Absolute and relative contraindications to dental implantation. Dental implantation. Indications, contraindications and preparation for dental implantation. Types and techniques of dental implantation

Dental implantation of teeth is a full-fledged surgical intervention. Like any operation, implantation has a number of contraindications and risks. Dental implants also have contraindications for installation. Dentists distinguish five main classes of contraindications - absolute, relative, temporary, general and local.

Absolute contraindications are those contraindications that have absolute force. In other words, if the doctor finds an absolute contraindication for you, he is forced to refuse surgical intervention. There are the following absolute contraindications for implantation:

• Some blood diseases. The most striking example of such a disease is a bleeding disorder, due to which even a minor wound can lead to death.
• Some diseases of the nervous system. For example, various schizotypal disorders, when the patient is weakly responsible for his actions.
• Malignant tumors. The fact is that surgical intervention can increase the growth of the tumor, which is absolutely unacceptable.
• Diseases immune system. During surgery and during the healing period, large numbers of bacteria can enter the bloodstream. If the immune system does not work well, this can lead to various pathologies.
• Diseases connective tissue. After surgery, it is important that the connective tissue around the new teeth grows normally. Therefore, diseases such as lupus, scleroderma and other rheumatoid diseases can serve as a serious argument against surgery.
• Some other diseases - tuberculosis, bruxism, diabetes Type 1, stomatitis, Sjogren's syndrome and others.

Relative contraindications

Relative contraindications are those contraindications that may serve as an obstacle to performing surgery. In other words, the doctor analyzes the medical history and then makes a decision about the operation. Typically, a single relative contraindication is not a reason to refuse surgery. If the patient has several relative contraindications, the doctor may refuse surgical intervention. For implantation there are such relative contraindications:

• Poor oral health and poor hygiene. If the patient does not brush his teeth, he has caries and tartar, the doctor is unlikely to implant teeth.
• Inflammation of the gums.
• Inflammation of the tissues around the teeth is marginal periodontitis.
• Pathological forms of bite.
• Disease of the joints of the lower jaw - arthrosis.
• Atrophy of the alveolar process.
• Bad habits - regular use large doses alcohol, tobacco smoking, drug addiction.
• Doctors also do not recommend getting implants during pregnancy.

General contraindications

General contraindications are such contraindications general, which are directly related to the functioning of the jaws. The jaw region is directly connected to all other human organs. In other words, the nervous system must function normally, oxygenated blood must regularly flow to the jaws, decay products must be removed from the body, and so on. There are the following general contraindications for implantation:

• Intolerance to anesthesia.
• Somatic diseases - endocarditis, rheumatism, heart disease, and so on.
• Taking certain types of medications that directly affect the survival of implants - immunosuppressants, cytostatics and other substances.
• Mental disorders - prolonged stress, exhaustion and others.

Local contraindications

Local contraindications are those contraindications that are associated only with the functioning of the jaw apparatus. There are the following local contraindications for implantation:

• Poor oral hygiene.
• Insufficient bone hardness.
• Insufficient amount of bone tissue.
• The proximity of the implants to the alveolar process and nasal sinuses.

Temporary contraindications

Temporary contraindications are contraindications that may go away over time. This is why some doctors prescribe additional tests, which, at first glance, have absolutely nothing to do with implantation.
There are the following temporary contraindications for implantation:

• Pregnancy and lactation period.
• Diseases in acute stage.
• Postoperative rehabilitation.
• Use of certain drugs and medications.
• Irradiation.

Risk factors

Risk factors are those phenomena that in themselves play little significance in making a decision about surgery. However, their combination can be a serious contraindication for dental implantation. Doctors divide all risk factors into three classes: cosmetic, biomechanical and general.

General risk factors

Before the operation, the patient undergoes a preliminary examination. Its goal is to identify hidden risk factors that may cause refusal to undergo surgery. The examination takes place in several stages:

1. General health assessment. Before installing implants, the doctor weighs the pros and cons. The most important thing absolute contraindication is the presence internal infections. There are a large number of them; for implantation, only one class of infections is taken into account - diseases in the area of ​​the osseointegrated implant. Research shows that infections in the implant area are very rare in chronic form. The likelihood that you will suddenly become ill during the operation is also quite low (this directly depends on the qualifications of the doctor). Some other relative contraindications (eg diabetes) can be ignored if the operation is supervised by an experienced surgeon. When compiling an anamnesis, the patient’s presence of bad habits. For example, smokers have a 10% lower rate than people who have never smoked or have quit long ago.
2. Age. Great importance has the age of a person. In people under the age of 18, the body is in a growth stage, so implantation in children is prohibited. Strictly speaking, there is no upper limit, but older people get sick more often various diseases, which may be the reason for refusal of implantation.
3. Psychology. It has been proven that the survival rate of implants is influenced by a person’s motivation. And here there is very important point— many people may not understand what implantation actually is. People often think that implantation is an ordinary cosmetic procedure, which people resort to only to solve purely aesthetic problems. This attitude can affect the treatment process. For example, a patient may not take treatment seriously - and therefore do not care enough about compliance strict rules hygiene during treatment.
4. Availability. The accessibility of the clinic to the patient is also of great importance. For example, before implantation, special procedures are often performed that should stimulate bone tissue regeneration. If the hospital is located far from home, the patient will visit the doctor less often, which negatively affects the treatment process.

Cosmetic risk factors

Previously it was used only to restore the patient's chewing function. However, with the growth of scientific and technological progress and the increase in citizens’ incomes, doctors began to engage in the restoration of all teeth for other purposes. One of the striking examples is the aesthetic restoration of the dentition. Many people want their teeth to be not only strong, but also beautiful. And doctors don't mind. When creating prostheses on implants, specific risks must be taken into account. They can be divided into four classes - gingival, dental, bone risk factors, as well as risk factors on the part of the patient himself.

Gingival risk factors

The patient wants to get healthy beautiful smile. Therefore, doctors often pay attention to the smile line. If it goes deep into the gums, this may be a relative contraindication. In this case, doctors often notify the client of this difficulty. The client must choose for himself whether he needs such an operation or not. The beauty of your smile is directly affected by the thickness of your gums. Thus, installing implants on thin gums involves a lot of difficulty, while installing implants on thick gums is quite simple.

