Make the upper jaw from implants. Features of implantation of the upper teeth. In what cases is

They are conditional (include health problems in which the procedure is prohibited, implantation is possible after their exclusion) and absolute (implantation is contraindicated).

Diseases of the heart and blood vessels are one of the absolute contraindications for surgery.

chronic grinding of teeth;
increased tone of masticatory muscles;
blood clotting disorder;
diseases of the central nervous system;
pathology of the heart and blood vessels;
dysfunction of the endocrine system.

Relative contraindications:

inflammatory processes of the oral cavity;
thinning of the bone structures of the jaw;

What is the complexity of implantation in the upper jaw

The procedure for implantation of the upper teeth is more complicated than the lower ones. due to the softer structure of the maxillary bone. Restoration of lost units from above is carried out with elongated models of titanium roots:

in areas near the maxillary sinus;
in pre-grown bone mass;
after a sinus lift (increase in the volume of the lost bone by raising the maxillary sinus and filling the resulting space with biomaterial).

How much will it cost on average in Moscow

The cost of implantation in different clinics is determined individually, taking into account:

scope of planned work;
used materials, medicines;

Anastasia Vorontsova

Today, in the arsenal of dentists, there are many ways to restore a beautiful smile to people who have lost their teeth.

Implantation of the anterior teeth located in the smile zone is a responsible task in terms of aesthetics. The front teeth are the most prominent of all.

The peculiarity of the restoration of the front teeth is that they are not intended for chewing and, therefore, the load on them should be minimal, and the visual effect should be the best.

When implanting teeth, pins are used that are implanted into the bone tissue of the gums. The part that protrudes above the gum serves to fix the crown.

When using titanium abutments, the metal may show through the metal-ceramic crown, the gum may change color, and a gray line may appear where the crown meets the gum.

Modern technologies include the manufacture of an abutment from zirconium. It is a biocompatible material and does not interact with tissues.

From the point of view of aesthetics, it is advisable to carry out the implantation of the anterior teeth in one stage.

At the same time, a temporary crown is installed simultaneously with the implantation of the implant. The appearance of the patient with this approach does not visually suffer.

Features of dental implants

In the smile zone, special dental implants are used, which have some features:

The anterior tooth implant should have a small diameter, which would make it possible to install it reliably and at the same time with minimal damage to surrounding tissues.
Have a special thread design.

If these requirements for implants are observed, the maximum volume of bone tissue is preserved, the soft tissues of the gums are not injured, and the engraftment process proceeds faster and more efficiently.

All this allows you to achieve the highest possible aesthetics of the front teeth.

How is it carried out

Implantation of front teeth includes several stages.

Preparatory stage

At this stage, the future operation is planned, an anamnesis is collected and a complete examination of the patient is performed.

The patient, both physically and mentally, prepares for surgery.

Sanitation of the oral cavity is carried out: caries treatment, canal filling, removal of decayed teeth, periodontitis treatment, professional teeth cleaning.
In the presence of severe forms of periodontal disease or periodontitis, these diseases are treated and the roots of the teeth are strengthened.
In the presence of atrophic changes in the bone tissue at the implant site, bone grafting is performed.
If prostheses or crowns unsuitable for use are found, they are replaced taking into account the compatibility of materials in order to prevent their corrosion or galvanization.

Surgical stage

Before the operation, local anesthesia or general anesthesia is performed. Painkillers of general action are used, their effect continues for another one and a half to two hours after the operation.

At the surgical stage, the implant of the front tooth is implanted into the jaw bone in place of the former root.

The duration of the operation is from thirty to fifty minutes.

Abutment installation (with traditional method)

This procedure is a minimally invasive surgical procedure. At this stage, the mucous membrane of the gums is injured.

orthopedic

This is the final stage of implantation. Prosthetics is performed: installation of a bridge, crown or removable structure.

Of all the above stages, the most important is the quality of the surgical stage.

Since it is its correct conduct that affects how long the implant will be used.

Implant implantation methods

Two-stage. At the first stage, an impression is taken from the bone and an implant is made on it. On the second stage, the bone is prepared for its implantation, the implantation process and the gums are sutured.

One-stage. A jaw computed tomography is performed, based on the data obtained, a computer simulation of the implant is performed, and then it is manufactured. Then the implant is implanted and the gum is sutured.

What material are they made from

For the manufacture of crowns on the implants of the anterior teeth, metal-free ceramics are most often used.

Artificial teeth made of zirconium and aluminum oxide are externally indistinguishable from real teeth, perfectly perform their functions and have an unlimited service life.

Advantages of installing aluminum oxide and zirconium oxide prostheses for anterior teeth implantation:

Implants on the anterior teeth made of these materials are highly durable and lightweight, which reduces the load on the gums.
Biocompatibility, hypoallergenicity of zirconium and aluminum oxide.
When using ceramics, there is no lowering of the gums.
Tooth tissues and ceramics have the same properties: high thermal conductivity, refraction, color stability, light transmission.

To achieve an ideal implantation result, it is recommended to make all components of the implant from metal-free ceramics.

Video: "Simultaneous implantation in the area of the front tooth"

Advantages of one-stage implantation

Allows you to quickly and effectively correct defects in the front teeth, freeing the patient from psychological discomfort.
After the implant is installed, a temporary crown is placed on the abutment, and the patient leaves the clinic on the same day with new teeth.
A few hours after the operation, the patient is allowed to eat.

