Implantation of teeth - Causes, symptoms and treatment. MF.

To date, dental implantology is one of the progressive and promising sections of dentistry, which brings together various specialists to solve the problems of rehabilitation of people with missing teeth. At the moment, implantation of teeth is the only alternative in dentistry to the bridge prosthesis with the loss of one tooth, a complete removable prosthesis - with the loss of all teeth.

The implant is a rod that is screwed into the jaw bone, where the missing tooth is missing, and performs the function of the root, on top of which the artificial tooth crown is worn. After which such a design perfectly functions for a long time in the oral cavity.

Implantation of teeth is a responsible and serious matter. The choice of a doctor and a clinic must be approached seriously. First of all, the clinic and the doctor must be trusted.

Type of implant in the mandibular bones

As with any manipulation in medicine, there are a number of indications and contraindications to implantation.

Contraindications to implantation of teeth:

Contraindications are absolute( in which you can never do surgery) and relative( when after eliminating some of the reasons you can perform the operation).

Absolute contraindications:

- Malignant tumors of various organs and systems, since the operation can cause the spread of the tumor and lead to sudden death;
- Tuberculosis;
- Various diseases of blood and blood-forming organs( hemolytic anemia).Since there may be bleeding that will be difficult to stop;
- Various diseases of the central and peripheral nervous system( eg, schizophrenia, dementia, psychosis);
- Pathology of the immune system( lupus erythematosus, hypoplasia of the thymus and parathyroid glands);
- Various diseases of the endocrine system( diabetes mellitus, adrenal pathology).
- Various systemic diseases of connective tissue;
- Diseases of the oral cavity( eg, chronic recurrent aphthous stomatitis);

Relative contraindications:

- Acute period of any disease;
- Dental caries and periodontal disease( gingivitis - gingival inflammation, marginal periodontitis - inflammation of tissues surrounding the tooth, paradontosis);
- Unsatisfactory oral hygiene;
- Some types of malocclusion;
- Bruxism( the night grinding of teeth);
- Diseases of the temporomandibular joint( arthrosis-arthritis);
- Various precancerous diseases of the oral cavity;
- Atrophy, lack of jaw bone;
- Harmful habits( smoking, abuse of coffee and alcohol);
- Pregnancy.
- A specific contraindication for intraosseous implantation is the lack of bone tissue together with the proposed operation, since at least two millimeters of bone should be kept around the implant from all sides. This is necessary for the prevention of bone tissue atrophy.

Indications for implantation of teeth:

- Single included dentition defect with healthy adjacent teeth. When one tooth is lost, and the standing teeth are healthy next to you, and to not grind them under the crowns, prosthesis can be used on implants.
- Incorporated dentition defects. When there are no consecutive 2 to 4 teeth, they can also be restored by implantation of teeth.

Prosthetics on the implants of the included lateral defect of the tooth row

- End defects of the dentition. When there is no chewing group of teeth( for example, sixth, seventh, eighth teeth).

Prosthetics on the implants of the terminal defect

- Complete absence of teeth. In such a situation, if a person is not morally ready for a complete removable prosthesis, then as a more expensive alternative, teeth implantation can be used.

Types of dental implants

Dental implants are usually composed of two parts:

• The implant itself( that is, the part that is fixed in the jaw bone and serves as the root of the tooth).
• The abutment is the link between the actual implant and the artificial crown of the tooth.

Components of the dental implant

There are many different classifications of dental implants. They differ in material, in the form of the intraosseous part of the stem, in the types and timing of implantation. The choice of these or those implants depends on the specific clinical situation( for example, on the number, height and width of the jaw bone, the nature of the defect in the dentition) and the tasks that need to be addressed by installing them.

Kinds of dental implants

Most often implants are made of titanium, which has anti-corrosion properties and biological compatibility with human bone. Such properties of titanium reduce the likelihood of destruction of bone tissue, for example, during chewing.

The most commonly used and popular dental implants are root-shaped. Used with sufficient amount of bone tissue. In the classical version it looks like a stepped cylinder with a thread. Among them, screw and cylindrical dental implants are most often used. Screws are easier to install and they give fewer complications.

Root implants have many variations. There are models with different surface textures, threads of different shapes, etc. Such a variety is needed to ensure the strength and reliable fixation of the structure in the bone tissue.

If there is a decrease in bone tissue or there are any anatomical features of the dentoalveolar apparatus that do not allow the use of root-shaped implants, plate, combined, intralucid, endodontic stabilized and other species can be used.

Plastic implants. They are used for terminal defects and when the jaw bone is very narrow, and root-like implants can not be used.

Implants of combined form - a combination of root and plate implants. Used for large defects of the dentition. The three types of dental implants listed above are related to intraosseous( endo-osseous) implants.

Subperiosteal implants( subperiosteal) are used with a strong thinning of the alveolar processes of the jaws. They are placed between the periosteum and bone.

