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Implantation of teeth - a modern technique for restoration of the dentition
Last reviewed: 23.04.2024
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Implantation of teeth implies the replacement of the roots of lost teeth, that is, the installation of a special design in the bone tissue of the jaw in place of missing teeth.
In the process of splicing with bone tissue (osseointegration), implants allow - with the help of subsequent prosthetics - to restore the dentition and thereby normalize the functions of the dentoalveolar system.
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Dental implantation of teeth: from iron to titanium
Currently, in the world of dental practice, titanium and its alloys are used for dental implantation. Titanium in its chemical and corrosion resistance is much superior to stainless steel and is used in aircraft, submarine and nuclear reactor designs.
The newest technologies of dental implantation - the achievement of the XX century. However, the oldest dental implant - a tooth from wrought iron in the upper jaw - was found in the skull at one of the burial sites in France. According to the X-ray study, the owner of the implanted iron tooth lived about 1900 years ago. This find pushed back to the second place a unique artifact, accidentally found in 1931 by the American botanical expedition in the valley of the Ulua River in Honduras. It was part of the lower jaw, which belonged to a Maya woman who lived about 1,400 years ago. In this jaw, instead of the left incisor, a dark stone was inserted, and the roentgenogram showed that this "implant" was inserted during life and even overgrown with bone tissue. So the Maya Indians practiced implantation long before the discovery of America by Columbus.
And titanium in dental implantation began to be used in the middle of the last century. The Swedish professor Per-Ingvar Branemark (not a dentist, but an orthopedic surgeon) with a group of colleagues from the University of Lund carried out research on the healing of bones. During the experiments, the titanium rod inserted into the femur of the experimental rabbit literally tightened together with the bone. Successful research led to the discovery of the ideal osseointegration of technically pure titanium, which they decided to test on the jawbone. So in 1965 the first titanium dental implant was installed.
One of the latest innovations in the field of dental implants is the application of biologically active coatings on titanium implants, which accelerates and strengthens their implantation in bone.
Advantages of implantation of teeth
The advantages of implantation of teeth are obvious. Root implantation of missing teeth - regardless of their number - allows them to be completely restored: an implantation of the front tooth or any chewing tooth, as well as complete implantation of the teeth (when there are almost none) is possible. In this case, dental implantation of teeth gives the chance to reproduce not only the highly aesthetic appearance of the dentition (which looks absolutely natural), but also to ensure the full functioning of the teeth. Terms "work" of implants are from 10 to 25 years.
In addition, if a bridge is planned to be inserted after implantation of the teeth, then it is not necessary to grind adjacent teeth. And fixing removable prostheses on implants will eliminate all the problems that often accompany their wearing. Dentists say that removable structures installed on dental implants do not have to be removed from the mouth every day: it is quite sufficient to carry out hygienic care for them every 7-10 days.
Implantation in the absence of teeth provides a real opportunity to refuse removable dentures, replacing them with conditionally removable structures. Or put non-removable structures, which in the absence of teeth and almost complete atrophy of the alveolar process of the jaw can not be used. As experts note, in this case any kind of prosthetics based on dental implants will be more comfortable for patients and effective from the point of view of the functioning of its dentoalveolar system.
Dental implants
According to dental implantologists, the survival rate of titanium dental implants is very high - at the level of 95-98%. But the probability of getting into those 2-5% of cases when the body rejects a "foreigner" certainly exists. In addition, the presence in the mouth of the implant requires not only careful care at home, but also systematic hygienic procedures performed professionally, that is, mandatory visits to the dentist.
One should be prepared for the fact that implantation of teeth will require maximum of your patience and a sufficiently long time (from several months to a year, depending on the case). Also, to the category of significant disadvantages of dental implantation is its high cost.
For reference, the minimum prices for dental implants in the UK (according to the Global Dental Implants Market survey) are 1,800 euros per tooth, in Italy 1,300 euros, in Germany and Slovenia 1,000 euros, in Croatia 800 euros. An American pays for one dental implant $ 2000, a resident of China - from $ 900 to $ 1500, a Muscovite - from 20 thousand to 40 thousand rubles ($ 600-1200), and the Kyivites spend at least 5-6 thousand hryvnia.
Dental Implant Systems
Today, industrial manufacture of intraosseous dental implants is conducted in 24 countries of the world, and in the market of dental services the implantation of teeth has grown to 18%. The pioneer in the production of implantation systems - Nobel Biocare (Sweden) - has been manufacturing implants for dentistry since 1981. Implants of the root form can be used for classical two-stage and one-stage implantation techniques. Nobel Biocare implants use a special TiUnite coating, which ensures good implantability and high implant reliability.
Swedish company AstraTech has developed a universal system of implantation of teeth
Astra Tech Implants Dental System, which is used around the world and has proven itself to be of high quality and reliability in solving almost any problems associated with tooth loss.
The Swiss company Straumann produces one of the best dental implants in the world. For example, the latest SLActive model, thanks to an innovative coating, is implanted in the patient's jaws in just a month.