Laser application

To achieve the best effect of implantation of the anterior teeth, a laser is used. Unlike a scalpel, it significantly reduces the size of the surgical field, reduces the time of the operation to 15-30 minutes, and reduces pain.
The laser beam cuts the tissues and seals the vessels at the same time, making this method bloodless. The laser beam also has a disinfecting effect, preventing the development of the inflammatory process.
After applying the laser, a photocoagulation film is formed on the wound surface, which protects the wound from the influence of negative factors. All these properties of the laser allow the bone tissue to recover faster, which helps to accelerate the survival of the implant.
The use of laser implantation of the anterior teeth does not cause negative sensations in the patient, it is a more gentle and minimally invasive method. After installing implants with a laser, the patient has the opportunity to immediately return to a full life.

Complications

Complications during the operation can be the result of the mistakes of the dentist, and the reaction of the body.

The sensation of pain during the operation is associated with insufficient anesthesia.
Bleeding in the paranasal sinuses.
Breakdown of bone tissue.
Overheating of bone tissue in the place of work with drills and burs.

At present, the use of modern equipment in kinics makes it possible to reduce the risk of complications to zero.

Complications after implantation

Pain after surgery.
Puffiness.
Hematoma formation.
Increased body temperature after surgery.
Presence of bleeding after implantation.
Postoperative inflammation. It can be the cause of infection due to insufficient cleaning of the bone bed, with poor oral care after implantation.
Divergence of seams.
Rejection of the implant, often occurs as a result of the onset of the inflammatory process. In some cases, rejection may occur if there is a burn of the bone as a result of its drilling. The presence of osteoporosis can also influence implant rejection.
Mobility of the installed implant. The process of strengthening the teeth in the jawbone continues for 14-20 days.
Increased reaction to sweet and cold.
Exacerbation of herpes.

Price

The cost of installing implants on the front teeth consists of many factors. The cost includes: the work of medical personnel, the use of equipment, rent of premises, the cost of consumables, payment for water and electricity, taxes of the owner of the clinic.

When installing an implant, a crown is still needed, the price of which is quite high. The most expensive implants are American and Swiss. Cheaper ones are South Korean and Israeli, which are no worse than American ones, although they are twice as cheap.

The cost of an implant is affected by the shape and material from which it is made. Some configurations, such as root configurations, are initially expensive. If we add to it the cost of the uppermost part, then the price of implantation will be quite high.

You can also choose a more budgetary version of the crown, then the price will be lower.

In this situation, the cost depends primarily on the material from which the crown is made.

At first glance, it seems that there is no difference between the upper and lower teeth. However, it is not. The fundamental difference lies in the density of bone tissue, which plays an important role in the implantation procedure in the absence of upper teeth. The fact is that in the process of chewing food, the upper jaw experiences much less load compared to the lower jaw. Therefore, the bone here is not so dense and atrophies much faster after tooth extraction. For this reason, bone restoration is often performed in the upper jaw prior to implantation so that the implant can be securely placed.

Another feature of the implantation of the upper teeth is the close location of the maxillary sinuses. With insufficient width and length of the jawbone in the area of the canines and lateral incisors, a sinus lift of the upper jaw (a type of bone grafting) is mandatory. If this is not done, then during the installation process, the implant will go through the bone and damage the sinus. During sinus lifting and implantation of the upper teeth, at the same time, the bottom of the maxillary sinus is first lifted and filled with osteoplastic material, and then the implant is installed in the bone tissue. Recently, in order to carry out implantation without a sinus lift, specialists began to use long zygomatic implants.

Interesting fact!

Despite the fact that implantation has become popular relatively recently, numerous finds by archaeologists testify to the active attempts of ancient people to master this dental direction, using the so-called implants from various materials: ivory, wood, precious stones, animal teeth and even dead people!

Implantation of anterior upper teeth

One of the most important tasks of implantation of anterior teeth in the upper jaw is not only the qualitative restoration of the functionality of the dentition, but also the improvement of the aesthetics of the patient's smile. Therefore, such an operation has the following features:

The need to create an aesthetic gingival contour. When implanting the anterior upper teeth, it is necessary to create a beautiful gingival contour. Otherwise, it will not be difficult to “calculate” the presence of a prosthesis even for a non-specialist. So that the gum does not lose volume and an aesthetic contour is formed, it is necessary to carry out one-stage implantation with immediate loading of the implant with a temporary crown. The prosthesis will create the necessary support for soft tissues and will not allow them to atrophy.

Precise placement of the implant is important. When implanting the upper front teeth, the most accurate installation of the artificial root is required. If you implant the implant at the wrong angle (see the photo below), this will make it difficult to install the crown, and in the future it can lead to complications. Computed tomography helps to plan the future operation correctly, which allows you to understand the anatomy of the upper jawbone in detail.

Special structure of implants. In addition, small-diameter implants with a special thread design are used for implantation of the anterior upper teeth in order to less traumatize the surrounding tissues.

High demands on the aesthetics of prostheses. Instead of metal abutments (a crown is attached to them), which can shine through the gum, white zirconium structures are used. The material of the dental crown must also have high aesthetic characteristics. Therefore, all-ceramic or zirconia prostheses are recommended.

Implantation of chewing teeth in the upper jaw

When implanting chewing teeth in the upper jaw, as a rule, a two-stage technique is used, in which the crown is fixed only after the implant has completely engrafted. This classical method is considered the most reliable and predictable. The operation is often accompanied by bone grafting or sinus lift. As for the type of implants, for the implantation of the upper teeth, the opinions of experts agree that the best option is prosthetics on classic root-shaped structures.

Implantation of the upper jaw in the complete absence of teeth

When implanting the upper jaw in the complete absence of teeth based on implants, depending on their number, it is possible to install individual dental crowns, bridges or complete conditionally removable structures. The latter option is more democratic in cost and is divided into several subspecies, which are discussed below.