Dental risk factors

It has been proven that the rectangular tooth shape contributes to better healing after operation. The triangular shape of teeth is a relative contraindication in some cases. The location of contact points also matters. If they are located at a distance of less than 0.5 centimeters to the bone, this promotes the survival of implants by enhancing the regeneration of interdental papillae.

Bone risk factors

Installation of the prosthesis can be complicated by the presence of various depressions in the area of ​​the vestibular surface. Due to trauma and/or periodontitis, bone height may decrease (vertical resorption of dental tissue), which has a negative impact on the survival rate of implants. The presence of bone elevations is important. If they are not there, the implants will become more loose.

Patient risk factors

The aesthetic requirements of the client are of great importance. If the client has a lot of money and is ready to get expensive implants, you need to explain to the client that such an operation may involve certain risks. After all, many expensive implants have been poorly tested because their use is low compared to standard implants. If the patient does not maintain oral hygiene, this can cause inflammation, which will lead to loosening and loss of the implant. This problem is partially solved by removable implants, which can be removed before performing hygienic procedures.

Biomechanical risk factors

Understanding the biomechanical aspects of implant placement can improve survival rates and avoid unpleasant side effects. Dentists distinguish four main classes of biomechanical risk factors: geometric, occlusal, technological, and implant-osseous risk factors.

Geometric risk factors

What matters here is the number of implants, their mutual arrangement and geometry of the prosthesis. It is not only the quantity that matters, but the number of roots that feed them. For example, canines have one root, but molars have two or even three roots. Large diameter implants are attached to a wide orthopedic platform. This fixation perfectly withstands strong loads on the implants. When implanting, you also need to take into account the natural teeth to which the implants are adjacent. This is explained simply - healthy teeth have a very high looseness, but implants do not. This creates poor distribution of stress on the oral cavity.

Occlusal risk factors

In dentistry, occlusion is understood as the closure of the teeth of the lower and upper jaw. People with bruxism or broken teeth are at risk. To prevent implantation from causing pathological processes from neighboring healthy teeth, it is necessary to provide them with additional fixation.

Risk factors from teeth and implants

After the operation, the doctor must do an additional examination. During it, he must evaluate the stability of the implant in the dental sinus. Knowing the degree of stability, the doctor can easily calculate the period of complete integration of the implant, as well as determine its ability to withstand heavy loads. Often after implantation, the doctor discovers that the primary stability of the implant after installation is in an unsatisfactory state. With time the implant will take root, and primary stability will lose its meaning. But doctors advise protecting implants from excessive load for about 1 year. Narrow implants bear load less well than their wider brothers. This also needs to be taken into account.

Technological risks

If the prosthesis was installed using a cemented method, it is important to achieve good stability of some types of abutments. To improve stability, screws made of gold and titanium alloys. However, if the screw is fastened too tightly, the patient will also be at risk.

Conclusion

Installation of dental implants has contraindications. Before installing implants, you need to assess the person’s health. To do this, dentists refer their patients to undergo specialized tests. This is not a whim, since implantation has a lot of contraindications. The most serious contraindications for dental implantation are: the presence of tumors, the presence of serious inflammation in the dental sinus, impaired immunity, and reduced blood clotting. Some contraindications are relative. These mainly include oral diseases - insufficient hygiene, gingivitis, periodontitis, arthrosis, and others. It is also undesirable for the patient to use tobacco, alcohol and various drugs. It is important to understand that relative contraindications are not absolute. If the installation of implants is carried out by an experienced doctor with long experience work, a number of relative contraindications can be ignored.

Installing implants involves certain risks. Dentists distinguish a large number of risks, which for convenience are divided into three classes - general, cosmetic and biomechanical. When compiling an anamnesis, age, availability of treatment and psychological factors are taken into account. The patient's requirements regarding the aesthetic appeal of the prosthesis are also of great importance. Also, when drawing up a treatment plan, parameters such as the quality and quantity of natural teeth, the type of implants, the shape of abutments and other parameters should be taken into account.

The patient’s attitude plays a big role in the survival rate of implants. If the patient stops smoking, this will significantly increase the chances of implant survival. But failure to comply with oral hygiene rules worsens the likelihood of a favorable outcome. The patient will have to change his lifestyle if he wants to recover.

Update date: 11/28/2018

Date of publication: 08/01/2012

Education: Institute of Journalism and Television Arts of KiMU, specialty "Journalist"

Like any other operation, dental implantation has indications and contraindications: everyone who is thinking about this method of restoring the dentition should familiarize themselves with them. We must not forget that installing implants is a type of surgical intervention, so it has strict limitations and is not suitable for everyone. Let's look at the main indications and contraindications for implantation.

Indications for dental implantation

Installation of implants followed by loading with prostheses helps restore one or more teeth and even cure complete adentia. Thus, the indications for implantation are the absence of any number of teeth in the upper or lower jaw. Today this technique is the most optimal: a titanium root functionally completely replaces a natural tooth, ensures uniform distribution of the chewing load, prevents the resorption of bone tissue and, as a result, the appearance of problems with gastrointestinal tract, impaired diction and distortion of facial features. Dentures on implants last longer and look natural.

In a word, the indications for dental implantation are exactly the same as for traditional prosthetics, but the problems will be solved much better.

Dental implants - absolute and relative contraindications

Are dental implants associated with harm and contraindications? Of course, their installation involves surgical intervention, that is, violating the integrity of body tissues. Even for immediate implantation, there are quite a few contraindications, and this technique does not even involve an incision in the gums: the doctor is limited to just a puncture. What can we say about the classic two-stage operation.

Contraindications to dental implantation can be divided into two main categories - absolute, that is, those in which the procedure is impossible in principle, and relative. These include diseases that require special control and attention from the doctor, or temporary conditions of the patient.

Let's take a closer look at the absolute and relative contraindications to implantation.

EXPERT STARTSMILE

Implant surgeon / Moscow

Absolute contraindications to dental implantation

When is implant placement not possible? Experts highlight a list of diseases that are considered absolute contraindications to implantation and any other operations. These are, first of all, severe disruptions to the functioning of the main systems of the body: cardiovascular, nervous (both central and peripheral), endocrine, circulatory.

