is reduced to the minimum.
The absence of contraindications, the availability of the necessary equipment and the experience of the doctor provide this method with great advantages over classical methods.
- The process of gum formation and installation of the product can be carried out in one visit.
- The procedure will cost less. This is due to the hole already ready for the pin.
- The minimum time between removal and implantation of the implant does not allow the formation of bone tissue deficiency, which often occurs due to the lack of masticatory loads on the gums.
- Makes the doctor's job easier. A fresh socket allows you to adjust the installation of the implant and more accurately calculate the installation process.
- The percentage of successful operation is 99%
All the charm of this method of implantation has its contraindications:
- The presence of signs of an acute inflammatory process at the site of removal. Even if the pin is implanted, there will be no guarantees for a good result.
- The patient has severe pain and swelling in the area of the extracted tooth.
- The presence of direct contraindications to implantation. For example, a strong deficiency of bone tissue, which was formed against the background of a periodontal cyst or periodontitis.
Note: If there is a desire to carry out the extraction of a tooth and the implantation of an implant at the same time, it is better to take care of this in advance. Find out which clinic has the necessary equipment and a professional doctor in the state.
The patient may suffer another disappointment. Like the polyclinic is selected. Professional found. The clinic has equipment. Everything is ready for the operation, but then an unforeseen situation occurs. The dentist-surgeon, for some reason, could not carry out the removal accurately. The hole turned out to be disfigured and already unsuitable for implantation. The success of implanting an implant in such a hole will be minimal.
Transgingival implantation
Many clinics say that transgingival implantation is a special technology for installing a dental implant. During its implementation, it is not required to make an incision in the gums, only a puncture of the mucous membrane is carried out, so it is difficult to call the procedure surgical. How true is this?
This non-surgical method is slightly exaggerated by its merits. The so-called puncture is carried out using a special mucotomy, which makes a circular incision of the gums and subsequent drilling of the bone. This is already an artificial tissue damage, which means a surgical intervention in the body, even if it is the most sparing one.
The difference from the classical method is a neat incision, which is equal to the size of the gum former. After the incision is made with a mucotomy and the excised gum is removed, the next step follows. Drilling of the jawbone to deepen and widen the hole will take place in the usual way, using a set of cutters.
In the absence of contraindications, the entire stage of implant installation is carried out according to the following scheme and in one step:
- The oral cavity is disinfected and local anesthesia is performed;
- A circular incision is made in the mucosa (puncture);
- Using a set of cutters, the hole is expanded and deepened to the desired size;
- An implant is installed with depth control;
- The gingiva former is installed immediately;
Contraindications
The transgingival method of implantation is considered to be less traumatic, so after a couple of days the doctor prescribes a control visit, after which some appointments may be withdrawn. This mainly happens when the patient does not have postoperative swelling and pain, as well as fever. If we compare transgingival and classical methods of dental implantation, then the first one is characterized by a lower manifestation of possible complications. This is due to the smaller size of the wound, where bacteria can enter and the inflammatory process begins.
Contraindications that may cause a refusal to perform transgingival implantation, or greatly complicate the procedure:
- Lack of complete information about the patient. Often this happens when a doctor sees a client for the first time, and this clinic does not have his card.
- The volume of bone tissue and mucous membrane is too small for implantation. First, you will have to carry out the bone augmentation procedure.
- The patient has atrophied alveolar ridge
Summarizing the above. Dental implantation without a gum incision is not feasible. The incision of the gums will have to be carried out in any case. The difference is only in what tool is used for this and how carefully the doctor will carry out the procedure.
The main stages of implantation are the preparatory, surgical and orthodontic stages. Any additions to the installation process depend on the structural features of the jaws and the general health of the patient. Regardless of whether the process of implantation of the implant is carried out by the transgingival, non-surgical or classical method, the procedure cannot be called highly traumatic. The process of installing dental implants does without cutting out the jaw bones and extensive wounds.
(votes: 1, average: 5.00 out of 5)
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