Complications after implantation of teeth in the upper jaw

Those planning implantation in the absence of teeth in the upper jaw should be aware that the following complications are possible during implantation:

swelling after implantation of a tooth in the upper jaw;
numbness of the upper lip;
nosebleeds;
rejection of bone material;
increased mobility of the implant;
rejection.

The above problems may arise due to poor oral care or due to the low qualification of the implantologist. Therefore, in order to prevent complications after the implantation of the upper teeth, it is necessary to provide the installed implants with proper postoperative care and choose a clinic with a good reputation, experienced specialists and modern equipment.

It may seem that there is no difference between the implantation of the upper and lower dentition. This opinion is erroneous, since the jaws have a different structure and density of bone structures. This is due to the physiological characteristics of the human body: while chewing food, the upper jaw experiences less stress than the lower jaw. The jaw bones of the upper dentition have a looser structure and are more likely to become thinner when one or more elements are lost. For this reason, it is not uncommon for an operation to build up the missing tissue before the implantation of the upper teeth.

The main danger of implantation of the upper teeth is that they are located next to the maxillary sinuses. With insufficient length and width of the bone during the restoration of canines and lateral incisors, there is a risk of damage to the maxillary sinuses. For this reason, bone grafting may be required prior to implantation.

Features of implantation of teeth of the upper row

Let us consider in more detail the features that doctors should consider when implanting the upper jaw.

The need to create a natural contour of the gums. If you do not take this rule into account, then others will notice the replacement of a natural tooth with an artificial one. In order to bring the contours of the implant as close as possible to the natural tissues of the tooth, a one-stage operation is performed with the loading of the structure with a temporary crown. This is done so that the prosthesis supports the soft tissues and prevents them from atrophying.

The importance of accurate installation of the restoring structure. Especially this rule applies to the restoration of the anterior upper teeth. If the implant root is installed in the wrong place, then it will create difficulties in further fixing the crown part of the product. Computed tomography allows to exclude such a problem, which makes it possible to study the bones of the upper jaw in detail.

Selection of implants of a special structure. For prosthetics of missing units of the upper jaw, only implants with a small diameter and a special type of thread are used to reduce trauma to the soft tissues of the gums.

The importance of choosing the right material for aesthetic characteristics. Zirconium structures are used instead of metal pins on which the crown is mounted. This is due to the fact that the metal shines through the crown, which can adversely affect the appearance of the entire structure. The material used to create the crown must also meet high aesthetic qualities. For this purpose, ceramics or zirconium dioxide are used.

CT results of the jaw before implantation

Types of implantation for adentia of the upper jaw

Two-stage standard surgery for an edentulous upper jaw is rarely used. Typically, dental clinics offer patients the following types of operations:

All on 4 and other types of procedures;
zygomatic implantation.

An important advantage of the techniques is the absence of the need to build up the missing bone tissue, as well as the possibility of installing a fixed prosthesis immediately after the operation.

All on 4

The prosthesis is placed on 4 or 6 pins implanted in the jaw bone. The first variant of prosthetics is used to restore the integrity of the row in the elderly and women. In adult men, chewing activity is higher, so All on 6 implantation will be more appropriate for them.

Before surgery, patients are advised to undergo a CT scan. This study allows specialists to bypass areas with the lowest bone density when implanting implants. CT in 98-100% of cases saves patients from the need for a sinus lift.

Indications for operation All on 4:

periodontal disease;
periodontitis;
the need for immediate loading of a removable or non-removable prosthesis;
carrying out one-stage implantation;
the impossibility of a sinus lift for any reason.

The All on 4 and All on 6 methods provide a number of advantages:

the ability to restore the missing elements in 1 day;
uniform distribution of chewing load on the entire dentition;
prevention of possible processes of bone tissue atrophy;
the possibility of intervention in diabetes mellitus and cardiovascular disorders.

In the latter case, the operation is possible due to the low traumatism of soft tissues and the use of local anesthesia.

Let's take a closer look at the stages of implantation using All on 4 technology:

Carrying out diagnostic measures - 3 D modeling, CT.
Implantation of pins: frontal teeth straight, lateral - at an angle. The parameters are determined individually for each person, taking into account the anatomical features of the structure of his upper jaw.
Removal of casts from the jaw for the manufacture of fixed temporary prostheses. Impressions are usually taken by a dental technician.
Installation of temporary prostheses on abutments screwed to the pin.

After the operation, the patient can eat and drink after 2 hours. However, in the first 2 weeks, it is worth reducing the chewing load on the installed structures. To do this, it is recommended to eat chopped food and refuse coarse foods.

Zygomatic implantation

Zygoma operation is used in severe clinical cases:

with thinning of bone structures in all departments;
with complete edentulous upper row;
in the presence of past maxillofacial injuries and benign neoplasms.

Completely edentulous upper jaw

The essence of the intervention is that a long implant is fixed in the tissues of the cheekbone. This site is chosen because it is not subject to atrophy. 3D modeling allows you to plan the course of the procedure and take into account important nuances.

Advantages of the implant used during Zygoma surgery:

smaller diameter of the pin cylinder, which reduces the invasiveness of the intervention;
the possibility of withdrawing the support for the bridge under the required axis.

How long does it take to get an implant? The average term is 4-6 months. Secondary stabilization requires another 4-5 months. The terms of rehabilitation depend on the state of health of the patient and his ability to follow the recommendations of the doctor. The longest implant takes root in people suffering from diabetes. The recovery period is lengthened by bad habits and non-compliance with the rules of personal hygiene.

To restore the missing elements in the upper jaw, mini-implants can be used, which differ from conventional products in a thinner rod. Due to this, the operation is simplified and the rehabilitation period is shortened.

