Implants contraindications. Contraindications for dental implantation. Preliminary diagnosis, indications and contraindications

Dental implantation is a complete 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 power. In other words, if the doctor finds an absolute contraindication in you, he is forced to refuse surgical intervention. For implantation, there are such absolute contraindications:

• Some blood diseases. The most striking example of such a disease is a clotting disorder, due to which even a minor wound can lead to the death of a person.
• 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 surgery can increase the growth of the tumor, which is absolutely unacceptable.
• Diseases immune system. During surgery and during the healing period, a large number of bacteria can enter the bloodstream. If the immune system does not work well, it can lead to various pathologies.
• Diseases connective tissue. After the operation, it is very 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, Sjögren's syndrome and others.

Relative contraindications

Relative contraindications are those contraindications that can serve as an obstacle to performing an operation on. In other words, the doctor analyzes the anamnesis, and then makes a decision on the operation. Usually a single relative contraindication is not a reason for refusing to perform an operation. If the patient has several relative contraindications, the doctor may refuse surgery. 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 called marginal periodontitis.
• Pathological forms of bite.
• Joint disease mandible- arthrosis.
• Atrophy of the alveolar process.
• Bad habits - regular use large doses alcohol, tobacco smoking, drug addiction.
• Also, doctors do not recommend placing implants during pregnancy.

General contraindications

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

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

Local contraindications

Local contraindications are such contraindications that are associated only with the functioning of the jaw apparatus. For implantation, there are such local contraindications:

• Violation of oral hygiene.
• Insufficient hardness bone tissue.
• Insufficient amount of bone tissue.
• The close location of the implants to the alveolar process and nasal sinuses.

Temporary contraindications

Temporary contraindications are contraindications that may pass over time. That is why some doctors prescribe additional tests that, at first glance, have absolutely nothing to do with implantation.
For implantation, there are such temporary contraindications:

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

Risk factors

Risk factors are such phenomena that in themselves play a weak role in deciding whether to perform an operation. However, their combination can become 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 purpose is to identify hidden risk factors that may cause the refusal of the operation. The survey takes place in several stages:

1. General health assessment. Before installing implants, the doctor weighs the pros and cons. The most important absolute contraindication is the presence internal infections. There are a large number of them; for implantation takes into account only one class of infections - diseases in the area of ​​the osseointegrated implant. Studies show that infections in the implant area are very rarely chronic. Also, the probability that you suddenly fall ill during the operation is quite low (this directly depends on the qualifications of the doctor). Some other relative contraindications (such as diabetes) can be ignored if the operation is under the supervision of an experienced surgeon. When compiling an anamnesis, the patient's bad habits are also taken into account. For example, smokers are 10% lower than people who have never smoked or quit long ago.
2. Age. Great importance is the age of the person. In people under the age of 18, the body is in the growth stage, so implantation in children is prohibited. Strictly speaking, there is no upper limit, but older people are more likely to get sick various diseases, which may be the reason for the refusal of implantation.
3. Psychology. It has been proven that the survival rate of implants is influenced by a person's motivation. And there is very important point- many people may not understand what implantation actually is. Often people think that implantation is an ordinary cosmetic procedure, to which people resort only to solve purely aesthetic problems. This attitude can affect the treatment process. For example, a patient may not be serious about treatment - and therefore carelessly treat compliance rather strict rules hygiene during treatment.
4. Availability. The availability of the clinic for the patient is also of great importance. For example, before implantation, special procedures are often performed that should stimulate the regeneration of bone tissue. 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 incomes of citizens, doctors began to restore all teeth for other purposes. One of the most striking examples is the aesthetic restoration of the dentition. Many people want their teeth to be not only strong, but also beautiful. And the 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.

Gingival risk factors

The patient wants a 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 such a case, physicians often notify the client of this difficulty. The client must choose for himself whether he needs such an operation or not. The thickness of the gums directly affects the beauty of a smile. So the installation of implants on a thin gum is associated with large quantity difficulties, while placing implants in thick gums is quite simple.

Dental Risk Factors

It has been proven that the rectangular shape of the tooth contributes to better healing after surgery. The triangular shape of the 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 from the bone, this contributes to the survival of implants by enhancing the regeneration of the interdental papillae.

Bone Risk Factors

The installation of the prosthesis can be difficult due to the presence of various recesses in the region of the vestibular surface. Due to trauma and / or periodontitis, bone height may decrease (vertical resorption of dental tissue), which adversely affects the survival of implants. The presence of bone elevations is important. If they are not, the implants will loosen more.

Patient Risk Factors

The aesthetic requirements of the client are of great importance. If the client has a lot of money and he is ready to put in expensive implants, it is necessary to explain to the client that such an operation may be associated with certain risks. After all, many expensive implants have been poorly tested, since their use is small compared to standard implants. If the patient does not observe oral hygiene, this can cause inflammation, which will lead to loosening and loss of the implant. Partially, this problem is solved by removable implants, which can be removed before carrying out hygiene procedures.

Biomechanical risk factors

Understanding the biomechanical aspects of implant placement improves survival and avoids unpleasant side effects. Dentists distinguish four main classes of biomechanical risk factors - geometric, occlusive, technological, and implant-bone risk factors.

Geometric risk factors

The number of implants, their relative position and the geometry of the prosthesis matter here. It is not only the quantity that matters, but the number of roots that feed them. For example, fangs have one root, but molars have two or even three roots. Large-diameter implants are attached to a wide orthopedic platform. Such fixation perfectly resists strong loads on implants. When implanting, it is also necessary to take into account the natural teeth to which the implants adjoin. It is explained simply - healthy teeth have a very high looseness, but implants do not. This creates a poor distribution of the load on the oral cavity.

Occlusal Risk Factors

Occlusion in dentistry is understood as the closing of the teeth of the lower and upper jaw. People with bruxism or broken teeth are at risk. So that implantation does not cause pathological processes in neighboring healthy teeth, it is necessary to provide them with additional fixation.

