Prosthetics on implants in the complete absence of teeth. What do we have to do

Almost every person who has mature years, you can miss one or even more teeth. Basically, the entire load goes to the molars, the health of which guarantees a healthy and comfortable state of the entire human body. And it is with the help of implantation that the problem can be solved overnight!

Benefits of Dental Implants

To date, the development of dentistry is quite rapid and considerable heights have already been achieved, thanks to which a person who has lost his teeth for some reason has the opportunity to feel full, confidently communicating with his own kind. The advantages of dental implants include:

• no need to touch adjacent teeth if even several teeth are missing in a row;
• the possibility of using dental implants as a support for prostheses of any kind, whether it is a partially removable prosthesis or a fully removable prosthesis;
• excellent integration even in a person with a certain stage of diabetes or hepatitis;
• quick adaptation to new teeth, which cannot be said about removable prosthetics;
• a long service life of such a prosthesis, of course, only if there is the necessary care for dental implants.

That is, it turns out that both dentists and their patients develop dental implantation very profitable, because they open up completely new horizons. Indeed, fixed prosthetics today can be carried out much easier, without affecting or grinding the teeth located in the neighborhood. It turns out that each tooth, as it should be, has to work for itself alone and thanks to this they do not deteriorate ahead of time.

How dental implants are performed

The manufacture of a partially removable or conditionally removable prosthesis is possible when several implants are installed at once, which will act as abutment teeth. Carrying out dental implantation of teeth is performed in the presence of local anesthesia, the action of which will be quite sufficient for the procedure. If a situation arises that local anesthesia is not enough, then anesthesia is given or general sedation is done (with a large amount of work). Most often, such situations are due solely to a psychological factor.

At the first stage of work, a dental implant is installed directly, the procedure can take from half an hour to 3-4 hours. The second stage of the procedure is bone integration (engraftment of the implant), usually it takes up to six months. On the mandible engraftment occurs faster than on the upper one, which is influenced by the peculiarity of the structure of bone tissues. The third stage is to install a gum shaper for a period of two weeks to one month, so that its relief subsequently turns out to be correct.

And already at the fourth stage, prosthetics are performed directly, that is, the crown is installed on a dental implant. But not in every case, the installation of an implant turns out to be so simple, because some people delay a visit to the doctor until the bone tissue is severely atrophied. Then there is a need to add such a stage as osteoplasty to the treatment. That is, the necessary for successful implantation volume bone tissue.

Dental implantation is currently considered the most long-term, reliable and justified method by which the dentition is restored, and with it the aesthetics of a smile and chewing function. Of course, it should be noted that there are certain contraindications to this procedure, but here everything becomes possible with individual approach to every client. Because if certain contraindications, which were considered absolute some time ago, are now recognized as conditional.

The cost of implantation

Before carrying out the procedure, it is necessary to consult with professional doctor so that he can cover all the nuances of the event. Choose dental implants for better quality own life Because we only live once! You can find out about the cost of the procedure by phone or from the price list presented on the City-Dent website.

Prices for dental implants

More and more patients are turning to the dentist to restore all their teeth, or one jaw completely. Ordinary removable dentures, clasp dentures and extended cermet bridges do not meet high requirements for convenience, aesthetics and durability. All these goals can be achieved with the help of dental implants.

Jaw implantation technique for total absence teeth is significantly different from implantation in the absence of only a few teeth. For example, the obvious fact is that it is not necessary to install 32 implants to restore all teeth. All the details of full dental implantation are outlined in this article.

Methods of prosthetics on implants in the complete absence of teeth

Prosthetics on implants in the complete absence of teeth can be divided into 3 types: removable, non-removable and conditionally removable.

Removable prosthetics on implants is suitable for those patients who have already used removable prosthesis but never got used to it. Any option removable prosthetics on implants will greatly improve the quality of life of such patients.

However, if you have never used a removable prosthesis, then psychologically it will not be easy to get used to such a design.
In this case, the best option there will be fixed or conditionally removable prosthetics on implants. Conditionally removable means that the prosthesis is fixed with screws. Only a dentist can remove it, the patient uses it like his own teeth.

Implantation of both jaws with simultaneous loading with plastic crowns

More details about each method of treatment are set out later in this article.

Implantation of the lower jaw

The lower jaw is denser in structure than the upper jaw, so in most cases 2 to 6 implants are enough to restore all teeth. The integration period for implants in the lower jaw is 3 months.