Here are examples from the list of contraindications for the installation of dental implants:

• diabetes mellitus in the decompensated stage
• malignant neoplasms(implantation can accelerate tumor growth and spread of metastases)
• autoimmune diseases
• chronic renal or liver failure
• connective tissue diseases
• osteoporosis
• bruxism and hypertonicity of the masticatory muscles
• hemocoagulation (blood clotting) disorders
• tuberculosis
• mental disorders
• chronic alcoholism and drug addiction

Also, a contraindication to implantation is a condition where tissue restoration is impaired. It can occur after a course of chemotherapy, organ transplantation, and also with immunodeficiency. If the patient takes anticoagulants or cytostatics that slow down the development and division of cells, the risk of implant rejection is very high.

Finally, one cannot fail to mention an allergic reaction to local and general anesthesia, which makes any surgical intervention impossible. It is also included in the list of absolute contraindications for dental implants.

Relative (temporary) contraindications to implantation

Unlike absolute contraindications, relative contraindications for dental implantation allow the procedure to be performed under certain conditions. For example, after changing lifestyle, eliminating inflammatory processes, recovering from conditions incompatible with surgical intervention, and the like.

What contraindications for installing dental implants are considered relative? Here are the main ones:

• insufficient bone volume
• malocclusion
• inflammatory processes and neoplasms in the oral cavity (cysts, granulomas)
• caries
• periodontitis and other gum diseases
• poor hygiene oral cavity, tartar
• pregnancy and breastfeeding
• viral infections
• exhaustion of the body, malnutrition And severe stress
• smoking more than one pack of cigarettes per day
• engaging in extreme sports that increase the likelihood of injury

Many of the above conditions can be corrected: bone tissue can be built up using a bone grafting procedure, the bite can be corrected with braces, and hard deposits can be removed. It will also be necessary to treat caries and other oral diseases before implantation. In certain conditions, the doctor will require you to adjust your lifestyle, limiting the number of cigarettes smoked, adjusting proper nutrition and reducing physical activity. Pregnant and lactating women should wait until childbirth and the end of lactation.

Among the relative contraindications for the installation of dental implants are a number of diseases that require increased monitoring by doctors, for example, compensated diabetes mellitus.

Age as a contraindication to the installation of dental implants

One of the key contraindications to dental implantation is age. Until the formation of the dental system and bone tissue is completely completed, the operation remains prohibited. This usually happens between the ages of 17 and 22. But there is no upper age threshold for implantation: it all depends on the general condition of the patient.

Is hepatitis a contraindication for dental implantation?

The doctor may refer the patient to additional tests to exclude liver dysfunction and, as a consequence, blood clotting, but there is no hepatitis in the list of contraindications for dental implantation. Of course, we are talking only about the remission stage: in the acute phase, surgery is not allowed.

It should be noted that modern clinics carry out thorough and multi-stage sterilization of instruments, so infection of other patients with hepatitis is excluded.

What are the contraindications after implantation?

Many patients are interested in how the implantation of artificial roots will affect their future life and whether they will encounter contraindications after dental implantation.

So, for the first 2 - 3 months, until the implants stabilize, you will have to avoid active physical activity, hypothermia and overheating (visits to baths and saunas, hardening). But after the implantation of the artificial root, there will be no restrictions in the patient’s lifestyle.

There is a common myth that dental implants are a contraindication for MRI. Indeed, you should not be in a tomograph with metal objects on your body, but titanium, from which most implants are made, is paramagnetic and practically does not react to action magnetic field. The only problem that the patient may encounter is distortion of the image at the site of installation of artificial roots, so before the examination it is necessary to warn the doctor about their presence. Modern equipment allows you to change settings, partially eliminating the error. The implants do not affect the results of examination of other parts of the body.

Despite the “horror stories” still circulating among people regarding dental implantation (they say that it is terribly harmful and there are many contraindications for it), today the installation of implants can be considered an even less traumatic procedure than, for example, removal complex teeth wisdom. That is, relatively speaking, in 95% of cases there is no talk of any terrible torment or “harshness”: modern dental implants are installed relatively painlessly, do not cause harm to the human body and can last for decades, as evidenced by numerous reviews from both doctors and and grateful patients.

However, why then is the installation of implants considered by some people to be harmful and dangerous to health - after all, this attitude probably arose for a reason?

Indeed, dental implantation, being essentially a surgical operation, in some cases is associated with rather complex, traumatic and lengthy manipulations by a dental surgeon (implantologist). As with any operation, not everything always goes smoothly - various complications and not very pleasant consequences are quite possible.

In addition, there are certain contraindications to the installation of implants and a list of diseases, without taking into account the presence of which implantation may have an impact. Negative influence both on the general condition of the body during and after implantation, and on the installed dental implants themselves (inflammation and suppuration in the area of ​​installed implants, their mobility, rejection, etc. harmful effects). Reviews of this kind, which are sometimes found on popular forums, precisely support the popular opinion about dental implantation as a harmful and very dangerous procedure for health.

About whether the installation of dental implants is really a harmful procedure, what unpleasant consequences at the same time, it can be observed what problems can occur due to the fault of the patient himself and due to the fault of the doctor - we will talk about all this further and in more detail...

“I want to tell everyone my story so that no one else ends up in the same difficult situation due to their own stupidity. About 3 years ago I wanted to get implants because I had nothing to chew and I didn’t want to wear false jaws like my grandma’s. During that period, a malignant tumor grew in my jaw, but it was small in size, so I was actively treated at my own expense at the oncology center.

I understood perfectly well that my tumor could scare off the doctor, and there was no reason for me to walk around with dentures, so I didn’t say anything about my illness. The implants were placed quickly, all that was left was to wait for them to take root. At that time I was just taking a course radiation therapy, but they irradiated the place where there were several implants. Most of the screws came off. Later they explained to me that it was necessary to immediately say what and how it really was: the rays disrupt the process of fusion of bone with metal. In general, they told me that I had screwed up myself, and (naturally) they redid everything at my own expense. It took a whole year for my dentist and oncologist to work together to solve the problem with the new teeth. In short, I warn everyone: it’s better to immediately tell the doctor everything as it is, otherwise it will turn out either like mine or even worse. Don’t risk your health!”