Risk factors for 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 sinus. Knowing the degree of stability, the doctor can easily calculate the period of full integration of the implant, as well as determine its ability to withstand heavy loads. Often after implantation, the doctor finds that the primary stability of the implant after installation is in an unsatisfactory state. With time the implant will take root, and the primary stability will lose its value. But doctors advise about 1 year to protect the implants from excessive load. Narrow implants are less load-bearing than their wider brothers. This also needs to be taken into account.

Technological risks

If the prosthesis was cemented, it is important to achieve good stability for some types of abutments. To improve stability, gold and titanium alloy screws are used. However, if the screw is too tight, the patient will also be at risk.

Conclusion

The installation of dental implants has contraindications. Before installing implants, you need to assess the health of a person. 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, as well as reduced coagulability blood. Some contraindications are relative. These include mainly diseases of the oral cavity - insufficient hygiene, gingivitis, periodontitis, arthrosis and others. It is also undesirable that the patient uses tobacco, alcohol and various drugs. It is important to understand that relative contraindications do not have absolute power. If the installation of implants is engaged in experienced doctor with a long work experience, a number of relative contraindications can be ignored.

Installing implants comes with 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 moment 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, such parameters 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 attitude of the patient is of great importance for the survival of implants. If the patient stops smoking, this will significantly increase the chances of implant survival. But non-compliance with the rules of oral hygiene worsens the likelihood of a favorable outcome. The patient will have to change his lifestyle if he wants to recover.

Like any intervention in the body, they also have contraindications for installation. In what cases is it better to resort to alternative methods orthodontic treatment and what complications can be after implantation of the implant, read in this article.

To date, the installation dental implants, is the most modern method of restoring lost teeth and returning not only attractive appearance smiles, but also a full distribution of the load on the masticatory organs. With the correct distribution of the chewing load, the jaw ceases to atrophy, as a result, the oval of the face is restored. This method preferable to prosthetics in that it does not require grinding or removing nerves from healthy teeth in the neighborhood.

When implanted in the gum bone, it does not cause allergies and takes root in almost one hundred percent of cases. The pin is also called an artificial root. When the "root" has taken root, a crown is placed on it. On the preparatory stage pathologies that can lead to complications are eliminated, and computed tomography and a panoramic x-ray of the jaw are taken to determine the place of implantation of the pin.

Depending on the type of implant, the gum is either cut or pierced. If there was an incision, then more time is required for the regeneration of the mucous tissue, respectively, the period during which infection can occur increases. There is no need to sew up the gum when punctured, it heals on its own. If the patient has contraindications related to the ability of the tissue to regenerate, blood clotting, poor hygiene, then it is recommended to use those types of implant that, during installation, injure the mucosa least of all.

Implantation is used in cases where it is impossible to use other orthodontic methods. They are installed if several teeth in a row are missing (due to the lack of support for the crown), if the patient cannot or does not want to wear removable dentures, and also if the extreme teeth are missing. But the desire of the patient to install the implant is not decisive for the surgical intervention. There are factors that are considered for installation artificial teeth contraindications.

How is it determined whether there are contraindications for implantation

Before proceeding with dental implantation, the dentist will check:

• the state of the mucous tissue of the oral cavity, teeth, bite;
• dentoalveolar system with the help of an x-ray;
• in the place where it is planned to implant the implant, the thickness of the mucous membrane and the alveolar part of the jaw is checked.

The doctor, in preparation for implantation, will prescribe a laboratory research such as:

• general analysis of blood and urine;
• coagulogram;
• blood to determine the level of sugar in the blood, the presence of HIV, hepatitis B and C, syphilis;
• X-ray;
• additional examinations depending on the specific pathology.

Contraindications for dental implantation

The following contraindications are distinguished for implant placement:

1. absolute (which makes installation impossible);
2. relative (implantation is possible, but after corrective therapy);
3. local (diseases of the oral cavity, which make it impossible to install an implant without prior sanitation);
4. temporary ( bad period. After elimination of the factor, implantation is possible).

Relative contraindications to dental implantation:

• insufficient oral hygiene (in this case, the dentures are made removable);
• inflammation of the oral mucosa (gingivitis, periodontitis);
• marginal periodontitis (inflammatory process in the tissues surrounding the tooth);
• incorrectly formed bite;
• pathology of the temporomandibular joint (for example, arthrosis arthritis);
• pathological conditions of the bone tissue of the alveolar process;
• pregnancy;
• sexually transmitted diseases.

When a Dental Implant Cannot Be Installed

Absolute contraindications include:

1. diseases in which blood clotting and the process of hematopoiesis are disturbed, since a serious loss of blood can become a complication;
2. mental disorders. There is a risk that the patient will not adequately respond to the actions of the doctor during the operation;
3. the presence of a tumor. The intervention affects the growth of neoplasms and their metastasis;
4. failure of the immune system. After the operation, during the period of implant ingrowth and tissue healing, the immune system must work hard so that there are no serious complications;
5. connective tissue pathology. In order for the artificial root to take root, connective tissue must form around it. With scleroderma, rheumatism, lupus erythematosus, this is impossible;
6. tuberculosis, as well as its complications;
7. chronic diseases oral cavity such as aphthous stomatitis, pemphigus, lupus erythematosus, Sjögren's syndrome and others;
8. type 1 diabetes mellitus (impaired bone formation process);
9. kidney failure;
10. HIV infection;
11. if chewing muscles are in hypertonicity, with bruxism (grinding of teeth in a dream).

General and local contraindications

General contraindications for dental implantation are the following factors:

• if the patient medical indications any surgical intervention is prohibited;
• impossibility of anesthesia due to intolerance to anesthetics (during medical manipulation local anesthesia is given, and if necessary, a sedative is given. If it is required to implant several pins or build up a bone, then general anesthesia is done);
• somatic diseases that can be aggravated by implantation ( cardiovascular pathologies or rheumatic);
• diseases of the central nervous system (inability to control movements or inappropriate behavior);
• prolonged depression;
• during the drug therapy certain drugs (eg, antidepressants, anticoagulants);
• depletion of the body.