Removable prosthetics on implants in the lower jaw performed on 2-4 implants. The most common option is to install 4 implants with spherical attachments (or locators). The advantages of this method are good fixation of the prosthesis, easy oral hygiene, simplicity of design, and, as a result, its low cost. A removable prosthesis on 2 implants with attachments is used in cases where there is not enough bone tissue to install 4 implants, the fixation of the prosthesis in this case is worse. The disadvantages of this method of treatment are that the prosthesis distributes the load not only on the implants, but also on the gum. Under the pressure of the prosthesis, the gums atrophy, so it is necessary to reline the prosthesis on average once a year. The fastening on attachments is also weakened, it is necessary to periodically replace the holding matrices. The service life of the prosthesis itself is about 5 years.

Removable prosthesis on 4 implants with spherical attachments on the lower jaw

Second option removable prosthesis on the lower jaw- this is prosthetics of the lower jaw on the beam on 4 implants. In this case, the load is distributed mainly on the implants and much less on the gum. The fixation of the prosthesis is very tight, the prosthesis feels almost like your own teeth. The prosthesis itself is made of plastic. It completely restores aesthetics and chewing function. The fact that the prosthesis is removable simplifies oral hygiene. A plastic prosthesis is not as rigid as a ceramic-metal or zirconium prosthesis, so it is easier for those people who have problems with the temporomandibular joint to get used to it. The disadvantage of this method of treatment is that a correctly made beam prosthesis is comparable in cost to a fixed structure.

One of the main conditions for the long-term functioning of such a prosthesis is that the beam that unites the implants must be very accurately connected to them. For this, multi-unit abutments are used, which provide an accurate connection of the implant with the bar, the bar itself must be made on a milling machine. Unfortunately, often patients are offered a bar prosthesis made without multi-unit abutments, or made by casting rather than milling. In this case, the bar will be fixed to the implants with tension, which will lead to a negative result, possibly even loss of the implants due to their overload.

Removable prosthesis on the fixation beam on the lower jaw

Fixed prosthetics of the lower jaw performed on 6 implants classical implantation. It is also possible to restore teeth on 4 implants using the all-on-4 method, in which case 2 out of 4 implants are placed at an angle of up to 45 degrees. The technique has its pros and cons. About All-on-4 will be written later in this article.

Fixed prosthetics completely imitate their own teeth and are the easiest to tolerate psychologically. For the period of implant integration, the patient uses a temporary removable prosthesis, or implantation of teeth is carried out with a one-time load of a non-removable one. plastic prosthesis.
The service life of a plastic prosthesis is 1 year. It can be replaced with metal-ceramic or zirconium after complete healing of the implants. On the lower jaw after 3 months. The implants themselves are not affected.

In the case when a permanent prosthesis is made on screw fixation, we are talking about conditionally removable prosthetics on implants. Conditionally removable means that the prosthesis can only be removed by a dentist. The patient cannot remove it on his own, it feels and functions like his own teeth.

Fixed prosthesis on the upper jaw on 6 implants, on the lower jaw on 6 implants

Upper jaw implantation

The bone tissue of the upper jaw is less dense than that of the lower jaw, so for complete prosthetics on the implants of the upper jaw, more implants are needed - from 4 to 8. The healing of implants on the upper jaw occurs within 6 months.

Removable prosthetics of the upper jaw performed on 4-6 implants. On 4 implants, it is possible to install a covering prosthesis with ball-shaped attachments. Covering prosthesis has the same borders as a regular removable one, it completely covers the palate. For the fabrication of a prosthesis upper jaw without a palate, 6 implants need to be installed. Spherical attachments, locators or a beam can be used as connecting elements. The best fixation of the prosthesis is achieved on the bar. However, the cost of such a prosthesis is comparable to a fixed structure.

For fixed prosthetics of the upper jaw it is necessary to install from 6 to 8 implants. It is also possible to install fixed prosthesis on the upper jaw on 4 implants using the all-on-4 method. It will be written about later in this article.

Installation of 6-8 implants the classic way- the most studied and reliable option for implantation of the upper jaw. The number of implants is determined by the presence of bone tissue and the shape of the upper jaw. During the healing of the implants, the patient uses a temporary removable prosthesis, or implantation is carried out with a one-time load with a non-removable plastic prosthesis.

The service life of a plastic prosthesis is 1 year. It can be replaced with metal-ceramic or zirconium after complete healing of the implants. On the upper jaw after 6 months. The implants themselves are not affected.

As well as the lower jaw, on the upper jaw it is possible to make a permanent structure on screw fixation - conditionally removable prosthetics. Only a dentist can remove a screw-retained prosthesis. The patient uses it like his own teeth.

The advantages of screw fixation are that the prosthesis can be removed if necessary. Unlike cemented prostheses, which cannot be removed without sawing them. However, the complexity of the design, and as a result, the cost increases.