Victoria, Moscow, 47 years old.

Five fictional horror stories about implants

If an unprepared person reads some, to put it mildly, not very professional articles on pseudo-dental sites, as well as reviews and discussions on forums, he may be horrified by the information, which in its essence is often far from medicine. Cases where unsuccessfully placed dental implants caused harm to the patient’s health are often described in a grotesque form, and there are also speculations and fears presented as truth.

In general, people who have not yet become happy owners of implants, but are just thinking about it, may be afraid to go to a dentist-implantologist even just for a consultation.

Let's look at 5 famous horror stories on this topic.

Myth #1: Dental implants can be “wrapped” so that they damage the orbit of the eye.

In fact, it is impossible to damage the orbit of the eye with dental implants for a number of reasons: controlled length of implants, monitoring the distance to important structures maxillofacial area from pictures, experience and common sense doctor, etc.

Meanwhile, there are indeed rare cases of damage to maxillofacial structures close to the implantation zone. According to statistics, the following complications can be distinguished by frequency of occurrence:

• Damage maxillary sinus;
• Disorder of the mandibular nerve;
• Exit of the implant into the sublingual space;
• Exit of the implant into the nasal cavity.

Each of these complications during implantation is rare, with the first place in occurrence of the three being “penetration” of the implant into the maxillary sinus. Currently, such cases are becoming less and less due to careful monitoring and control of the distance of the maxillary sinus using digital images in different projections, as well as due to the wide possibilities for building up additional bone (sinus lift). All this is used professional dentists as part of the prevention of possible complications.

“I had an implant installed in Simferopol and was quite pleased. The most important thing is that nothing came out of the nose, like others, it’s not running, the lips and cheeks are not swollen, like a hamster, and the mood is good. It’s been 7 days since the screws were inserted, and I’m fine, although I thought it would hurt a lot. The only thing that was stressful was taking tests and the long preparation for implantation. I can say right away that I was lucky with the dentist, as he explained everything to me clearly, how and what would happen. That it depends not only on him how the implants will behave in the future, but also on my good behavior.

In general, guys, don’t be afraid - it’s not scary. The main thing is to find out thoroughly about the clinic and the doctor who implants implants in the jaw, do not sign anything if you have not read it in detail, find out about the guarantees in advance. They gave me a contract with a guarantee, so I can sleep peacefully. You just need to clean it all well and regularly, otherwise it will fly out in a few months along with the jaw to such and such a mother.”

Sergey, Simferopol

Myth No. 2: Dental implantation is always painful

The implantation process in terms of anesthesia is almost no different from pain relief during tooth extraction, with the exception that in some cases a gradual “freezing” is required ( local anesthesia) different areas of the jaw. The modern level of anesthetics allows you to individually select a drug that is suitable for each specific person, as well as administer anesthesia in various, most adapted ways to achieve 100% pain relief. Fortunately, such options, especially within large dental clinics, a lot.

In fact, most reviews indicate that the installation of implants takes place without much pain.

If there are contraindications to local anesthesia and (or) indications for anesthesia, then implantation is performed with loss of consciousness. The most important advantage in this case is that with such an operation it is possible to give a full guarantee that when installing implants during sleep, the patient will not feel any pain or any unpleasant emotions associated with the type of dental instruments (some sensitive people are afraid not only of pain, but but also the type of blood, instruments, as well as unpleasant sounds - drilling, crunching, etc.).

On a note

Under local anesthesia there is no pain in approximately 95-98% of cases, since it is necessary to take into account not only the professionalism of the doctor and the level of the clinic, but also the anatomical features of the human jaw, the individual characteristics of the nervous system, as well as some associated factors (alcohol, drugs, stress, panic fears, current medication intake, etc.).

Myth No. 3: Dental implants are always installed under anesthesia, and anesthesia is harmful to the brain

In practice, the situation is like this: the installation of dental implants is most often carried out under local anesthesia, when the person is conscious from the beginning to the end of the procedure and can directly or indirectly control the situation. Narcosis is good alternative in cases where local anesthesia either does not produce results or can even cause harm to the patient during the installation of dental implants due to contraindications to it.

In cases where a person, on a whim, insists on anesthesia, hiding his current illnesses from the doctor, the consequences can be very different, including very harmful to health and even life-threatening. Be that as it may, a highly professional doctor will do everything in his power to prevent possible problems and choose the appropriate tactics regarding anesthesia - it is only important to cooperate with the doctor, without concealing information about your health from him, no matter how insignificant it may seem to you .

There is an opinion that anesthesia causes significant damage to the brain, impairs memory and generally reduces a person’s intellectual abilities. And although you can indeed find many similar reviews on the Internet, most experts consider horror stories about the dangers of anesthesia to be nothing more than a myth.

“I’ll share my personal experience. I have had four surgeries internal organs, all of them were carried out under general anesthesia. After all this, my memory often began to fail me, I became very forgetful. Sometimes memory lapses happen altogether. I also began to suffer from frequent headaches.”

Oksana M., St. Petersburg

Doctor's review:

“As a person who uses anesthesia up to 5 times a day, I can say that it does not affect the brain, even if done in old age. Yes, such patients sometimes experience an exacerbation of encephalopathy after anesthesia, but this goes away after about a week. In general, there are no drugs that we use that would lead to any irreversible changes in the functioning of the brain. So the damage from anesthesia occurs more on the liver and kidneys than on the brain, but the body quickly copes with this too.”

Sergey, Moscow.

Myth No. 4: after implantation, the gums always hurt for a long time, the cheek swells, and blood flows from the mouth for a long time.

In the first hours after the installation of implants, when the effect of the anesthetic wears off, a painful reaction and discomfort are indeed possible. There may also be slight swelling and minor bloody issues. To reduce the severity of these consequences, an experienced implantologist always prescribes a set of drugs that eliminate or reduce the body’s response to a traumatic factor.

IN in rare cases there may be prolonged pain, significant swelling and bleeding, which with accompanying additional features(fever, prolonged numbness of the jaw, suppuration from the gums, bad smell from the mouth, etc.) is dangerous complication, quite likely associated with the doctor’s incorrect tactics. By contacting your doctor in time, you can almost always quickly solve the problem, avoiding further harm to health in case of problems with the installed implant.