Local contraindications for dental implantation:

1. lack of oral care culture;
2. insufficiency of bone tissue or the impossibility of implanting an implant due to its structure;
3. pathology of the structure of the jaw, malocclusion;
4. carious lesions of the teeth;
5. increased abrasion of tooth crowns.

According to dentists, there are not so many contraindications to the installation of dental implants, which make the implantation of an artificial root dangerous and fraught with serious consequences and rejection. Most common and local diseases can either be cured or pre-corrected.

For example, if it is possible to suspend or reduce the intake of certain groups of medications, cure an infection, conduct immunostimulation, stop smoking, sanitize the oral cavity, or build up bone tissue.

If a lot of time has passed between the time a tooth was lost and the patient decided to restore it, then the bone tissue has decreased and become more porous. To restore it, a sinus lift is required. The jaw bone grows in height, length and width. After the procedure, it must take root, which can delay implantation for more than three months.

When to delay dental implants

Temporary contraindications for dental implantation:

• somatic and dental diseases in the acute phase;
• the stage of recovery of the body after an illness;
• pregnancy;
• restoration of the immune system after irradiation.

The most likely complications of dental implants

While dental implant placement is not difficult surgical operation, but still it can provoke some undesirable consequences, which include:

Some patients are stopped from implantation not only by the need for prior treatment of some common diseases or fear of complications, but enough high price similar service and the time spent. A couple from installing a titanium pin to obtaining a result in the form artificial tooth may take up to a year.

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 hereditary, acquired dental diseases, injuries or improper hygiene. If you do not take action, then soon, due to the additional load, there will be serious problems with neighboring teeth.

How is an implant placed?

In order to avoid disastrous consequences, it is important to consider, before placing dental implants, contraindications and the presence of any diseases. An artificial tooth is based on a metal screw that is implanted 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 their 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 that differ in shape.

• Root - the most common, have a cylindrical shape, similar to the root of a tooth;
• Subperiosteal - are installed on too thin bone tissue from the inside of the gums. 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, supports can protrude into the oral cavity and cause discomfort. This can be avoided by building up the bone, but not all patients agree to such an operation;
• When it comes to prosthetics of the anterior teeth, endosseous, or intraosseous, plate dental implants are installed.

Contraindications, if any, do not depend on the type of construction chosen. There is also a way to reinforce a loose tooth with endodonto-endosteal 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 jaw.

Indications and benefits of implantation

As a rule, artificial teeth are resorted to for medical reasons, although for aesthetic purposes, the procedure to correct defects is carried out quite often. The loss of front teeth is a serious problem that entails difficulty in chewing food. Therefore, the only way out is dental implants. Contraindications are an important point that requires special attention.

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

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

In addition, now there is no need to grind and thereby spoil the neighboring ones. Implantation is indicated when one or more teeth are missing in a row, end defects are observed, and 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 former include such severe chronic diseases as:

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

Relative contraindications:

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

It is necessary to carefully study, before placing dental implants, contraindications. Pregnancy itself is not a ban, but stress in this position is very dangerous for the mother and 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 examine for the identification or exclusion of the above facts prohibiting implantation. Further, at an appointment with an orthopedist, options and methods of implantation, cost, timing and methods of treatment after surgery will be considered.

Many are concerned about the question of whether there are contraindications for dental implants for the elderly. Age doesn't seem to matter. The problem lies in the general state of human health, its attitude to medicines and anesthesia. In elderly people more diseases which may interfere with the procedure.

Some medical examinations have, if there are large fragments, staples, clips on blood vessels and dental implants, contraindications. MRI is one of those because of 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 gum is incised under local anesthesia.
3. A hole is drilled in 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.

The oral cavity after implantation will have to be looked after a little differently than the way we used to do it from childhood. The dentist will advise special hygiene products that must be used. In addition, after the operation, during the time that the doctor prescribes, you should not eat too hot or cold foods, as well as solid foods.

oral care

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

The patient may feel pain after the operation. In this case, the doctor prescribes general and local treatment. Local treatment includes rinsing the mouth and lubricating the inflamed gum area. General treatment is carried out with antihistamines and painkillers, as well as antibiotics. They have contraindications for dental implants (reviews about them overwhelm 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 disturbed, and they feel just like their own. About aesthetic effects 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.

Service life of false teeth

How much the patient carries is influenced, first of all, by the individual characteristics of the patient. For starters, these are biological compatibility with the implanted material, bone volume and gum structure.

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

4D implantation

A new method of implantation - 4D-implantation. It is practiced in Europe quite successfully. Its peculiarity is that it became possible to insert a titanium pin even into a small amount of bone tissue. Patients not only can, but should load such dental implants already two weeks after the operation (if there are no visible complications). Contraindications have not been canceled with this method, and therefore examinations and preliminary consultation with a doctor are required.

Such implantation costs less than usual, because it does not require a large number of surgical interventions. Due to the fact that the implants are integrated into the bone, there is no specific innervation in this connection. Therefore, the pain strong pressure on an artificial tooth will not be felt.

As you know, dental implantation is a process of restoring teeth lost for any reason by introducing an artificial root into the jawbone, on which a crown or prosthesis will be installed in the future. These artificial roots are called implants and are a structure made in the form of a screw. Implants can be made from either titanium or zirconium. Currently, there are a number of different different features implants.

Thus, implantation is optimal way restoration of a tooth for each person. But here many people have a question - what are the indications and contraindications for the installation of dental implants? Now we will try to answer this question.

And so, first of all, I would like to acquaint you with the actions and activities that are carried out before the operation to restore teeth by implantation.

Surely many of you know that one of the most important stages of implantation is the stage of planning and preparation, since it is at this stage that the patient's contraindications to dental implants are determined.

The doctor who will perform the implantation must study the patient's medical history in detail, as well as timely and efficiently carry out all necessary examinations and inspections. In addition to a blood test taken from a patient, it is also necessary to do panoramic shots of the upper and lower jaw using special templates with regular-sized radiopaque pins fixed in them. This is necessary to determine the features of anatomical formations.