Different options for implantation in the complete absence of teeth. 8 implants in the lower jaw, 6 implants in each jaw, 8 implants in the upper jaw

All-on-4

The All-on-4 technique (all-on-four) was developed by Nobel Biocare. It involves the installation of 4 implants on one jaw with a simultaneous load with a fixed screw-retained prosthesis. 2 extreme implants are placed at an angle of up to 45 degrees, which allows you to bypass anatomically difficult places: maxillary sinuses on the upper jaw and the exit point of the nerve on the lower jaw.

Initially, the All-on-4 technique was positioned as minimally invasive, without bone grafting. However, for successful functioning, it is necessary to install sufficiently long implants, because. 4 implants must carry the load for the entire dentition. Unfortunately, not all patients have the required height of the alveolar ridge. Insertion of shorter implants may result in increased load one of the implants will fail. And then all-on-four will turn into nothing on three. That is why patients are offered “all-on-4 modifications”, for example, All-on-6 (all-on-six implants), because. the installation of an additional 2 implants significantly reduces the risks.

After 3-6 months after implantation according to the All-on-4 method, gaps appear between the prosthesis and the gum, because. for this is the remodeling of the gums after implantation. It is necessary to either rebase the existing prosthesis, or replace it with a permanent one - ceramic-metal or zirconium.

Bone grafting for jaw implantation

The more implants are placed, the more likely the fact that the existing bone tissue will not be enough for the installation of implants and it is necessary to build it up. Bone deficiency can be either in thickness (very thin bone) or in height (close to the maxillary sinuses in the upper jaw, nerve in the lower jaw).

With a slight shortage of bone tissue in thickness, one-stage bone grafting with implant placement is possible. It is also possible to perform a sinus lift (a type of bone tissue growth with insufficient distance to the maxillary sinus) with one-stage implant placement.

With a large deficiency of bone tissue, operations are first performed to increase it (open sinus lift, bone block sampling and grafting), and after 3-6 months, implantation. In this case, the total duration of treatment can be from one year to one and a half years.

How to avoid bone grafting?

There are proven methods that allow you to reliably restore teeth in one or both jaws without additional operations to build up bone tissue.

First of all, it is worth mentioning the positions in which the implants are installed.
In total, a person has 32 teeth, 16 teeth in each jaw. The 2 extreme teeth are wisdom teeth, they do not carry a functional load, therefore they are not restored during prosthetics. Of the remaining 14 teeth (7 on each side), the sixth and seventh teeth are the most problematic in terms of restoration (counting from the center). They are located close to the maxillary sinus in the upper jaw and to the nerve in the lower jaw. Just for the restoration of the sixth and seventh teeth, long-term osteoplastic operations are necessary.

According to the recommendations of the International Association of Implantologists ITI - International Team for Implantology, in the complete absence of teeth, it is necessary to restore the dentition up to the sixth tooth inclusive (12 teeth in each jaw). This method completely restores both the function of the jaw and the aesthetics of the smile. At the same time, additional risks associated with the close location of anatomically important formations (maxillary sinuses and nerve) are avoided.

In this case, the implants are installed in the anterior part of the jaw, and the extreme ones in the area of ​​the fifth teeth (the so-called Frankfurt University Protocol). In the future, a one-piece non-removable prosthesis is installed on them. The combination of all implants into a single design compensates for lateral chewing loads and ensures the full functioning of the entire jaw with only 6 implants in the lower jaw and 6-8 in the upper jaw.

Another problem is the deficiency of bone tissue in thickness ( thin bone). To avoid bone grafting in this case, it is possible to use thin implants. However, not all systems guarantee that their thin implants are able to withstand the load of full jaw prosthetics. Such guarantees give German Ankylos implants, also a company Straumann has developed a special alloy of titanium and zirconium, which allows thin implants to function without building up bone tissue, it is called Straumann Roxolid.

And finally, with a deficiency of bone tissue both in height and width, a possible way out is to install short and thin implants, but in more. Instead of 6 standard ones - 8 short ones. The total length of the implants in this case will be equivalent.

Which implants to choose?

Today, there are more than 3,000 implant systems in the world. However, not all of them can boast a long history of observations and clinical trials around the world. There are also some implant systems, which, despite their reliability, are not very common in Russia. This can lead to difficulties in terms of delivery of original components of implant systems.

It is worth choosing only generally recognized implant systems used by different, independent doctors. Otherwise, the patient runs the risk of being in a situation where no one can help him.

An important point when choosing an implant system is the type of implant-abutment connection. It depends on how long the implant will last. The most reliable today is the implant-abutment conical connection with the effect of platform switching. It is able to withstand heavy loads, compared to a flat connection, has tightness and does not cause bone resorption around the implant.

