The teeth lost for various reasons not only spoil the smile, but also cause a number of other problems: increasing the load on the remaining teeth, changing the bite, worsening diction, digestive disorders, and so on. The modern way of restoration of the dentition is implantation of teeth, the features of which will be considered below.
Implantation of teeth - indications and contraindications
Implantation of teeth is a surgical intervention that allows replacing missing teeth by installing a metal implant in the maxillary tissue that performs the role of a tooth root and a crown fixed on it. The installed design accurately simulates the tooth and performs all the proper functions. Implantation of the teeth is as follows:
- complete or partial adentia due to loss of teeth or congenital anomalies;
- diseases that lead to loosening of the teeth, their denudation and loss of teeth;
- the lack of the possibility of installing and wearing permanent prostheses;
- various anomalies of occlusion .
It is worth knowing that some patients this type of replacement of damaged teeth, which is a complex process, may not be suitable because of the limitations and contraindications. In addition, sometimes there is a need for preliminary operative manipulation to restore the jaw bone, if a lot of time has passed since the loss of the tooth, and the bone has had time to atrophy. Let's consider, in what cases implantation of a teeth to execute it will not be possible:
- severe pathology of the respiratory and cardiovascular system;
- diseases of the immune system;
- mental disorders;
- bleeding disorders;
- rheumatic diseases of connective tissue;
- tuberculosis in the acute phase of the course;
- pathology of the temporomandibular joint;
- oncological diseases;
- diabetes;
- osteoporosis ;
- acute infectious diseases of the oral cavity;
- pregnancy, the period of breastfeeding.
Types of implantation of teeth
There are several types of implantation of dental implants, each of which is characterized by its own peculiarities, pluses and minuses. This is a classical, basal , one-step methods, implantation of teeth all on 4. What teeth implantation is best for the patient in each case, the doctor will be able to determine, having inspected and necessary diagnostic procedures.
Classical dental implantation
The classical technique has been used since the eighties, it is precisely worked out and is the most widely used type of implantation. In this case, one can not expect a quick result, since the procedure is carried out in two stages: insertion of the implant into bone tissue and prosthetics. The time interval between these steps can be from one to six months, depending on the rate of engraftment.
In addition, before the dental prostheses are installed on the implants, a special construction is made for the formation of the gum and the abutment is installed - the connecting element between the implant and the crown . Another important feature of the method is that it can be applied only 1.5-3 months after tooth loss, after complete healing of the socket.
The advantages of classical technology:
- the body is easier to adapt to the implantation of the structure through a phased process;
- reliable anchoring in bone tissue;
- the possibility of restoring all the teeth in the series, fixing to the implant a bridge of several crowns.
Minuses:
- a long period of treatment;
- risk of impaired appearance of the gum;
- a complicated postoperative period.
Basal implantation of teeth
Unlike the classical technique, in which implants are wound into the cancellous layer of the bone, basal bone implantation of the teeth is performed by placing the structure in a deeper and stronger layer of the jaw. Due to this it is possible to put a denture even in the absence of teeth or their long-term loss - the bone tissue of the alveolar bone is not important, and the basal tissue is not subject to atrophy. The design is very firmly attached.
The advantages of the method:
- basal implants can be installed at an angle;
- minimum terms of treatment;
- minimal trauma of soft tissues.
Negative sides:
- often with the help of this method, at least three teeth are restored at once;
- increased requirements for the qualification of the doctor performing the operation.
Immediate implantation of teeth
An excellent alternative to the classical step-by-step method can be a one-stage (single-stage) implant installation, performed immediately after extraction of the affected tooth. So it is possible to conduct an implant without additional dissection of soft tissues. For one visit to the clinic, a dental implant, an abutment and a temporary crown are installed. The method can be used only in the case of healthy and strong alveoli tissue.
Advantages of the methodology:
- low traumatism;
- psychological comfort;
- short term recovery.
Minuses:
- fixing the structure is not reliable;
- next to the removed tooth should be located healthy teeth.