Ways to restore the upper front teeth

The upper dentition is restored through a classic two-stage puncture. This method of restoration allows you to achieve optimal aesthetic performance. With this type of operation, the doctor takes into account the smallest details and adheres to the following algorithm of actions:

evaluates the thickness and strength of the bone tissue of the upper jaw;
advises sinus lifting in case of insufficient quality of the jaw bones;
implants titanium pins into the bone, which are substitutes for the natural root system;
installs a gum shaper to correct the appearance of mucous structures;
forms a prosthesis.

A significant drawback of two-stage implantation is the duration of the procedure (up to 18 months). Most of the time for the restoration of the teeth of the upper jaw will have to be spent by people who have a history of a lack of thickness of the jaw bone tissue and other diseases that prevent the prosthesis from being fixed ahead of time.

If a sinus lift is not performed with poor quality of the jaw bones, then the following dangerous consequences may occur after implantation:

falling out of the structure from the hole;
trauma to the maxillary sinuses;
meningitis.

Restoration of chewing teeth

The main purpose of the group of elements under consideration is the grinding of food. Upper teeth are more prone to decay than lower teeth. When restoring chewing upper dentists often face the problems of jaw atrophy, in the presence of which patients are offered one-stage implantation. Using this technique, it is also possible to restore the end defects of a row.

Terminal defect of the dentition

One-stage implantation of the upper teeth provides a number of advantages:

the ability to avoid a sinus lift;
maintaining the health of the oral cavity;
the possibility of eating 2 hours after the intervention.

Procedure steps

The operation to install an implant on the upper jaw has its own functional and aesthetic nuances. Difficulties during the intervention are associated with insufficient density of the bones of the upper jaw. For this reason, specialists try to use only modern technologies for the operation. Also, the patient is assigned additional preparatory measures:

CT examination;
otolaryngologist consultation.

With the help of modern technologies, aesthetic problems are also solved, which may arise due to an incorrect gum contour or the placement of the implant at the wrong angle. Computer models make it possible to correctly determine the area of pin insertion and the parameters of the crown part of the prosthesis (color, shape, size).

Implantation may include the restoration of one or more elements. The optimal type of intervention is selected by a specialist after all the necessary diagnostic studies have been carried out.

Implantation of the teeth of the upper jaw can be one- or two-stage. In the first case, the installation of a titanium rod is performed immediately after tooth extraction, in the second case, up to 4 months can pass between the removal of the native and the installation of an artificial element.

When restoring anterior elements, it is important that artificial prostheses do not differ in appearance from adjacent natural teeth. In this case, the dental technician must work together with the implantologist.

Disadvantages of implantation

Doctors have to solve a fairly wide range of problems during the procedure to restore the integrity of the upper row. Also, the specialist must be extremely careful during the operation in order to prevent the dangerous consequences of the intervention. Despite the advantages of implantation, the procedure also has a significant drawback - the price. This is a more expensive method compared to prosthetics, due to the high cost of the materials used and the long service life of implants.

After surgery on the upper jaw, complications are observed much more often. However, in general, negative consequences after the intervention are noted in extreme cases. This is due to the fact that the technique of restoring teeth with the help of implants is well developed and studied.

The consequences usually manifest themselves with insufficient qualifications of the doctor who performed the operation and if the patient does not follow the recommendations in the recovery period. Complications appear as:

pain in the jaw;
bleeding gums;
swelling of the soft tissues of the mouth;
numbness of the mouth and lips;
rejection of the materials from which the product is made;
divergence of seams;
increase in body temperature;
mobility of an artificial tooth.

Pain in the jaw is often noted immediately after the anesthesia wears off. The symptom is considered normal and is associated with damage to the soft tissues of the gums and bone structures of the jaw during implant placement. If the operation went without complications, then the sign disappears on its own for 3-4 days. To reduce the intensity of pain, you need to take an analgesic. Discomfort that manifests itself for more than 4 days is a reason for a second visit to the doctor.

Swelling is also a reaction to soft tissue damage during implantation. In the normal state, the symptom can be observed for about a week after the intervention. A dangerous symptom is an increase in edema in size and its spread to neighboring tissues. At home, you need to apply a cold compress to the problem area. It will allow you to relieve some discomfort before a visit to a specialist.

Numbness of the jaw is noted in the first 4-5 hours after the end of the action of the anesthetic drug. Long-term persistence of numbness should not be ignored

Bleeding in the first days after the operation to implant an artificial tooth is a normal reaction of the body. The appearance of a symptom can also be triggered by taking drugs aimed at reducing blood clotting. Severe bleeding that does not stop within 2-3 hours is an alarm signal indicating the possible development of a hematoma, damage to blood vessels.

Hyperthermia in the first days after the intervention is also not considered as an abnormal sign. The reason for going to the doctor is a high temperature (more than 38.5 degrees) that persists for more than 3 days. This condition indicates a possible infection of the surgical site or rejection of an artificial tooth.

The likelihood of complications depends not only on the literacy of the doctor's work, but also on the patient's behavior in the postoperative period. After the operation, it is necessary to more thoroughly clean the oral cavity from food debris and plaque in order to avoid infection of the sewn gums. Also, hygiene measures will minimize the negative impact on the implant.

Several factors affect the cost of the operation:

the need for bone grafting;
the quality of the materials used;
pricing policy of the clinic;
doctor's professionalism.

The cost of the procedure in Moscow, excluding bone grafting, is 30-70 thousand rubles, with sinus lifting - up to 120 thousand rubles. To this cost it is necessary to add the price of crowns: metal-ceramic - from 10 thousand rubles, all-ceramic - up to 50 thousand rubles, zirconium - up to 35 thousand rubles.