The engraftment of implants is affected by the purity of the titanium from which they are made. The most common is Grade 4, which is commercially pure titanium. Grade 1,2,3 alloys are even cleaner. Grade 5 - less pure, contains impurities of vanadium and aluminum.

The surface of each implant is a unique patented technology. It is on the surface of the implant that osseointegration occurs - the fusion of the implant with bone tissue. Serious implant manufacturers conduct a lot of research, proving that their implants are integrated not only in standard situations, but also, for example, in people suffering from diabetes or a bleeding disorder.
The following systems meet all these requirements: Straumann (Switzerland), Ankylos (Germany), Astra tech (Sweden), Nobel biocare (USA/Sweden). Osstem implants (South Korea) can be distinguished from inexpensive systems. They have proven themselves worldwide as a reliable and economical implant system.

How much does implantation cost in case of complete absence of teeth

Despite the apparent high cost of implantation in the complete absence of teeth, it can be more profitable than restoring already hopeless teeth. In addition, the service life of implants is unlimited. Treatment is carried out in stages and paid too.

So, the price of jaw implantation in the absence of teeth depends on the type of construction (removable, non-removable) and the implant system.
For example, the cost of jaw implantation classical technique with a one-time load with a non-removable plastic prosthesis is from 350,000 rubles.

The price of a zirconium prosthesis on implants of one jaw is from 200,000 rubles.

Author of the article Akhtanin Alexander Alexandrovich. Dentist-implantologist, orthopedist. long time trained in Berlin, Germany. Member of the International Association of Implantologists ITI - International Team for Implantology.

Implantation is reliable and effective method restoration of lost teeth, which allows you to get beautiful smile and a healthy dentition, fully performing its functions. Unlike bridges, implants do not require grinding of adjacent teeth, which allows them to maintain their integrity and health. In the clinic "32 healthy tooth» restore missing teeth using modern zirconium implants and the latest technologies implantation.

The implant is metal structure, which replaces the root of the tooth and visually resembles a screw. It is implanted in an empty place in the dentition and affects the jaw bone, preventing it from thinning, as is the case with other types of prostheses. An abutment is installed in the implant - an adapter, on which a crown is subsequently attached, visually indistinguishable from a real tooth.

Stages of implantation

Implantation is a complex dental operation, therefore it is carried out by the specialists of the 32 Healthy Teeth clinic in several stages. First of all, before the procedure is carried out careful preparation patient, which includes visual inspection and consultation with an implant surgeon, assessment of the condition of bone and soft tissues, as well as X-ray diagnostics. Caries and others must be eliminated before implantation can begin. If your health condition allows you to perform the operation, then a few days before the implant is implanted, the doctor may prescribe antibiotics or other anti-inflammatory drugs to reduce the risk of complications.

Many patients in preparation for implantation experience bone atrophy. In order to compensate for the lack of bone, bone replacement is performed - osteoplasty. It is especially important to carry out bone replacement (so-called sinus lift) when implanted in the upper jaw. Since the implant designs will be longer than the bone, they can damage maxillary sinus and cause infection.

After eliminating problems with bone tissue, comes surgical stage implant placement - implantation itself. The procedure is carried out under local anesthesia, it does not deliver to the patient pain and takes no more than 50 minutes. The surgeon forms an implantation bed and installs an implant in it, after which he completely sutures the wound. After the procedure, the stage of osteoregeneration begins - healing of bone tissue and engraftment of the implant, which can last up to six months. Upon completion of regeneration, an abutment is installed on the implant - the basis for the future crown.

In some cases, comfortable wearing of the implant also requires soft tissue plasty, which restores the white-pink aesthetics of the smile. Aesthetic plasty during implantation allows to achieve an even gingival contour, as well as to ensure a reliable fit of the implant with soft tissues.

The final stage of implantation is the orthodontic restoration of the tooth crown. To select the optimal shape, casts are taken from the dentition, after which a crown is made. Methods for fixing the crown may vary depending on the individual needs of the patient - it can be both fixed, and removable or combined designs.

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• We have been treating teeth with the whole family in this clinic for probably 12 years. I am being treated by Cherebyako S. M. It's just super! In general, it seems to me that the implant that he put in is a native tooth! Special thanks to Dr. Ivanov D.V. for his patience while we are trying to fix our daughter's teeth! And to all the administrators and assistants - many thanks!

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• For a long time I experienced fears before going to the dentist, as I was afraid that I would have to pull out half of it. But when I came to Unimed32, I was reassured that everything was not so bad and most can be restored.) I have been walking regularly for almost 3 months and my smile is becoming more beautiful before my eyes.) Thanks to the wonderful dentist Ivanov Denis!