In some cases, the doctor may also need:

• Separate pictures of the jaw,
• Biopotentiometry of oral tissues,
• Determination of the thickness of the oral mucosa and the width of the alveolar region of the patient's jaw.

And so on this moment The main indications for dental implants are:

• Missing one or more teeth for any reason
• Complete adentia, that is, the absence of all teeth
• Discomfort (pain) when using prostheses
• Suspension of the process of resorption of the jawbone in a place where there is no tooth, and accordingly there is no load on the bone

Contraindications to dental implants, as a rule, are determined based on information about what disease the patient was previously exposed to, the results general examination patient, information regarding the psychological and emotional state of the patient. Contraindications to the use of dental implants can be absolute and relative.

• Chronic diseases such as rheumatism, diabetes, tuberculosis, diseases inflammatory nature oral mucosa, for example, stomatitis. Implantation is not performed for such diseases, since the patient has a rather low ability to heal wounds, which also disrupts the engraftment of the implant.
• Diseases in one way or another related to the blood and hematopoietic organs. The operation is prohibited, since when the implant is inserted, the patient may begin to bleed.
• Diseases of the nervous system.
• Diseases of the skeletal system, during which its restorative abilities are noted.
• Oncological diseases (tumors).

To relative contraindications Dental implants include:

• Pregnancy and the period of feeding a child with milk (lactation).
• The patient has bruxism (subconscious regular grinding of a person's jaws).
• Individual features of the jaw, which exclude the possibility of a dental implant. As a result, it is first necessary to carry out reconstructive operations on the jaw. Such situations arise with atrophy of bone tissue, in the presence of impacted teeth, with a close location of the maxillary sinuses.
• Diseases associated with the temporomandibular joint.
• Violation for any reason of oral hygiene in a patient.
• The patient has already implanted foreign bodies in other places, such bodies include: implants, heart valves, pins, screws, artificial joints made of metal, plates, wire sutures, pacemakers, pins, etc.
• Precancerous diseases of the oral cavity in a patient.
• Violation of the bite, which in turn leads to increased abrasion of the teeth.
• The patient has periodontitis.

Implantation is an excellent solution to the problem of missing teeth. It can solve almost any problem that has arisen, in contrast to the removable and non-removable type of prosthetics. But it also has a number of disadvantages, one of which is that it is not possible for all patients. Like any medical operation There are indications and contraindications for dental implants. Depending on the combination of both, the doctor chooses whether you can perform the procedure or not.

Important: Therefore, before proceeding with the procedure, it is necessary to study all the pros and cons.

In order to find out about the limitations, the doctor needs to have a conversation with the patient. Examine the cavity and evaluate its condition. An x-ray would be helpful. A more accurate picture is given by blood tests - general and biochemical. If necessary, a consultation of other specialists and an ECG is carried out.

Based on the results obtained, the doctor concludes that the operation is prohibited and may advise to stop on the traditional method of prosthetics.

They can be divided into: absolute (in which the procedure is not even considered) and relative (can be carried out after treatment).

Absolute, which it is advisable to replace with removable or permanent dentures:

• diabetes mellitus, which has an unstable form,
• AIDS and HIV infection,
• general ailments of various body systems, especially the nervous system, resulting in an inadequate response to treatment,
• tuberculosis in its various stages,
• muscle hypertonicity and bruxism,
• contraindications to anesthesia,
• blood disease associated with a violation of blood clotting,
• systemic connective tissue disorders,
• most malignant tumors different systems organism.

• diabetes mellitus in a state as close to normal as possible, which requires careful monitoring by a doctor,
• weakened immune system
• various dental diseases
• marginal periodontitis,
• bad habits and pregnancy,
• malocclusion,
• temporomandibular joint disease,
• poor quality care.

• general bans on surgical operations,
• ban on anesthesia
• the presence of somatic ailments that can respond with a reaction after implantation,
• pre-treatment, which is able to react to engraftment and wound healing,
• mental abnormalities, when the patient's reaction is unknown,
• severe stress, which can be caused by various factors,
• exhaustion,
• poor hygiene.

• propensity for poor care,
• on the jaw bone it is impossible to carry out the procedure,
• risky distance to nerve endings, sinuses and alveolar process.

1. 1. Acute form of the disease.
   2. The process of recovery and rehabilitation.
   3. Pregnancy.
   4. Less than a year after exposure.
   5. Drug addiction.

On a note: Despite such an impressive list of prohibitions, it should be noted that only a small part of them is an indicator of the impossibility of the procedure.

For example, such an indicator as age is only a restriction on the use of certain species, but by no means a final ban.

Among the indications for their use are:

• loss of one element,
• loss of several nearby
• complete destruction with the preservation of its root - this is an opportunity to carry out a one-time restoration procedure,
• loss of teeth throughout the jaw,
• loss of extremely valuable
• complete loss,
• various allergic effects for removable dentures.

Before proceeding with the procedure, it is worthwhile for the doctor to conduct a diagnosis. And if restrictions are found, then it is necessary to carry out preliminary treatment.

The procedure itself will cost within 25,000 rubles, and if treatment is necessary, the cost will consist of the sum of the price of the implant and preliminary treatment.

Previously, adults who lost their teeth had no alternative - they had to do without them or use false jaw or pins. Preparation procedure for wearing removable dentures was extremely painful, and the dental equipment inspired genuine horror. Today innovative technologies Dentistry has also been touched; dental implantology is being practiced in full swing in the world. The only obstacle possible contraindications to dental implantation, which must be strictly observed.

Implants are so optimized for the needs and feedback of a modern person that almost everyone in need wants to put them. But doing this is not as easy as we would like. Possible complications too serious to be dismissed.

successful operation and postoperative rehabilitation completely depend on the solution of all contraindications and their number. Some doctors refuse to perform implantation in case of deviations that do not fit into the category of permitted items.