Myth #5: Implants sometimes fail, and when they fail, jaw gangrene occurs.

In fact, even if the implant was installed incorrectly and the doctor made many mistakes, gangrene of the jaw does not develop. In the worst case, inflammation and suppuration occurs in the implantation area, the implant becomes mobile and is rejected. It is impossible not to notice this, and painful sensations already in the early stages they will simply force the patient to return to the dentist.

The photo below shows implants removed from the jaw:

In those rare situations when, for some reason, whether or not dependent on the doctor, implants installed in the jaw are rejected, a banal loss of bone tissue occurs. Such bone loss can later be quite easily compensated for by its artificial restoration using a bone graft.

If you analyze popular reviews on the Internet about dental implants, you can be convinced that sometimes minor complications that arise do not harm a person’s health and are easily overcome by the body’s forces against the background recommended by an implantologist. drug therapy. Here is an example of such a review:

“...Two months ago, after installing the implants, I had the following complication: the gum next to one of the implants was very swollen, so that my cheek actually puffed out. I went back to the clinic. There they opened my gums and did a cleaning and prescribed rinses. Now, thank God, everything is fine! The new teeth have already taken root and I no longer feel any problems.”

Veronica, Neftegorsk

When implants are not necessary at all: absolute contraindications to implantation

Any surgical intervention has its limitations, and in this regard, dental implantation is no exception. Meanwhile, there is no consensus regarding the exact list of diseases that determine contraindications to the installation of implants.

Firstly, this is due to the fact that all contraindications are divided into relative (surmountable under certain conditions) and absolute. Secondly, due to the fact that modern medicine does not stand still, every year the indications for implantation are expanding, and those contraindications, ignoring which previously could directly or indirectly harm health during and after the installation of implants, are today overcome with the help latest technologies and drugs.

Today, most experts are of the opinion that dental implantation is not recommended for:

• Severe diseases of the cardiovascular, endocrine and nervous systems;
• The presence of malignant tumors;
• Certain blood diseases;
• Chronic renal and liver failure;
• Allergies to local and general anesthesia drugs;
• Chronic alcoholism and drug addiction.

For example, under certain conditions, the installation of implants is possible in the following cases:

• In old age;
• In case of diabetes mellitus type 2 (sometimes type 1) in the stage of compensation without impairment metabolic processes in bone tissue;
• After suffering heart attacks and strokes;
• When using a pacemaker;
• After oncology;
• For smokers.

There are two main reasons that force a doctor to refuse implantation:

1. Acute and (or) severe forms of diseases, especially in decompensated form;
2. And also when serious violations tissue regeneration.

However, this also does not mean that the installation of implants will be put to rest forever. For example, ARVI, acute respiratory viral infection, at the height of the disease will be a contraindication to dental implantation. And this is quite obvious: against the background of reduced immunity, with high temperature, runny nose, cough and sore throat, it is impossible to carry out high-quality implantation, since this is with high probability may have a negative impact on the already unsatisfactory condition of the patient. However, already 1-2 weeks after recovery, the installation of implants can be carried out without any harm to health.

As for tissue regeneration disorders, this affects, first of all, the possibility of integration (engraftment) of the implant into the bone. There are often situations when this possibility tends to zero. For example, if a person undergoes radiation therapy for oncology in the maxillofacial area, the regeneration of bone tissue in the implantation zone will be impaired, so the implants are almost 100% likely to be rejected in the near future after their installation.

“They planned to have implants inserted up and down + also to have my gums corrected, since after my teeth were removed, my wounds healed very unevenly due to suppuration. In short, they will insert four implants at the top and the same number at the bottom. I’m a little afraid, although the operation will take place under anesthesia, so I’ll sleep and not think about anything. The only bad thing is that I have type 2 diabetes and my blood sugar sometimes goes over 20, which can affect how the implants heal. But my doctors reassured me and told me not to be afraid: I was not the first one with such a disease. Let’s hope everything goes 5+!”

Elena, Moscow

Dental implantation and pregnancy

Some experts speak out against dental implantation during pregnancy, since the process of installing dental implants can, with a certain probability, cause harm to the expectant mother, and through her condition, harm to the developing fetus.

Generally speaking, pregnancy is only a relative contraindication to implantation, and installed and normally implanted implants do not in themselves have a negative impact on the health of the expectant mother and fetus.

However, when installing dental implants, there are two main potential harmful factors for the health of the pregnant woman and fetus:

• Drug therapy;
• X-ray radiation.

The second point is clear: before and during implantation, it is necessary to carry out diagnostics and quality control of installed implants, and for this, dentists take photographs of the teeth. It could be a CT scan ( CT scan), panoramic radiography or intraoral contact radiography. As it were, bad influence X-ray radiation during pregnancy is not warranted (except in some emergency cases).

Drug therapy is carried out at the first stage of implantation, when it is required that the body accept external interference adequately and the person feels as comfortable as possible. For this purpose, antibiotics, analgesics, antihistamines, as well as drugs local action(for the oral cavity). Moreover, most of the drugs on this list are contraindicated for pregnant women, so risking the health of the unborn child due to a planned dental implant surgery would be the wrong decision.

On a note

There are cases when dental implantation for a pregnant woman is urgently necessary, especially in situations where nothing but implants can be offered. For example, if a pregnant woman received a mechanical injury that resulted in the removal of a front tooth, then so-called immediate implantation can be performed, when short time implants are installed together with aesthetic crowns (usually temporary). Depending on the chosen technique, this process can take from 3-5 days to 2-3 weeks. And here the woman needs to decide, first of all, whether she is ready to go without her front teeth for several months or still risk the health of the fetus (even if the risk is insignificant) and install implants immediately.

Implantation for heart patients: harm or benefit?

Cardiovascular pathologies “scare” many implantologists no less than situations with pregnant women seeking help. Of course, no doctor wants a patient who has recently suffered a heart attack or stroke to die in his chair, ruining the reputation of the clinic and the specialist himself. But what about people with cardiovascular diseases who have the opportunity to get dental implants and get rid of problems with constantly falling and (or) uncomfortable removable dentures?