Dental implantation of the upper jaw is a complex procedure that requires high competence and professionalism from the doctor performing the operation. Negative consequences after the procedure rarely appear, but basically they are all associated with the wrong behavior of a person in the rehabilitation period or a doctor's mistake. Signs that require a second visit to the doctor are profuse bleeding from the surgical field, intense pain for 4 days, high fever for more than 3 days, severe swelling of the soft tissues of the mouth.

What complications after implantation of teeth can await you on the way to restoring the ability to chew normally and a beautiful smile;
What problems sometimes arise immediately at the time of the operation, and what - a few days, weeks, months and even years after the installation of implants;
List of contraindications for implantation and their relationship with the development of dangerous complications;
How can you recognize the problem in time - what is considered a harmless side effect, and what is a dangerous complication;
How to protect yourself from possible troubles as much as possible;
What types of implants are characterized by the lowest risk of complications;

... And also other interesting nuances from a practical point of view regarding possible complications during dental implantation.

Unfortunately, human permanent teeth, in case of their loss or serious damage, are not able to recover on their own and require artificial replacement, since a violation of the chewing function not only causes significant damage to the digestive system, but also negatively affects the quality of life in general. In order to restore aesthetics and normal chewing of food, dentists already at the end of the 18th - beginning of the 19th centuries began to use the first, then still primitive, dental implants made of wood, various metals, porcelain and other available materials. However, very frequent complications after dental implant operations forced doctors to constantly look for new technologies and more advanced materials suitable as implants.

It is thanks to such continuous research and successful experiments of doctors who are supporters of dental implantation that at the end of the last century this direction in dentistry became one of the most popular and in demand among the general population. The most important result of such hard work was that complications after dental implantation ceased to be regular and quite expected, and dental surgeons learned to minimize damage to health to one degree or another even in the event of certain problems.

Currently, prosthetics on implants are gradually replacing "ordinary" dental prosthetics, which often require the grinding of healthy teeth, or the use of partial or complete removable dentures, which are often called "dentures" by the people.

However, is it possible today, when the 21st century is already in the yard, to say with full confidence that complications after dental implantation and the corresponding risks of problems during and after surgery are already completely a thing of the distant past? Well, the answer here is quite unambiguous, and, unfortunately, it is negative - complications are still quite common in the practice of implantologists. But why?

In connection with the spread of numerous systems of implants, various methods and technologies of implantation, as well as the training of many hundreds of practicing maxillofacial surgeons, at least 20 thousand implants are installed in our country alone per year. And along with this, the number of unsuccessful operations and negative reviews on the Internet quite naturally increases - problems can begin due to the fault of an insufficiently qualified doctor, due to the choice of low-quality implants (rarely, but it happens), as well as through the fault of the patient of the dental clinic.

About how to minimize the risk of problems during dental implantation, how to avoid the most common problem with implants - their “rejection”, as well as what to do if problems do emerge - that’s all we’ll talk about later and in more detail ...

Complications that may arise during the dental implant procedure itself

It is useful to keep in mind that some complications may already arise directly during the dental implant procedure, right on the dental chair. Moreover, the nature of undesirable consequences may depend on whether the implant is installed on the upper or lower jaw.

Below is a brief list of possible complications that may occur during the implantation procedure (in descending order of their frequency):

heavy bleeding;
Pain;
Perforation of the bottom of the maxillary sinus and nasal cavity;
Damage to the wall of the mandibular canal and nerves of the lower jaw.

Let's look at these complications in order.

heavy bleeding

During implantation of teeth, slight bleeding is considered normal and in most cases can be easily eliminated with conventional hemostatic techniques. Abundant bleeding can occur both through the fault of the doctor and through the fault of the patient himself.

It is in the power of every person sitting in the dental chair to reduce the risks of developing this complication. Most often, bleeding from a wound occurs with an increase in blood pressure, as well as with a violation of blood clotting (taking drugs that “thinn the blood”, cardiovascular pathology, etc.).

Control of blood pressure, timely administration of drugs under the supervision of a cardiologist or therapist, the correct medication and psychotherapeutic sedative (relieving nervous tension) preparation, as well as the obligatory informing of the implant dentist about existing diseases will help to avoid not only early bleeding during implantation, but also in the delayed period. Of no small importance in order to prevent complications is also the implementation of all recommendations after dental implantation, when a fresh wound is a zone of increased attention, especially if more than 4-5 dental implants were installed in one day.

From the practice of a dentist

Bleeding due to the fault of the dentist occurs much less frequently than most people think (after all, what thoughts can the patient have: “Here, he ruined my entire jaw, now the bleeding does not stop, couldn’t it have been cut more carefully ...”)

However, doctors who are just starting their activities in the field of dental implantation and stuffing their first bumps really sometimes have unpleasant flaws in their work. However, even if errors are made during the surgical operation, even an inexperienced surgeon can easily use modern hemostatic techniques and tools to eliminate negative consequences. Only injury to large vessels located deep in the jaw, for example, with an incorrectly selected implant, can endanger the patient's life, but this is very, very rare (virtually excluded).

Pain during dental implants

Sometimes during the procedure of dental implantation, quite strong pain can occur, which, however, is usually easily eliminated with an additional dose of anesthesia.

But in rare cases, it happens that anesthesia does not work well. This is most often associated with the individual characteristics of a person. This situation is resolved simply: dental implantation is performed under anesthesia, in other words, when consciousness is turned off.

Therefore, if you have been injected with an anesthetic, but the pain is still felt, you do not need to endure and be silent - you should definitely and immediately tell the doctor about it.

Perforation of the bottom of the maxillary sinus and nasal cavity

Currently, this complication of implantation is much less common than it used to be. Progress has been largely due to the ability to accurately determine the distance to the cavity formations using panoramic images and computed tomography (CT).