List all possible complications without going into medical terminology, it is impossible, but submit a submission - please. The first criterion that surgeons of maxillofacial therapy consider before implantation is the psycho-emotional mood of a person. If the patient experiences doubts and uncertainty, then it is better to postpone dental implantation, all actions will be harmful.

The most common contraindications to implantation are blood and heart diseases.

• dental condition,
• mucosal plaque,
• the presence of caries or gingivitis,
• jaw x-ray,
• determination of the thickness of the alveolar area of ​​the gums.

The dentist determines the course of preoperative measures, the main objective which - to reduce the significance of contraindications and thereby make dental implantation more promising.

Correction of contraindications is possible if they are relative, i.e. do not represent big problem and are treatable. However, if the contraindications are absolute, the risks of dental implantation should be weighed more carefully, as they may appear after surgery in the form of serious complications. More often, dental doctors refuse to operate on a patient with absolute contraindications to dental implantation.

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People with implants simply need an oral irrigator. Features of the Donfeel or 820m model are described here.

The most common contraindications are blood and heart diseases. They are at the top of the list:

• disorders of hematopoiesis and blood,
• oncology,
• heart failure,
• mental health disorders,
• pathology of bone and connective tissues,
• immune system ailments
• diabetes and tuberculosis
• endocrine diseases,
• osteoporosis,
• age,
• problems with the peripheral and nervous systems,
• bruxism, excessive tone of masticatory muscles,
• venereal diseases,
• intolerance to anesthetics.

When metabolism is disturbed, hormonal disbalance which does not allow implants to take root. The processes taking place in connection with bone formation also negatively affect dental implantation.

When the metabolism is disturbed, a hormonal failure occurs, which does not allow the implants to take root.

More sparing - relative contraindications:

• malocclusion,
• gingivitis,
• bad habits,
• pregnancy and breastfeeding,
• periodontitis,
• anatomical features of the structure of the jaw.

These obstacles can be removed or a dental implant consultation can be re-advised after a certain waiting period, as in the case of recent chemotherapy, after which surgery cannot be performed immediately.

There are many more rules that must be followed. For example, smokers want to quit bad habit a couple of weeks before implantation. You should not take blood-thinning drugs for at least a week before surgery, you should be more careful about oral hygiene. And, although pregnancy is not an absolute contraindication, the event should still be postponed to the postpartum period - it will be safer for the fetus, there is no need to once again expose it to anesthesia.

Common incompatible contraindications to implants are the following factors:

• stress,
• exhaustion,
• somatic disorders,
• allergic reactions,
• taking antidepressant medications.

Physical parameters are evaluated individually - the doctor decides whether there is enough bone tissue in the place where the implant should be placed, and whether the distance from the nose to the nose is enough. maxillary sinus What are the general contraindications for dental implants. With the help of tests, a specialist checks whether acute chronic diseases are present, whether the patient is ill with drug addiction or alcoholism.

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Dental implants are actually complicated operation, but upon successful completion, the result exceeds all expectations. Implants are virtually indistinguishable from healthy teeth. And, although there are a great many contraindications, most of them are surmountable, provided there is a preliminary medical examination and treatment.

When should implants be placed? If the entire row is missing, one tooth, there are some defects, it is impossible to use removable dentures and the increased abrasion of enamel interferes with life. Also, implantation is indicated for poor jaw closure and uneven bite.

In any case, after deciding to have dental implants, the most important step is to choose a professional qualified specialist about which there are positive reviews. Dental implantation is not a matter of one day, a specialist must examine the oral cavity and the more carefully he does this, the greater the likelihood of a successful operation.

Often, after dental implantation, a lot of health takes a period of rehabilitation. The temperature rises, appears on the seam white coating, cheeks swell, the face acquires a certain asymmetry. Present nagging pain. These signs are among the most expected consequences of the operation, complications are eliminated through a course of antibiotics prescribed by the dentist.

If the patient experiences doubts and uncertainty, then it is better to postpone dental implantation, all actions will be harmful.

Implant mobility is also likely - here, perhaps, there is a doctor's mistake, who underestimated the features of the connective tissue. That is, dental implantation always takes place individually, for someone it is painless and successful, for someone the implant does not take root for a long time, the teeth hurt, and the body temperature rises, inflammatory processes begin. If the situation develops in this way, then you need to either complain about the dentist, or about your own body characteristics.

Complications are also possible during the operation. It is still a surgical intervention and there is a risk here. Although rare, they do happen:

• soft tissue damage,
• perforation of the nasal cavity,
• perforation of the maxillary sinus,
• violations of the alveolar canals,
• facial nerve damage
• overheating of the bone
• bleeding.

Dental implants are already being practiced for a long time, for which its high-tech has tripled. Today they do not use terrible equipment that can terrify with its very appearance.

It is worth choosing a dentist more carefully and not looking at the price list, relying on the positive feedback from customers.

Now, before the operation, they carefully prepare, preparing the patient's jaw for gentle intervention and experienced hands of the dentist. Pain has become almost taboo - every clinic uses powerful painkillers, calling them local anesthesia.

How is dental implantation performed? An incision is made in the gum, a rod is inserted into this socket, which will subsequently imitate the root. After the implant has taken root, a ceramic crown is placed on the titanium rod. The whole process takes place under the close supervision of a dentist.

It is important that the specialist pays a lot of attention to each case, then negative reviews and unnecessary complications will bypass him. The work must be done to a high standard European standards so that colleagues do not have to redo it.

In modern dental therapy, dental implantation is one of the most expensive services. There are no budget options yet. Since implants are durable, their price greatly exceeds the cost of removable dentures. Expensive, but justified. In the price list, prices range from 20 thousand rubles to 50 thousand rubles, depending on the complexity of the case and the patient's personal card.

Contraindications for dental implantation are numerous, but most of them are reparable. The success of the operation largely depends on the surgeon, his assessment of the patient's health and qualifications. The patient himself must also strictly follow the recommendations of the dentist, otherwise some complications are likely.