Let's deal with it right away acute forms diseases: in case of any cardiovascular pathology in the acute stage, the dentist will not install implants, since the potential harm from the operation is too great (for example, death). But in the compensation stage, implantation can be carried out for almost any cardiovascular disease, but again only if comprehensive health monitoring has been carried out and, if necessary, approval has been obtained from the attending physician (generalist, cardiologist, etc.). In rare cases, the practice of cooperation between the dentist and specialists from cardiology centers is used to ensure complete safety of the procedure.

On a note

The quality of life of any person depends not least on the condition of the maxillofacial area. Often, when there are disturbances in normal chewing of food, diseases of the heart and blood vessels are accompanied by a whole bunch of diseases of the digestive tract (not to mention psychological problems And nervous disorders due to the “false jaw” and toothless mouth).

Often, for “core patients” in the risk category, the dentist chooses basal implantation, which is carried out in a short time (in 3-5 days). Despite some of its disadvantages, this type of implant installation can reduce the time a weakened patient spends in a chair and quite quickly returns to a normal and fulfilling life in society.

What can objectively affect the quality of a doctor’s work?

First of all, it is necessary to understand that not even the most first-class implantologist will cope with his work if certain conditions for his work are not created. Most often, the quality of a doctor’s work is affected by:

• Level of equipment of the clinic;
• Sterility of the office, equipment and instruments;
• Characteristics of instruments for implantation;
• Dental implants used in work (and they come in different price categories and, accordingly, different quality).

In other words, you can hardly count on successful installation implants in unsanitary conditions, with blunt cutters, drills, dubious Chinese implants, etc. The statistics of successfully completed operations are influenced by all the little things: from disinfectant for the treatment of premises before selecting a manufacturer of the implantation system. And if the clinic tries in every possible way to save on purchases, then most often this leads to an increased likelihood of complications during and after implantation.

To prevent this from happening to you, you need to take a responsible approach to choosing a dental blade: analyze reviews (both positive and negative), take into account the recommendations of your friends and relatives, and also draw certain conclusions at a consultation with a potential attending physician. If the slightest suspicion arises regarding the qualifications of a specialist, the level of equipment of the office, and, especially, visible to the eye violations, it is better to go to another clinic.

An example showing that different dentistry can vary quite a lot:

“A year ago I had two implants placed. I’ll say right away that it didn’t hurt, but then within a couple of days there was swelling, which quickly went away. The implantation didn't last long, I wasn't even tired. It is important here that you get a normal doctor: an honest one. If he is only interested in the contents of your wallet, then he will persecute and torment you thoroughly until he takes out all the money, and his teeth are a fiasco. In general, choose only an experienced and honest doctor. And my personal advice: get imported implants if you don’t want to have problems..."

Natalya, Murmansk

Problems with implants caused by the person himself

Unfortunately, there are factors associated with the behavior of the person (patient) that can lead to problems with implants after their installation, regardless of the level of the clinic and the professionalism of the implantologist.

The main reasons for implant rejection and the development of peri-implantitis due to the patient’s fault, when he harms himself, include the following:

• Ignoring doctor's recommendations;
• Poor oral hygiene;
• “Malicious” smoking;
• Lack of preventive visits to the doctor.

Poor oral hygiene causes the accumulation of plaque and tartar on installed implants, disrupting the periodontal attachment and provoking inflammatory processes. In such a situation, their natural teeth often become mobile due to periodontitis, and the implants also “get it” to the fullest.

“Girls, today the surgeon wanted to remove my gum formers, and there was a plaque as thick as a finger. I didn’t touch them at all when brushing my teeth, he didn’t tell me anything, but how do I know that these things almost had to be rubbed with a brush. Well, underneath there was blood and an unhealed sore gum. I'm terrified and in pain. But in the picture everything turned out to be fine: there was no inflammation in the bone. The doctor cleaned and put the formers back, now a week later I’m back to him like a bayonet. Now I’m cleaning everything as it should be and waiting for it all to be over.”

Tatyana, Yaroslavl

But there are mixed opinions regarding smoking. Smoking itself in most cases does not lead to problems with implants, but it is worth remembering that when insufficient hygiene oral cavity, “heavy” smokers risk getting periodontitis or periodontal disease, which often leads to peri-implantitis.

Some implant techniques, such as basal dental implants, are marketed as suitable for smokers. But even in this case, we should not forget that the tissues surrounding the implant are still damaged by smoking, which creates additional risks of inflammation even when installing basal implants.

Be healthy!

if you have personal experience If you encounter any problems related to the installation of implants, be sure to leave your feedback at the bottom of this page (in the comments field).

Interesting video: truth and fiction about dental implants

How much does dental implantation cost today?

Implantation is a surgical intervention in the human body, more precisely in the oral cavity, to restore a tooth or a number of teeth that have been lost due to many reasons. This can be caused by hereditary, acquired dental diseases, injury or poor hygiene. If measures are not taken, then soon due to the additional load there will be serious problems with neighboring teeth.

How is the implant installed?

To avoid disastrous consequences, it is important to consider contraindications and the presence of any diseases before placing dental implants. The artificial tooth is based on a metal screw that is inserted into the bone tissue. Next, a prosthesis, or crown, is attached to it. The metal embedded in the bone is biologically inactive, therefore it does not harm the body and does not cause allergies.

At first, only a few large companies could afford to restore teeth. medical centers. Now this operation is available to everyone.

Types of implants

Depending on where the implants will be installed, they are divided into several types, differing in shape.

• Root - the most common, have a cylindrical shape, similar to the root of a tooth;
• Subperiosteal - installed on too thin bone tissue from the inside of the gum. Despite the simplicity of this procedure, such devices have their drawbacks. A metal structure is implanted under the periosteum and takes up a lot of space. Due to the lack of tissue, the supports can protrude into the oral cavity and cause discomfort. This can be avoided if the bone is augmented, but not all patients agree to such an operation;
• When it comes to prosthetics of anterior teeth, endosseous, or intraosseous, plate dental implants are installed.

Contraindications, if any, do not depend on the type of design chosen. There is also a way to strengthen a loose tooth with endodontic-endosseous implants so as not to lose it completely.

Today, thanks to a large number of manufacturers, it is possible to individually select the type of system that is ideal for anatomical structure patient's jaws.