Implantation of teeth all on 4
Prosthetics of teeth all on 4 ("all four"), developed by Nobel, is performed in the case of complete absence of teeth in the oral cavity and atrophy of bone tissue. The technique involves implanting four implants: two into the anterior section of the jaw, which are fixed vertically, and two into the zone of the chewing teeth that are fixed at an angle. Prostheses consisting of 12 crowns can be installed immediately after implanting the structures in bone tissue. At full adentium put prostheses, consisting not only of crowns, but also of artificial gums.
The advantages of the method:
- minimally invasive;
- quick result;
- high reliability of prosthesis fixation.
Disadvantages:
- Applicability only with a moderate and mild degree of bone atrophy;
- risk of rejection of implants (as in the case with other techniques).
Types of dental implants
There are many types of implants, but all of them are often made of titanium alloy, more rarely - of zirconium oxide (such models are expensive). In addition, all implants have an identical structure. Consider what the dental implant consists of (basic parts):
- a body that is inserted into the bone tissue (may look like a plate, cylinder, tape, machine);
- abutment (head) - a part for fastening the prosthesis, it can be a twisting or locking lock;
- neck - the element between the body and the head;
- The gingival cuff is a screw that is screwed in temporarily to give the gum aesthetic shape.
Depending on the shape, strength and technology of the installation, these types of implants for teeth are distinguished:
- root-shaped;
- plate;
- combined;
- subperiostal;
- endodontic stabilized;
- intralesive;
- mini-implants.
Rating of dental implants
It should be borne in mind that the established dental implant life can be different, mainly determined by the quality of the materials used. The correctness of the installation technique, the condition of the soft and bony tissues of patients, and the subsequent care of the prosthesis are important for the durability of the implanted structure. Manufacturers set different warranty periods for implants, which can be 10, 15, 20 years or more. The most high-quality and expensive dental implants of the new generation from the following companies guarantee a lifetime lifespan:
- Nobel Biocare (Switzerland);
- Straumann (Switzerland);
- XIVE (Germany);
- Astra Tech (Sweden);
- Anthogyr (France).
A little cheaper, but they are characterized by good quality products of such manufacturers:
- Schutz (Germany);
- Niko (Russia);
- Zimmer (USA).
How is dental implantation performed?
Let's consider how the implantation of teeth takes place in most cases, from which main stages is formed:
- Determination of indications and identification of contraindications to the procedure.
- Preparation for implantation, consisting in the treatment of patients with teeth, gums, replacement of old crowns.
- Performing a panoramic snapshot of the jaw and computed tomography for revealing hidden pathologies and selecting the exact location of the implant.
- Surgery to install the implant, which if necessary precedes the build-up of bone tissue.
- Installation of the shaper and abutment shaper.
- Installation of the prosthesis.
Extension of bone tissue during implantation of teeth
For the implantation of a structure and its reliable attachment, it is necessary to have sufficient height and width of bone tissue, so sometimes a preliminary bone extension is required for implantation. This is done under local or general anesthesia in one of the following ways:
- bone plastic (transplantation of a patient's bone particle, donor bone or replanting of artificial materials);
- bone regeneration (replanting the membrane from a biocompatible material that promotes natural bone build-up);
- sine-lifting (mechanical lifting of the maxillary sinus, due to which the volume of bone tissue increases).
Installation of dental implants
Implantation of the teeth is performed under local or general anesthesia. The duration of manipulation to install the body of the structure is approximately 20-30 minutes. By means of a drill and special drills in the bone, a bed is formed, into which the implant is placed. Further procedures for installing the rest of the structure and the dental crown depend on the type of technique chosen. The most difficult and laborious in view of anatomical features is the implantation of the upper teeth.
Implantation of teeth - complications
Manipulation of implant installation is associated with a risk of negative consequences. So, during the operation there is a possibility of development of bleeding and perforation of the bone. After implantation, complications can be early and late. We note the inevitable consequences with which implantation of teeth is associated: edema, pain syndrome, elevation of body temperature. These are normal reactions of the body in response to surgical intervention. Deviations from the norm are:
- rejection of the implant;
- peri-implantitis;
- atrophic bone processes.