The screw implants of the Israeli company Alpha-Bio Tec successfully apply dental clinics in 48 countries of the world. Especially popular are conical implants SPI and DFI. A system of implantation of teeth by Bicon Dental Implants (USA) specialists is established even in cases when the degree of atrophy of the gum bone does not allow putting implants of other systems.
Among the implants manufactured in Germany, the specialists of the conic system TissueCare brand Ankylos. This system is easy to use and provides maximum functionality in combination with an excellent aesthetic appearance of dental implants.
The types of implantation of teeth, or rather, the types of endosteal (intraosseous) implants - depending on their shape - are divided into screw, cylindrical, conical, tubular, plate, with steps, cortical lining,
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Stages of implantation of teeth
Many people are interested in how the implantation of teeth occurs. The technology of implantation of teeth involves the gradual implantation of artificial roots of lost teeth.
A very important stage is preparation for implantation of teeth. First of all, all available teeth should be cured - to avoid the risk of infection and even rejection of the implant. When examining and drawing up a treatment plan, the dentist-implantologist always signs the whole process (protocol of treatment) and chooses the type of implant design and the method of implanting it into the jaw that are most suitable for each individual patient, taking into account the method of subsequent prosthetics.
Preparations for dental implants include a detailed examination of the oral cavity and teeth using an orthopantomogram (a digital panoramic jaw) and computed tomography (CT). The data of these studies give an idea of the general condition of the oral cavity, bone tissues of the jaw, as well as its anatomical features or defects.
For successful operation, you will need to pass tests for dental implants: a general blood test, a blood test for sugar, HIV, hepatitis and venereal diseases.
At the second stage on the jaw (with a two-stage implantation), bone tissue is increased, the volume of which, with prolonged absence of the tooth, significantly decreases (atrophies) both in width and height. To insert bone tissue, either the patient's own bone (autograft from the iliac bone, chin or back of the jaw) or different allografts and alloplasts is used. The duration of bone graft healing is at least 3-4 months. As the specialists note, 70-80% of patients in this stage of dental implantation can not be avoided, since the structures should be securely fixed in the jaw bone, while the bone deficit prevents this.
Sinus-lifting or subantral augmentation is currently used to install dental implants on the upper jaw. In the course of this operation, in order to increase the width of the bone tissue of the jaw crest, the bottom of the maxillary cavity in the area of the maxillary sinuses is lifted and the artificial bone tissue is prevented from being released into the vacated niche. In a few months - after its adhesion with the jaw bone - you can implant a dental implant.
The actual installation of the implants takes place in stage III. Surgery to implant an implant replacing the roots of the tooth is performed under local anesthesia. Implantation of teeth under anesthesia (that is, general anesthesia) is extremely rare and only in those rare cases when simultaneous installation of several implants.
To install a dental implant, the tissues of the gums are dissected, a groove (bed) is drilled into the bone corresponding to the size of the titanium structure, an implant is inserted into it, a screw-plug is put on top, and the gum is sewed. The incision of gum tissue can be performed not with a scalpel, but with a laser. This is the so-called laser implantation of teeth or bloodless implantation of teeth. Procedure for dissecting the mucous tissue of the gum, which lasts no more than half an hour.
In this case, according to dentists, the probability of rejection of the implant is minimal, and absolute sterility serves as a pledge of very rapid healing. But this is not possible in all dental clinics (due to the lack of this equipment), and such an operation will cost 20% more than using traditional instruments.
Seams after implantation of teeth are removed, usually after 7-10 days. But the implant will fuse with the jaw bone 4-6 months, and in some cases - a year and longer.
If the restoration of the dentition is carried out using a disassembled (two-component screw) implant, the next step is the installation of its superstructure (abutment) or abutment - that is, a special "adapter" between the dental implant and the design that will be used for prosthetics. The gums again dissect, the cap is removed, and the abutment is screwed into its place. After this operation (which is also done under anesthesia), the gum tissue is healed within two weeks.
When single-stage methods of implantation of teeth are used non-separable structures (single-stage), in which the abutment and the intraosseous rod - a single unit, and the part on which the denture will be located, immediately over the gum. This allows to speed up the implantation process.
The final stage of implantation of teeth is the installation of artificial teeth, that is, prosthetics. Prosthetics can be carried out by various designs: cement or screw fixation of crowns and bridges, a removable prosthesis with several mounting options.
Methods of implantation of teeth
Depending on the technique of dental implantation, two-stage and one-stage dental implantation are distinguished.
Two-stage implantation of teeth, which many experts call classical, is a very long procedure with surgical intervention (its technology is briefly described in the previous section on the stages of dental implantation). Even if there are no indications for increasing the volume of the jaw bone, two-stage implantation of the teeth lasts at least six months, since it is carried out by a collapsible two-component screw implant.
One-stage implantation of teeth, in which non-segregated structures are used, allows the implant to be installed in one step and does not wait long for the installation of an artificial tooth. This method of implantation has such widespread names as express implantation of teeth, one-stage implantation of teeth, immediate implantation of teeth.