Indications and benefits of implantation

As a rule, artificial teeth are used to medical indications, although for aesthetic purposes the procedure to correct defects is carried out quite often. Losing front teeth is a serious problem that leads to difficulty chewing food. That's why the only way out from the position - dental implants. Contraindications are an important point that requires special attention.

Even in cases where there are gaps in inconspicuous parts of the jaw, it is highly recommended to implant implants in place of missing teeth (to preserve adjacent ones). A similar operation gives:

• minimal risk of injury to healthy teeth;
• durable and reliable strengthening of dentures in the oral cavity.

In addition, now there is no need to grind down and thereby spoil the neighboring ones. Implantation is indicated when one or several teeth in a row are missing, end defects are observed, or all teeth are missing. In the latter case, a complete removable denture can be fixed.

When should dental implants not be placed? Contraindications, diseases

There are two types of contraindications for implantation - absolute and relative. The first include such heavy chronic diseases, How:

• tuberculosis;
• diabetes;
• oncology;
• disorders in the nervous system.

Relative contraindications:

• diseases of the oral cavity (bad bite, periodontitis);
• pregnancy.

Before placing dental implants, you need to carefully study the contraindications. Pregnancy in itself is not a prohibition, but stress in this situation is very dangerous for the mother and the unborn child, so no doctor will agree to perform an operation. In any case, before the procedure, it is necessary to consult a doctor and undergo an examination to identify or exclude the above facts that prohibit implantation. Next, at an appointment with an orthopedic surgeon, options and methods of implantation, cost, timing and methods of treatment after surgery will be discussed.

Many people are concerned about whether there are any contraindications for older people getting dental implants. Age, as it turns out, doesn't matter. The problem is general condition human health, his attitude to medications and anesthesia. Elderly people have more diseases that can become an obstacle to the procedure.

Some medical examinations have, if there are large fragments, staples, clamps on blood vessels and dental implants, contraindications. MRI is one of these due to the presence of a metal foreign body in the oral cavity.

Stages of the operation

1. Examination of the patient by a specialist.
2. The gums are incised under local anesthesia.
3. A hole is drilled into the bone.
4. A metal pin is inserted.
5. The wound is sutured.

The procedure takes 30-50 minutes, the implants will take root no earlier than in two months.

After implantation, you will have to take care of your oral cavity a little differently than the way we are used to doing it since childhood. The dentist will recommend special hygiene products that need to be used. In addition, after the operation, for the time prescribed by the doctor, you should not eat too hot or cold foods, as well as hard foods.

Oral care

Implants are foreign bodies, which need at least two months to take root. Following the recommendations will allow you to consolidate the results and enjoy your new teeth for many years.

The patient may feel pain after surgery. In this case, the doctor prescribes general and local treatment. Local treatment includes rinsing the mouth and lubricating the inflamed area of ​​the gum. General treatment is carried out with antihistamines and painkillers, as well as antibiotics. Dental implants have contraindications (reviews about them fill the Internet). However, they are not always objective, so it is not worth making final conclusions without a doctor.

As a rule, patients who have undergone such an operation remain positive reviews. After all, the functionality of the teeth is not impaired, and they feel just like your own. About aesthetic effects It’s hardly worth saying: a perfect smile is the dream of every person who does not have it from birth. And yet, before deciding on harm, contraindications - everything must be taken into account in order to get the desired result.

Lifespan of false teeth

How much a patient carries is influenced, first of all, by the individual characteristics of the patient. To begin with, this is biological compatibility with the implanted material, the volume of bone tissue and the structure of the gums.

On average, if you properly care for your teeth and follow your doctor’s recommendations, you can wear the system for 20-25 years. However, the skill of the doctor and the quality of work play an important role.

Implantation using the 4D method

A new implantation method is 4D implantation. It is practiced quite successfully in Europe. Its peculiarity is that it is possible to insert a titanium pin even into a small volume of bone tissue. Patients not only can, but should also load such dental implants within two weeks after surgery (if there are no visible complications). No one has canceled the contraindications for this method, and therefore examinations and preliminary consultation with a doctor are mandatory.

This type of implantation costs less than conventional implantation because it does not require large quantity surgical interventions. Due to the fact that the implants are integrated into the bone, there is no specific innervation in this connection. Therefore, pain when pressing hard artificial tooth will not be felt.

Only the patient accepts. Since implantation is a radical and most correct solution to many problems with absence.

On modern level With the development of medicine, even complete edentia is not an irreversible disaster. The number of contraindications is inexorably decreasing every year.

Contraindications to dental implantation

If you start to understand in detail, contraindications are classified into temporary and permanent, absolute and relative, general and local. However, it is much easier for ordinary patients to divide contraindications into 2 groups: 1) general and absolute, 2) relative.

Absolute and general contraindications

In which implantation is completely contraindicated and their complete elimination is required. So, implantation is impossible in the following cases:

• Patient age less than 16 years
• AIDS, HIV and other pathologies of the immune system
• Uncompensated diabetes mellitus
• Malignant tumors
• Oncological diseases during or recently after therapeutic treatment. It is recommended to carry out implantation no earlier than one year after chemotherapy
• Mental illness and the central nervous system
• Tuberculosis
• Diseases of the blood and organs involved in the process of hematopoiesis
• Rheumatism, rheumatic arthritis, rheumatoid arthritis, Sjögren's syndrome, systemic scleroderma, periarteritis, systemic lupus erythematosus and other diseases associated with improper restoration of connective tissue. Since without proper recovery Damaged tissue makes successful implantation almost impossible.
• Intolerance or allergy to anesthesia
• Increased tone of the masticatory muscles
• Serious diseases of the cardiovascular system
• Endocrine disorders and pathologies
• Serious infectious diseases (such as syphilis)
• Exhausted state of the body. In fact, not every dentist can determine it.
• The use of certain types of medications. For example, antidepressants, cytostatics, anticoagulants (including aspirin), immunosuppressants.
• Deep depressive state patient

The list is quite large, but the good news is that not everyone has it.