In order to reduce the risk of this complication to almost zero, it is necessary to trust only an experienced doctor with a long work history, and in case of doubt, consult other implantologists. In the case of a close location of the maxillary sinus and the bottom of the nasal cavity, a "building up" of the bone (sinus lift) can be carried out beforehand, and then there are no problems.

The photo below shows an example of bone growth before dental implantation:

Damage to the wall of the mandibular canal and nerves of the mandible

This complication during dental implantation does not always have long-term negative consequences, since, despite the frightening name, in fact, it usually manifests itself only by numbness in the lower jaw (most often, lips become numb). Even without treatment, these symptoms can resolve on their own within 2-3 weeks, a maximum of 2-3 months.

In addition, it should be borne in mind that a feeling of numbness on the corresponding side of the face can also be the result of nerve compression in the mandibular canal. This sometimes occurs due to bleeding in the bone marrow spaces - blood can go out not only towards the oral cavity, but also gradually move through the spaces of the bone, because the intraosseous tissue of the jaw is not “solid”, but cellular. The entry of even a relatively small amount of blood into the area of the passage of the mandibular nerve in the canal creates a temporary squeezing. Gradually, the blood masses dissolve, but it takes time for the nerve to recover from such a squeezing effect (usually no more than 5-7 days).

On a note

Complications such as fracture of the instrument during surgery, fracture of the wall of the alveolar process, insufficient fixation of the implant, pushing it into the sinus of the upper jaw, etc., are even less common. The myth that a dental implant can come out of the eye or out of the jaw through the cheek makes some people terrified of implantation. In fact, no doctor in their right mind will deliberately harm your health by using implants of the wrong length, and thoughtlessly screwing them "to the stop." Therefore, this situation can only be considered from the point of view of popular horror films.

What complications sometimes occur after the installation of implants

Complications after the installation of dental implants can be divided into early ones, which manifest themselves within a few days after surgery, and late ones, which occur weeks, months, and sometimes even years after implantation.

Early complications include:

Painful sensations;
swelling;
bleeding;
Increase in body temperature;
Divergence of seams.

Generally speaking, pain is a normal reaction of the body in response to a traumatic intervention by a dental surgeon during dental implantation, and such pain appears after the anesthesia wears off.

Analgesics prescribed by a doctor are usually effective in relieving pain, and the engraftment process does not bring too much discomfort to the patient. Normally, pain should not disturb for longer than 2-3 days, during which medication is indicated. If the expressed pain lasts longer, this is an alarming sign.

Soft tissue edema is a consequence of almost any surgical operation, including dental implantation. Moderately pronounced edema is a natural reaction of the body to injuries and the “invasion”, in general, of a foreign implant, and rarely leads to complications. Typically, tissue swelling lasts no more than 5-7 days.

A possible complication in the form of an excessive increase in edema can be prevented by immediately applying cold to the area of the face where the implants were placed immediately after the operation. At the same time, you should be careful and adhere to elementary common sense so as not to cause frostbite and tissue necrosis (that is, comrades who simply take something icy from the freezer, put it on their cheek and hold it for two hours - this is wrong and very dangerous) .

Slight bleeding in the area of dental implants can be observed within a couple of hours after implantation, when the vasoconstrictive effect of adrenaline added to the anesthetic ends. Even if such bleeding drags on for a whole day, this is not a cause for concern. It is important at the same time to distinguish the ichor (bloody fluid) from a strong and incessant bleeding for more than 5-8 hours, which does not stop.

It should be remembered that a common cause of bleeding is the inattention of the person himself to the existing problems. For example, taking aspirin and a number of other drugs worsen blood clotting, and increased blood pressure prevents the formation of a clot in the wound; a number of diseases of the cardiovascular system make almost all home methods of stopping bleeding ineffective. It is important to always correctly and timely assess the scale of the problem and notify your doctor in advance about such nuances.

As for a slight increase in body temperature after implantation, this is also a completely normal reaction, which reflects one or another stage of the local inflammatory process after surgery. On the first day, the temperature can even rise to 38.0 ° C, but you should not worry- the problem is solved with the help of antipyretic drugs, which, most likely, the doctor himself will mention.

However, if, say, closer to the night the temperature on the very first day after implantation "passed" far beyond 38 degrees, and antipyretic drugs do not help, then it is advisable to call an ambulance, make a lytic mixture, and consult your dentist in the morning, as this may be a sign of a complication after dental implantation.

Most often, the temperature does not rise to such high values, but it can stay within the range of 37.0-37.3 ° C for several days, which is a reaction of the body that is within the normal range.

Perhaps it is worth mentioning also the divergence of the sutures, often applied to the wound after implantation. The photo below shows an example of the normal state of the sutures immediately after the operation:

The divergence of the seams, as a complication, is almost never a sign of unsuccessful dental implantation, since it characterizes the result of the behavior of the person himself to a greater extent. Violations can be very different: from non-compliance with the principles of oral hygiene and ignoring the recommendations of a doctor, to unauthorized “pecking” in the oral cavity with fingers, toothpicks, etc., which either leads to mechanical damage to the seams, or contributes to the onset of the inflammatory process. This provokes the divergence of the seams in the future.

Late Complications

Among the late complications that sometimes occur after a long period of time after dental implantation, the following can be distinguished:

peri-implantitis;
Rejection of the implant.

These complications can occur regardless of whether implants were placed in the upper or lower jaw, several or just one, whether expensive or not very expensive implants were used. The risk of rejection and peri-implantitis (inflammation in the area of the implant) is always present, although, of course, quite certain factors influence the likelihood of such an unpleasant outcome.

Popular medical forums, where a lot of people's reviews about the results of dental implantation are published, are often full of descriptions of various problems after seemingly successfully installed implants. Moreover, violations associated with the "engraftment" of implants are usually among the first.