However, as specialists in this field of dentistry note, with this method of implantation of the teeth, there is a risk that the implant will not firmly grow into the bone tissue of the jaw, and subsequent prosthetics can be unsuccessful.
In addition, this kind of single-stage implantation, such as endoscopic implantation of teeth, which patients call tooth implantation in a day, is applied only immediately after tooth extraction: the implant is placed in the alveolus of the tooth, that is, with its safety and bone presence. And in this case, the whole one-piece structure takes the place of the lost tooth without cutting the gums - just for one visit to the dentist. A crown on the implant is worn a few days later.
Basal implantation of teeth
To the newest technologies of implantation of teeth is the basal implantation of teeth. Its main difference from other methods is that it eliminates the need to build up bone tissue. Here, implants are introduced into deeper basal layers of bone, which are not subject to atrophy, which is inevitable with complete or partial loss of teeth.
The basal osteointegrated implants (BOI-implants) developed in Switzerland have a fundamentally different design (reminiscent of an inverted T-letter). In addition, their installation is performed from the side of the jaw bone.
BOI-implants are immediately put up with bridges, and patients acquire beautiful teeth and can chew food after one week from the operation.
However, basal implantation of the teeth is used only when restoring three or more teeth.
Contraindications to dental implantation
Since dental implantation involves surgical intervention, there are contraindications to dental implantation. Among the absolute contraindications are osteoporosis, systemic diseases of connective tissues (scleroderma, rheumatoid arthritis, etc.), chronic kidney and liver failure, mental disorders, addiction to alcohol and narcotic substances. Implantation of teeth in diabetes is also not carried out. Age restrictions of the installation of dental implants are advanced age and age up to 16-18 years.
Relative contraindications to dental implantation are associated with the presence of coronary heart disease, arterial hypertension, blood diseases, tuberculosis, malignant tumors and a general decrease in immunity. Implantation of teeth with periodontal disease (in severe forms) and with an incorrect bite is also contraindicated.
To solve the issue of "pregnancy and dental implantation", experts advise to approach with care and take into account such factors as anesthesia during surgery and the probability of taking any medications after it. Not to mention the inevitability of additional and undesirable disturbances for the future mother.
Complications after implantation of teeth
According to the clinical practice, complications after tooth implantation are observed in less than 5% of cases and are expressed as pain, swelling and bleeding.
Pain after implantation of the tooth comes after anesthesia goes away, and can last up to three days. For longer pains, consult a doctor to make sure there is no inflammation or nerve damage.
The tumor after implantation of the teeth (swelling) is a natural phenomenon. The surgical site begins to swell a couple of hours after the operation, reaches a maximum on the third day, and a week later the swelling disappears. But if you apply a cold compress in your cheek (wrapped in a towel with ice pack - for 15 minutes, every 30 minutes), then the tumor will disappear faster.
Minor bleeding from a dissected and sewn gum for several days should not cause concern. However, in case of longer bleeding, which can cause damage to the vessel, you should consult a doctor who prescribes appropriate medications.
Treatment after implantation of teeth
Treatment after implantation of teeth is aimed at relieving pain and accelerating healing, for which the doctors recommend the dally-adhesive paste Solcoseryl. The drug is well tolerated and has no contraindications, it should be applied to the gum seams twice a day.
In the first days after the procedure for installing a dental implant, you need to make oral baths with antiseptic solutions: 0.05% Chlorhexidine solution or 0.01% Miramistin solution (keep the drug in your mouth 3-4 minutes several times a day after eating).
With pain after tooth implantation, doctors recommend taking non-steroidal analgesics and anti-inflammatory drugs. For example, instant Naise tablets (analogous to Nimesulide, Nimesil) are prescribed 100 mg twice daily after meals. The maximum daily dose is 400 mg. One tablet of the drug should be dissolved in a teaspoon of water. The drug is usually well tolerated and can be applied within 10 days.
Rehabilitation after implantation of teeth will pass without problems, if one strictly observes all post-operative recommendations of the dentist-implantologist.
So, you need to exclude any physical activity, avoid overcooling, overheating and air travel. Alcohol after implantation of the teeth, as well as smoking for two weeks are strictly contraindicated. With caution (with a closed mouth), sneeze, blow your nose or cough.
Where to do the implantation of teeth? A few tips
Where to do tooth implant is your personal choice, but it should be a solid dental clinic with a special, well-equipped unit for dental implantation. And you need to choose a clinic where you will be given a guarantee that the originally calculated "estimated cost" of the entire procedure will not increase during its implementation ...
It is useful to take an interest in the clients' reviews of the clinic or about a specific dental implant specialist. By the way, reviews about dental implants placed on the websites of some Russian clinics are often posted by their employees.
In the notice, for today implantation of a teeth is widely practiced in 196 countries of the world. According to the Association of Oral and Maxillofacial Surgery, 69% of American adults (35-44 years old) lost at least one permanent tooth for various reasons. In addition, more than 74% of the elderly in the country lost all their teeth. And the world statistics testifies to the partial absence of teeth in three quarters of the population of our planet.