It should also be mentioned that according to all methods, if the patient is unable or unwilling to care for the oral cavity sufficiently, then this is a complete absolute contraindication. And in these cases it is recommended removable dentures. However, in practice, it is unlikely that a doctor will refuse a client (if he is generally adequate, of course). And, after a lecture on the topic “rules of oral hygiene” and the patient’s solemn promise to follow all recommendations impeccably, the implantation process begins.

Relative contraindications

These are those in which implantation is possible, but they should be taken into account and certain measures should be taken to level out their influence. When performing implantation, the doctor must carefully consider the following characteristics of the patient:

• Patient age less than 22 years
• Incorrectly formed bite
Insufficient oral hygiene - caries, stomatitis, gingivitis (and other gum inflammations)
• Inflammation of the soft tissues surrounding the teeth (periodontitis, for example)
• The presence, location and material of other implants and other dental structures. It is strictly not recommended to combine different metals (for example, zinc and titanium) in the oral cavity.
• Alcoholism, drug addiction
• Smoking is worth mentioning separately. The fact is that smoking is not a contraindication for all methods. For example, with basal implantation, smoking is actually not a contraindication.

Treatment or proper compensation of these contraindications allows implantation to be performed with minimal risk.

Local contraindications for implantation are as follows:

• Insufficient amount of bone tissue in the implant site
• Inappropriate bone structure in the healing zone
• Poor oral hygiene by the patient - this contraindication can be easily resolved
• Poor jaw structure

Temporary contraindications include acute illnesses, recovery periods after illnesses, and pregnancy.

Simultaneous dental implantation - contraindications

The peculiarity of this type of implantation is that implantation is carried out immediately or recently after tooth extraction. Therefore, there are a number of features:

• Simultaneous implantation is not possible if the hole formed after tooth extraction is too large. In this case, the implant will fit too loosely.
• A relative contraindication is the presence of multi-rooted teeth.

In fact, the patient can only find out about the presence of these contraindications in the dental chair. It is very rare for a patient to know whether he has multi-rooted teeth or not.

Contraindications for dental implantation - video

Intelligible and quick video about the main contraindications to dental implantation

Possible complications after dental implantation

So, the implantation operation was successful, the doctor explained everything to you in detail, you listened to him and, out of fear or joy, forgot everything. What bad things can happen:

Pain after implantation

Pain is inevitable. If the implantation is successful, the pain should not be acute and can be relieved if you start taking medications immediately after the anesthesia wears off. Usually the effect goes away within 2 - 4 hours after the operation; your doctor will tell you more precisely. After two to three days, the pain should completely disappear. The following are considered complications:

• Sharp and sharp pain after the end of anesthesia. Either constant and pulsating, or after some mechanical impact. This indicates that the implants are not installed correctly.
• Prolonged pain (not acute) for more than 4 days indicates possible inflammation. You need to see a doctor.

Edema

also inevitable. The size of the swelling depends individual characteristics patient and from timely application of cold. Swelling will appear two to three hours after implantation. In normal cases it will disappear after 5-7 days.

If the swelling does not go away after the period described above, then this is a clear sign inflammation.

Fever

The normal temperature is a constant temperature of 37 degrees for 3 days. If the temperature does not go away, or is higher than indicated, then this is again a sign of inflammation.

Bleeding

Light bleeding is a completely normal and logical consequence after surgery. Additional bleeding is possible if the patient is taking anticoagulant drugs, including aspirin.

If bleeding continues for more than 5 days, you should pay attention to this. Excessive bleeding can cause blood to pool and form a hematoma. As a result, all this can end in suppuration and suture divergence.

Numbness

It is the result of the action of an anesthetic. Ideally, the numbness should go away immediately after the anesthesia wears off. If this does not happen and the numbness continues, then the following options are possible:

• As a result of edema, it was “pinched” maxillofacial nerve. It's not scary. Through certain time after the swelling subsides the nerve will return to normal condition and the numbness will go away.
• During the operation the nerve was damaged. There are two possible scenarios.
  • The nerve damage is not very serious. However, the nerve will take a long time to heal - up to six months.
  • The nerve was seriously damaged. This rarely happens, the doctor must either be a complete loser or completely incompetent. In this case, restoration of the nerve, even surgically, is impossible. The numbness will not go away.

Seam divergence

This isn't exactly a complication, but it's worth mentioning. Discrepancies are possible for the following reasons:

• Mechanical impact. There is no need to chew on the side of the implant, much less reach into it with your fingers, forks or other devices.
• As a result of the appearance of hematoma, suppuration or inflammation.
• The stitches were placed incorrectly

In any case, you must immediately register on emergency appointment to the doctor. Under no circumstances should you try to solve the issue yourself or endure it.

Implant exposure

It does not pose any health hazards, it is purely an aesthetic issue. Occurs as a result of improper gum formation.

The complications described above are mostly minor and are unlikely if all postoperative instructions from the doctor are followed. But the problems described below are very serious problems.

Reimplantitis or inflammation of soft tissues

1. Poor oral care after surgery
2. Insufficient sanitation of the oral cavity and especially adjacent teeth
3. Suppuration due to bleeding
4. Poor quality or loose fitting crown
5. Damage to the maxillary sinuses
6. Implantation with a violation of technology. Wrong angle, wrong depth.
7. Infection in the socket due to insufficient sterility

Reimplantitis manifests itself in the form of acute and constant pain. If you do not pay attention to it in time, this can lead to thinning and destruction of the bone, and the appearance of mobility in the implant, and ultimately to rejection.

Inflammation of the mucous membrane

Or “mucositis”. An extremely unpleasant process that can be avoided. It becomes possible when the patient does not take sufficient care of the oral cavity in postoperative period. Accompanied by the following symptoms:

• Bad breath
• Pain, swelling and itching of the gums during chewing
• Minor local bleeding and spotting

It happens rarely, but the consequences are extremely unpleasant. Happens for the following reasons:

• Individual allergy to implant material. This is mainly titanium; in rare cases, ceramics - zirconium dioxide - are used. Allergies are very rare.
• Due to inflammation of soft tissues and reimplantitis
• Smoking
• Overheating of the bone as a result of the drill
• Injury caused by surgery
• Ignoring absolute and relative contraindications

In fact, with a competent approach, all complications are extremely rare. It is enough to find a competent doctor in a normal clinic and follow all the instructions after the operation, then the likelihood of complications tends to zero.