In reality, peri-implantitis and implant rejection are not as common today as one might think after reading the related negative reviews. Each major clinic maintains official statistics on its unsuccessful cases, and the percentage of rejection from all registered implantations is no more than 3-5%.

Moreover, often in such cases there are people who were warned about the risks of rejection of dental implants due to existing contraindications, or who regularly violated the recommendations for their care of prostheses on implants and had bad habits.

On a note

Peri-implantitis is an inflammation of the tissues surrounding the implant. An infection that has been caught due to poor hygiene (most often), or in violation of the implant installation technique (extremely rare) can literally corrode the bone, leading to swelling, suppuration and severe pain. Such a complication is sometimes accompanied by the appearance of an unpleasant one.

Further progression of peri-implantitis in case of failure to provide timely assistance leads to rejection of the implant - in such cases it is better to remove it immediately, without waiting until the inflammatory process leads to much more serious complications.

Rejection of the implant is often accompanied by its mobility and pain under load (pressure). However, modern dentistry sometimes makes it possible to solve even this, at first glance, the most terrible problem for many patients. However, we are not talking about the fact that the rejected implant will successfully take root after some manipulations by the doctor - no, it usually needs to be removed and re-implanted.

The photographs below show the removed implants:

After removal of the movable implant, the procedure for complex preparation of the hole for the next implantation is carried out, which can be carried out in 1-2 months. For example, with a significant loss of bone tissue or proximity to the maxillary sinus, it may be necessary to build up the jaw bone under a dental implant (sinus lift surgery).

Indications and contraindications for dental implantation and their relationship with possible complications

An indication for implantation is the absence of one or more teeth, as well as the impossibility of classical prosthetics. However, errors and complications during the installation of implants occur most often in those dentists who are guided more by the indications than by fully taking into account contraindications for implantation (sometimes this approach is due to commercial considerations, because no one wants to lose "expensive" patients).

Absolute contraindications for dental implantation:

Chronic diseases in the decompensated stage;
Serious violations of hemostasis;
HIV and a number of other seropositive infections;
Some mental illnesses.

Relative contraindications:

Diseases in the acute stage, especially acute viral infections;
Chronic infectious diseases;
Condition after a heart attack and stroke;
Pregnancy and lactation;
Risk of bacteremia in patients with prosthetic heart valves who have had rheumatism or endocarditis;
Exacerbation of chronic forms of diseases;
Treatment with medications that impair tissue regeneration.

Relative contraindications give the doctor the right to delay the procedure of dental implantation. For example: after a complete cure of a viral disease, a year after a heart attack, after the end of breastfeeding a child, stopping the use of drugs that create risks of complications during and after implantation, etc. All this is necessary to minimize the risks of developing negative consequences during dental implants.

It is interesting

More recently, diabetes mellitus was an absolute contraindication to dental implantation. But at the moment it has been proven that type 2 diabetes mellitus in the compensation stage does not affect the course of implantation and does not create risks of implant rejection. However, the operation takes place under the strict supervision of an endocrinologist with mandatory monitoring of blood glucose levels (significant fluctuations in glucose levels are unacceptable).

Some people who by all means want to get a beautiful smile as soon as possible after dental implantation sometimes have reasonable questions:

Or maybe you can still do dental implants during pregnancy?
And during an acute infectious process?

So, the simultaneous removal and implantation of teeth during pregnancy can in some cases have serious negative consequences for the fetus, and it is difficult to imagine a situation where the operation is simply urgently needed. It's better to wait. Pregnancy itself does not affect the process of "engraftment" of implants, but drug therapy, which is necessary after their installation, can have a negative impact on the developing fetus.

Even in the event of an emergency, such as an acute injury that led to a fracture of a tooth or root and its subsequent removal, implantation should not be rushed during pregnancy. It is clear that an aesthetic problem that has arisen in a young girl can lead to stress and a nervous breakdown, but the health of the unborn child should come first.

As for implantation in acute infectious processes, due to the action of the infection, the body is weakened, and there is an increased risk of peri-implantitis when implants are installed at this time. However, this does not mean that it is impossible to put implants in the hole of a tooth removed due to exacerbation of chronic periodontitis. Adequate drug therapy, competent selection of the implant system and technology can, of course, minimize the risks of complications even in such extreme cases, although in general it can be unreasonable and dangerous to neglect contraindications, especially when this is done by a doctor only for commercial gain.

How to recognize the problem in time: from harmless side effects to dangerous complications

Despite the associated risks, a huge number of people around the world get implants, get a Hollywood smile and the ability to chew their food normally. As for possible complications, some are more lucky, some less, but the positive effect of implantation directly depends not only on the professionalism and intuition of the dentist-surgeon, but also on the patient himself.

Not every person has the knowledge that allows to recognize the problem that has arisen in time and promptly direct the situation in their favor. And if we paraphrase a well-known saying, we get a kind of formula for a successful rehabilitation period after dental implantation: "Who owns the information - he owns the situation."

Suspicious symptoms most often occur on the day of implantation or within 1-2 days after it.

Side effects can be observed even after building up the jaw bone for a dental implant, which, however, does not always indicate the possibility of developing a dangerous complication. Sinus lift is carried out with a good purpose, for example, to build up bone tissue near the bottom of the maxillary sinus, so that during the installation of implants it does not perforate.

In general, bone grafting is almost always well tolerated; it is often performed at the same time as the implant is placed. But sometimes there are quite harmless temporary side effects, masquerading as complications that can scare.

For example:

An increase in temperature to 37.5 degrees;
Feeling of heaviness in the maxillary sinus;
swelling of the face;
Small hematomas.