Within a year after the operation and a few weeks before, a person who puts himself implants should doubly take care of oral hygiene, restore dental health and eat hard, not forgetting about vitamins.

Currently, there are over 2000 systems in the world for dental implantation. All systems can be divided into 3 price categories: economy, business and luxury.

To implants economy class includes most implantation systems Russian production. However, their rather low price does not justify their quality at all. The percentage of failure of these implants is higher than the same percentage of implants in other categories.

A well-known manufacturer of luxury implant systems is the company Astra-tech. However, the cost of this type of implants is very high, and not everyone can afford to install such implants. However, they can always find an alternative. So business-class implantation systems are practically not inferior to them in quality, and their price is several times less.

Luxury implants include the brand Astra Tech (Sweden). The company is the leader of the Scandinavian implant production market, with branches of the company operating all over the world. Astra Tech manufactures medical equipment since the 1940s. The latest developments in the field of healthcare are combined with the accumulated experience of clinical research.

The Astra Tech implant system has several differences from systems from other manufacturers. These differences allow you to provide your artificial teeth with an additional "margin of safety", as well as an impeccable appearance.

Titanium rods have a special surface OsseoSpeed™ with micro-roughness. It stimulates bone growth and accelerates healing, thanks to which Astra Tech is fixed in the jaw earlier and stronger than implants from other manufacturers. Numerous clinical observations show that OsseoSpeed in most cases, it allows simultaneous implantation with tooth extraction and immediate loading of the implant. This means that the time of acquisition full tooth significantly reduced for you.

Attaching the implant and abutment Conical Seal Design™ provides a stronger connection of these elements. Micro-leaks and micro-displacements between the implant, abutment and prosthesis are practically excluded. Conical Seal Design also simplifies and speeds up abutment placement. The elements are self-guiding, so there is no need to take an extra x-ray to check the position of the abutment.

Implants have different threads at the bottom and top. Top part The stem is covered with finer MicroThread™ threads. It reduces the risk of damage to the edges of the bone and soft tissues - accordingly, your gums will look like the gums of a healthy tooth.

microthread and Conical Seal Design distribute the load on the implant in a special way. Through these elements permissible load increases up to 3 times!

A wide range of compatible rods and abutments allows you to solve almost any clinical problem.

Recent scientific achievements have allowed dentistry as a separate scientific practice to perform previously unthinkable operations. One of these operations was dental implantation, which even no one knew about just 15 years ago. AT modern dentistry Dental implantation is far from the last place, since thanks to it it has become possible to restore a single tooth with the help of implants, as well as several teeth in a row or even the entire jaw.

What are implants and what are they made of?

Implants are the most effective substitute a lost tooth that is implanted into the gum bone. There are several advantages to the implant: firstly, during implantation, replanning in development adjacent teeth can be avoided, while maintaining the functionality of the entire dentition. Secondly, implantation is used in case of need to install a fixed prosthesis. Naturally, a fixed prosthesis is much better in terms of functionality and aesthetics than a conventional removable prosthesis design. Thirdly, the creation of additional support for prosthetics.

Implants are made of highly durable materials approved for use in medicine. The design of the implant consists of two parts: a support in the form of a steel rod, on top of which the abutment is attached. The abutment is a special link between the rod and the denture.

How does a dental implant procedure work?

Before describing the procedure of dental implantation step by step, it is worth understanding one thing. important thing– the whole operation to implant an artificial tooth is quite lengthy and takes place with painful sensations, but in the field of all this you will be able to admire your new snow-white smile in all 32 teeth. The main stages of implantation:

• Stage 1. Preparation. Includes examination of the dentition, surface preparation, informing the patient about the features of the operation.
• Stage 2. Sinus lift, which is carried out in case of need to raise the height of the gum bone.
• Stage 3. The implant is placed in the gum.
• Stage 4. Installation of the abutment.
• Stage 4. The process of wound healing, which takes approximately seven to ten days.
• Stage 5. Prosthetics.

What are the contraindications for implantation?

There is a list of contraindications applied to implants:

• General or local
• temporary or chronic
• Relative or absolute.

Implants are a concern for the health of patients, while providing highly qualified assistance in the treatment, prevention and restoration of the dentition.

The method of implant-supported prosthetics is popular at the Stomatolog11 clinic in SAO. Experienced dentists are waiting for you individual approach for each patient, as well as affordable prices for services and operations.

The advanced method of installing dentures on implants allows you to return to the patient healthy smile in short time, painlessly, using advanced equipment. It's about about innovative methodology prosthetics, without relying on healthy teeth. This type of prosthetics will restore the dentition completely even for patients with a small amount own teeth, the procedure is also suitable for those people whose teeth condition does not allow mounting on removable structures.

Implant-supported prosthetics, justified by a radiant smile and patient comfort, are recommended in the following cases:

• implantation of one tooth (installation of the structure will be one-time or in a couple of stages),
• implantation of several teeth located next to each other (installation of a bridge supported by two screws),
• installation of two or more teeth in different places dentition.

• preparation of healthy teeth and tissue is not required,
• teeth are not used as a support, as it happens with standard prosthetics,
• the main role in the process of prosthetics is given to the titanium screw, which replaces the root of the tooth, - neighboring teeth will not suffer from additional load, and their absence, all the more, will not interfere with the implantation of new teeth,
• The main advantage of implant-supported prosthetics is the installation of new dentures, even in the outer dentition.

In our clinic in Moscow, implant-supported prosthetics are carried out using modern equipment, using innovative techniques.

Our clinic staff will qualified assistance in areas of interest. Dentists are highly experienced and highly qualified.

If you have previously applied to another clinic and have not resolved your issue with your teeth, call right now. The doctor on duty will agree on the time of the first visit, at the consultation after preliminary survey the dentist will explain in detail options prosthetics.

If you successfully agree and choose a course of treatment, you will not have to wait long in line - you will be able to start prosthetics in the near future.