Endodontic stabilized implants. They are placed in the jaw bone through the tip of the root of the tooth. With such an installation, the mucous membrane is less injured than in other species, and the healing process is faster. Used when you need to strengthen the root of the tooth.

Intralucosal implants. They allow you to dispense with implantation into the jaw bone. They are mainly used to improve the stabilization of full or partial removable dentures.

It is known that after tooth extraction, with insufficient loading on the alveolar bone, atrophy of bone tissue occurs at 40-60% during the first two, three years after removal and then lifelong resorption by about 1% per year. If you drag with implantation for a long time, the amount of bone tissue will become smaller every year, and eventually it will not be enough. It will also change its topography, which prevents the installation of implants in the optimal position. To help in these situations, many augmentation techniques have been developed( bone volume increase) - autotransplantation of bone blocks, thickening of the sinus floor( sinus-lifting), aimed at improving the conditions for the installation of implants.

Teeth implantation procedures

There are two main techniques for implantation of teeth:

1. Single-stage, i.e. The implant is installed in one dentist's trunk directly into the socket of the removed tooth or a couple of months after its removal( delayed implantation).

2. Two-stage. First the intraosteal part of the implant is established, and after its engraftment( after several months) - the abutment.

The success of implantation depends on the materials, conditions and techniques of the operation, as well as the preparation stage for implantation, from the implementation of dentist recommendations. With a careful and attentive attitude implants can serve more than 10 years.

Stages of implantation of teeth

1. Thorough planning. When planning an implantation operation, you need to undergo an examination of the doctor - an implantologist, an orthopedic doctor, and if necessary, an orthodontist and periodontist.

Planning consists of a preliminary assessment of the state of the human body. Estimates, like the oral cavity, and the whole body as a whole. At this stage, the oral cavity is inspected. Panoramic pictures of jaws( orthopantomogram), 3D computer tomography( depending on the situation) are studied. Using a three-dimensional model of the jaw, the doctor can perform a virtual extraction of teeth to assess the possibility of a single-stage implantation of the teeth. Can check how the implants are correlated with the relief of bone tissue, natural teeth and the future orthopedic design. Using such 3D technology allows you to achieve high-quality results.

Before proceeding with the further planning of implantation of the teeth, it is necessary to pass blood and urine tests, if necessary, to carry out preliminary treatment.

Before the operation it is necessary to cure carious teeth, to make a professional cleaning of teeth( remove dental deposits).It is necessary to learn the proper oral hygiene and the peculiarities of the care of prostheses on implants. After all, microbes that live in dental plaque can interfere with the engraftment of a titanium rod. And if a person does not or can not "keep clean" the oral cavity, then this is the basis for refusing implantation. In this case, prosthetics are recommended with removable or non-removable dentures( depending on the clinical situation).

2. Surgical stage - the main stage of implantation of teeth. The technique itself is performed under local, powerful anesthesia. The essence of it is to install the implant in the jaw bone. The length of the implant installation takes 30-50 minutes on average.

After anesthesia, an incision is made of the mucosa, special tools drill a hole in the bone and install an intraosseous rod, after which the wound is sutured( two-stage technique).The procedure is absolutely painless, but some discomfort is possible, so it is felt, something in the mouth that something is being done. After that, the titanium pin is allowed to settle down.
For several months, the implantologist is following the process of engrafting.

Steps for installing the implant

3. Installing the abutment. When the doctor sees that the implant has taken hold( there was a so-called osteointegration - fusion of a titanium pin with a bone), a new incision is made in the same place and an abutment is installed over the gum. After its installation, it takes about a week to complete the entire prosthetic stage on the implants.

4. Orthopedic stage. At this stage, an artificial crown of the tooth or other elements of the prosthesis is attached to the abutment. Then you can use the new design with pleasure.

Complications after implantation

As with any medical operation, complications may occur after implantation. Complications can be as early( in the first months, year) and later( 2-3 years and later) after the installation of implants and prostheses. According to some estimates, the number of complications is about 5%.

Complications after a dental implant operation related to the technique itself:

• damage to soft facial tissues;
• damage to the facial artery( bleeding) and nerves( especially when performing surgery on the lower jaw);
• perforation of the nasal cavity, the mandibular canal, the maxillary sinus;

Complications not related to the technique of implantation:

• atrophy of bone tissue in the area of ​​implant fixation;
• rejection of the implant;
• inflammation;
• perimplantitis( inflammation adjacent to the implant of tissues);
• appearance of bone growths at the site of fixation of the implant.

Advantages of implantation of teeth:

1. Do not injure nearby healthy teeth;
2. Convenience and comfort, incomparable with other types of prosthetics;
3. The use of implants makes it possible to produce a permanent prosthesis.
4. The implant life is approximately 2 times longer than that of conventional bridges.

Doctor dentist Mashchonok Y.