The fact is that the tissues of the maxillofacial region have an abundant blood supply (especially the lower jaw), and almost any surgical intervention can be accompanied by phenomena that sometimes frighten even informed patients. However, the frightening appearance of edema and hematomas in 90-95% of cases does not correspond to their real danger - that is, it all looks scary, but is not dangerous to health and does not lead to serious complications.

A decrease in the severity of such edema and hematomas is observed already in the first days after dental implantation (and sinus lift), and finally they usually disappear after 1-2 weeks.

In general, any surgical methods of dental implantation, as well as stages of bone grafting, are not without side effects, although in most cases it is not reasonable to consider them as complications.

How to distinguish harmless symptoms that have arisen after dental implantation from a developing dangerous complication? Here are some examples:

Pain. As noted above, this is a normal reaction of the body to traumatic intervention, usually easily removed with painkillers. They are prescribed by a doctor after dental implantation or sinus lift. But if severe pain accompanies healing for more than 3 days from the moment of implantation, then a complication can be suspected.

Edema is also a common result of the inflammatory process, occurs 2-3 hours after the intervention. Within a week, edema of the maxillofacial region disappears on its own. If they persist after 7 days from the date of implantation of the teeth and, moreover, with an increase in size, it is necessary to urgently consult a doctor.
Bleeding. Intense bleeding within 8-10 hours after dental implantation most often indicates bleeding disorders or problems in the cardiovascular system. If these main reasons are excluded, then almost always the blood stops safely. The exceptions are injuries of large vessels during implantation, but such complications are extremely rare and are manifested by severe bleeding, starting from the first day of surgery and more than 5-7 days with the formation of large hematomas.
Temperature rise. Just like after a sinus lift operation, an increase in body temperature even up to 37.5 for 2-3 days is normal. In rare cases, the temperature on the day of implant placement can rise to high values (above 38.5), especially after implantation of more than 6-8 dental implants, but this is not the result of complications or errors made during the operation, and in 90% of cases it is individual body reaction. A serious complication can be suspected if the temperature not only does not decrease within 3-4 days, but also tends to rise slightly, and purulent discharge appears at the implant sites (pus may have an unpleasant odor).
Loss of sensation in the face. Loss of sensation in a part of the face is a rather unpleasant, but not very often observed complication after dental implantation. Usually reduced sensitivity lasts no more than 3-5 days. If during implantation the dentist-surgeon allowed serious damage to the nerve, then its independent recovery sometimes ends only within 4-6 months. Recovery can be accelerated by physiotherapeutic methods of treatment and drug therapy, without surgical intervention.

Sometimes the appearance of an unpleasant putrefactive odor in the area of a recently installed tooth implant makes patients think that a serious problem has arisen - perhaps rejection has occurred, because “something is rotting and decomposing” ...

In this case, it is useful to know a number of quite characteristic signs that really warn of the beginning of implant rejection:

Heavy bleeding for more than 3-4 days;
Increased edema and its persistence for more than 2-3 weeks;
Gradual increase in pain within 2-3 days from the moment of implantation of the teeth;
Feeling of "moving" of a foreign body in the mouth, where the implants were placed.

But as for the appearance of bad breath - everything is not so simple. Such a smell can be caused both by the formation of pus (which may indicate a serious complication), or by the completely natural bacterial degradation of organic matter, sometimes even under the implant plug.

How to prevent negative consequences after the “implantation” of implants?

We note a number of simple rules, following which you can not only significantly reduce the risk of complications after dental implantation, but also in some cases speed up the process of engraftment of implants, making it as comfortable as possible.

Here are the rules:

It should be borne in mind that only a dentist can choose an adequate course of medication for you, based on your individual characteristics and concomitant diseases. Therefore, an independent choice of one or another home treatment method and drug may be fraught with undesirable consequences (for example, some comrades strive to smear their gums with some ointments: Metrogyl Denta, Solcoseryl dental adhesive paste or others, although this is not always desirable).

It's important to know

Until the seams are removed, boiled vegetables, light warm soups and fish dishes (without bones) are ideal meals. But hard, sticky, floury, and especially spicy and hot dishes can contribute to the development of inflammation in the implant area.

Once crowns and bridges have been placed on implants, it is important to take care of them carefully and regularly. Twice a day you need to brush your teeth and once - the interdental spaces. Where the implant is in contact with the gum, it is recommended to clean it from plaque and food debris in the evening with a soft brush for the interdental spaces.

And, of course, the right choice of a dental clinic, taking into account the reviews of patients who have already visited it, helps to avoid complications. In addition to the clinic itself, no less, if not even more attention should be paid to the choice of a specific doctor who will perform the work, because the final result directly depends on his qualifications.

Which implant systems are characterized by the lowest risk of complications?

At the moment, there are more than 300 types of dental implants, which differ from each other in many ways. However, among all this variety, there are no such implants that would be characterized by a zero risk of developing possible complications after their installation.

Meanwhile, there are several really well-established systems that are extremely rarely rejected with the correct and professionally performed implantation technology (and the corresponding statistics confirm this well).

You can choose the most secure implant system based on 5 main selection criteria:

At the moment, dental implants from Sweden, Switzerland and Israel have proven themselves from the best side according to all these 5 criteria. At the same time, more and more cheap analogues of Asian origin have recently appeared from companies that have neither a long history nor sufficient experience in using their products. Behind the low price of dental implantation using such analogues, there may be a high risk of complications, for which some clinics are far from always ready to bear responsibility.

Therefore, in order not to become the hero of the well-known saying “The miser pays twice”, one should take the most responsible approach to choosing a clinic, doctor, implant manufacturer and going through the rehabilitation period after the operation. Then the result of dental implantation will be a really high-quality treatment without any unpleasant complications.

Be healthy!