The generally available cost of dental prosthetics based on implants will allow you to choose the best design option. At the appointment, the dentist will diagnose the condition of the dentition, offer an algorithm for prosthetics and calculate the preliminary cost of treatment.

• implant placement,
• installation on the jaw of a structure based on implants with fastening on metal paws-staples.

Read more: Dental implantation - cost and description, contraindications and pregnancy, reviews and prices.

1. Installation of a dental implant
(including X-ray diagnostics, sutures, anesthesia, follow-up examinations)

2. After 1.5-2 months, the installation of the gum shaper

3. After 2 weeks, the installation of metal-ceramics - crowns

ADVANTAGES OF METAL FREE ZIRCONIUM CERAMICS:

1. High aesthetics, color and shine of healthy teeth
2. Strength and lightness of construction
3. Biocompatibility, hypoallergenic (does not cause allergies)

• - Dental implants - review reviews:
  Read the reviews of our patients after dental implantation - implant placement.
• - Dental implants and pregnancy:
  if you are planning a pregnancy or are already pregnant, then it is better to postpone dental implantation. A weakened body may react poorly to a foreign body. Antibiotics are harmful to the fetus, nursing mother.
• - The cost of dental implants and dental implants:
  The cost of implantation on a turnkey basis includes all materials, including implants, work and all additional services, such as x-rays, anesthesia, etc.
• Don't forget about 50% discount on dental cleaning during dental implants!

1. Installation is possible with some contraindications, in which conventional implants cannot be placed
(for example, diabetes)
2. Less implant survival time
3. Longer lasting result

Dental implants - what is it?

• is a dental direction that has been successfully developing for the last thirty years. Despite his young age, he firmly occupies a worthy place among the medical sciences,
• - a way to restore lost or extracted teeth,
• - an alternative to dentures,
• - a section dealing with the restoration of teeth with dental implants.

Dental implantation of teeth is classified:

• - according to the material of the denture,
• - in the form of an intraosseous dental implant (screw, cylindrical, plastic, tubular, in the form of a natural tooth, with steps, with cortical overlays),
• - according to the method of implantation,
• - according to the timing of implantation (one-stage, two-stage, immediate and delayed)

Dental implant (dental implant) – This is a conical rod about 3-5 mm in diameter, which is implanted into the bone of the upper or lower jaw. Subsequently, it serves as a support for an artificial tooth (denture).

What are dental implants (implants)?

We are pleased to offer you a large selection of implants that differ in shape and design:

Plastic dental implants. Allows you to restore several teeth at the same time. They are usually used to replace chewing teeth,

Androot-shaped implants. The shape resembles a stepped cylinder with a thread. Often dentists use if the patient has a wide dentary (sometimes the bone has to be pre-built),

Tocombined implants. It consists of a combination of plastic and root-shaped implants. Primarily used to eliminate large defects in the dentition,

Psingle bone implant. This is a rather thin construction, which is installed when the bone tissue is thinned between the periosteum and the bone,

Eendodontically stabilized implants. Typically used to strengthen or lengthen the root of a tooth,

ATnutrimucosal implants. Allows you to do without the implantation of the prosthesis into the bone tissue.

What are dental implants made from?

Our dentistry uses implants made from modern materials :

• - Titanium group metals - titanium and zirconium. These metals do not cause allergic reactions,
• - Various types of ceramics,
• - Leucosapphire, etc.

1. The supporting part of the tooth is an artificial root, which is a rod that is surgically implanted into the bone.

2. The upper part (abutment) - is attached to the supporting part and serves as a support for installing a prosthesis or artificial tooth.

How is dental implantation carried out in our dentistry?

The dental implant procedure consists of several stages:

- Diagnostic examination. This procedure allows you to determine the condition of the oral cavity. Dental imaging or tomography is also needed so that the dentist can assess the condition of the bone tissue,

- Ooperation. If no contraindications are found during the diagnostic examination, the dentist proceeds to the operation. The procedure itself will not give you discomfort as local anesthesia is used in the process. During the operation, the dentist implants an artificial tooth root (installs the root part of the dental implant in the bone bed),

- Uimplant attachment. This process can take anywhere from a few weeks to six months.

- Pprosthetics is carried out only after the dental implant is firmly fused with the bone. To ensure that the crown does not stand out from the general row of teeth, the dentist carefully selects the color of the crown to match the natural color of the patient's teeth.

Indications for implantation are:

Missing one or more adjacent teeth

• - terminal unilateral and bilateral defects of the dentition,
• - absence of chewing teeth,
• - the presence of large defects in the dentition (in this case, the dental implant serves as an additional support for the bridge),
• - absence of the last teeth,
• - the absence of one of the teeth in the frontal section,
• - complete absence of teeth (in this case, a removable prosthesis is fixed on the dental implant).

The ability to correct various defects in the dentition, without turning and other adverse effects on adjacent teeth,

The use of safe materials in the manufacture of the implant, which eliminates the rejection reaction and the development of allergies,

Allows you to make fixed prostheses in the absence of teeth over a long jaw, as well as in the complete absence of natural teeth.

In order for the implant to serve you as long as possible, it is necessary to monitor oral hygiene,

• Visit the dentist regularly
• Treat teeth early
• Hygienic care is carried out with soft brushes,
• Soft foods are recommended.

33.2. INDICATIONS AND CONTRAINDICATIONS FOR DENTAL IMPLANTATION. CHOICE OF IMPLANT DESIGN

Testimony to dental implantation are:

Partial defects in the dentition in the frontal or end sections;

Complete absence of teeth in patients without atrophy and with atrophy of the alveolar processes of the jaws;

Persons who cannot use removable dentures (increased gag reflex, allergic reactions to plastics, congenital and acquired jaw deformities).

Dental implantation is performed in young and middle-aged people. However, in elderly patients, with good general condition and the absence of contraindications, it is also possible to perform it.

Contraindications for dental implantation can be absolute and relative, general and local.

Absolute contraindications are:

Chronic somatic diseases of the body (tuberculosis, collagen autoimmune diseases - rheumatoid arthritis or Sjögren's syndrome, etc.);

Severe diseases of the cardiovascular system;

Endocrine diseases (diabetes mellitus, toxic goiter, dysfunction of the pituitary or adrenal glands, etc.);

Diseases of the skeletal system (dysplasia, osteodystrophy, osteoporosis);

Systemic connective tissue diseases (lupus erythematosus, scleroderma, etc.);

Diseases of the blood and hematopoietic organs (leukemia, agranulocytosis, coagulopathy, anemia, etc.);

Mental illness (psychosis, neurosis, etc.);

Radiation sickness;

chronic alcoholism;

Addiction;

The presence of malignant tumors (inoperable tumors, chemotherapy treatment, high doses of radiation therapy).

Relative general contraindications :

Diseases associated with a lack of intake of vitamins in the body (avitaminosis);

respiratory diseases;

Specific diseases (syphilis, actinomycosis);

Preoperative radiation therapy of malignant tumors at their early stages of development in organs and tissues located far from the maxillofacial region;

Dysproteinemia due to inadequate protein nutrition;

Dysmenorrhea;

Pregnancy;

Infectious diseases;

During the period of deterioration of the general condition of the body, due to various reasons (increased blood pressure, etc.);

Exacerbations of the chronic course of inflammatory diseases in various organs and tissues;

Absolute local contraindications for dental implantation can serve:

Malignant tumors of soft tissues and bones of the facial skeleton;

Benign tumors and tumor-like formations (dysplasia) of the jaws;

Radiation necrosis of the jaws (osteoradionecrosis);

The presence of precancerous diseases of the red border of the lips or the mucous membrane of the oral cavity;

The presence of clinical symptoms of metal intolerance (applies to metal structures of implants);

Severe form of generalized periodontitis and periodontal disease;

Idiopathic diseases with progressive damage (lysis) of periodontal tissues (Papillon-Lefevre syndrome, etc.);

Systemic connective tissue diseases with their manifestation in the maxillofacial region;

Low hygienic culture of the patient or his unwillingness to maintain high oral hygiene.

Relative local contraindications :

Exacerbation of chronic (periodontitis, periostitis, etc.) and the presence of acute (abscess, phlegmon, etc.) inflammatory processes in soft tissues and jaws;

Destructive processes in the jaws of non-tumor origin (osteomyelitis, cysts), provided that filling of postoperative bone defects with osteoplastic materials (bioinert or bioactive ceramics, etc.) is included in the complex of their treatment;

Gingivitis, stomatitis, tonsillitis, sinusitis;

When treating diseases of the peripheral nervous system (neuralgia, neuritis, etc.);

Diseases of the temporomandibular joint (arthritis, arthrosis, dysfunction);

Pathological bite;

Poor oral hygiene.

Of course, this short list cannot take into account all possible diseases and conditions that can cause complications during dental implantation. Therefore, the doctor needs to be especially careful and thoughtful when preoperatively examining the patient and choosing him for dental implant surgery.

After making a positive decision on dental implantation, the doctor needs to justify the choice of material and design of the implant. The design of the implant is selected based on the topographic and anatomical features of the patient's dentition and jaws. In frontal section cylindrical implants are used, and in distal- plate and cylindrical implants.

According to G.M. Weiss (1992) the choice of implant design also depends on type of alveolar process of the jaw. At wide alveolar process both cylindrical and plate implant designs can be used. If a alveolar process of medium width, This is the advantage of plate implants over cylindrical ones. At narrow alveolar process not endosseous, but subperiosteal implantation is shown.

According to K.P. Konstantin (1997) when implanting, it is necessary to take into account thickness of the mucoperiosteal flap, located along the crest of the alveolar process of the jaw, the width of its bone and size of loops-lacunae of cancellous bone at the intended injection sites. The author noted that in patients with a thickness of the mucoperiosteal flap located along the crest of the alveolar process of the jaw of 1-5 mm and a width of its bone part of 3.5-5.5 mm, X-ray revealed medium looped(1-2 mm) spongy bone. With a thick (5 mm or more) mucoperiosteal flap along the crest of the alveolar process and narrow (up to 3.5 mm) of its bone part - small-looped(up to 1 mm), and with a thin (up to 1 mm) mucoperiosteal flap of the alveolar ridge and a wide (more than 5.5 mm) of its bone part - large-looped(more than 2 mm) spongy bone structure (Fig. 33.2.1).

Rice. 33.2.1. Large - (a), medium - (b) and small-loop (c) structure of the bone tissue of the jaw at the site of the planned implant insertion (according to K.P. Konstantin).

1 - almost the entire thickness of the jaw consists of a homogeneous compact bone;

2 - a thick layer of compact bone, placed around a dense trabecular bone;

3 - a thin layer of compact bone covers dense trabecular bone;

4 - a thin layer of compact bone surrounds loose trabecular bone.

V.P. Protasevich (1998) believes that three main types should be distinguished architectonics jaw bones:

I type - bone increased density. The spongy layer is thin and is represented by powerful trabeculae. The ratio of compact and spongy layers can be expressed in a ratio of 2:1;

Type II - bone of medium density. The spongy layer is represented by a well-developed network of strong trabeculae and is surrounded by a compact layer of bone 2–3 mm thick. The ratio of compact and spongy layers is 1:1;

Type III - the spongy layer is represented by a few thin trabeculae and is surrounded by a compact layer, the thickness of which does not exceed 1 mm. The ratio of compact and spongy layers is less than 0.5: 1. This type of architectonics corresponds to the state of regional osteoporosis.

With the structure of the jaw bone tissue, which corresponds to types I and II, the author prefers screw and cylindrical implants, because. with these types of architectonics, there are conditions for achieving osseointegration.

According to R.A. Lewandowski (1996), the implant should be of such thickness that after its insertion into alveolar ridge jaw thickness bone walls should not be less than the thickness of the implant itself. That is, the thickness of the implant should be no more than 1/3 of the width of the alveolar process of the jaw.