Dental implants for the entire jaw. What are the features of implantation of the upper and lower jaw? Prosthetic options: delayed, immediate and early prosthesis placement

From this article you will learn:

• rating of dental implants,
• dental implantation methods - types and prices on a turnkey basis (for 2020),
• contraindications for implantation.

Dental implantation is a method of restoring lost teeth, which consists in implanting so-called (implants) into the bone tissue of the jaws, which then serve as a support for subsequent fixed prosthetics with crowns and bridges, or can be used as an additional factor in fixing removable dentures. This method allows you not to grind adjacent teeth for crowns (next to the missing ones), as well as to get a completely fixed prosthesis even on a toothless jaw.

Dental implants (in dentistry, the synonym "implants" is more often used) - in shape they resemble the roots of human teeth. Implants are made from biocompatible materials, for example, high-purity medical titanium, less often ceramics, or an alloy of titanium and zirconium dioxide. But their most important feature, which determines the speed and overall success of the fusion of the implant with the bone, is the characteristics of the surface of the root part of the implants. And usually the cheaper the implant, the simpler the surface it has.

Dental implants in dentistry

As a rule, the clinic can offer you a choice of no more than 2-3 models of implants from different manufacturers. These limitations are due to the fact that the installation of implants from different companies, as a rule, requires excellent equipment, which is expensive. In addition, there are different methods of dental implantation, some of which are safer for the patient, but more time-consuming for the implantologist. The human factor leads to the fact that the patient is not always offered the most optimal option for him.

Below you can find the rating of the most reliable implants, which presents both premium and fairly high-quality economy-class implants. In this article, we will pay special attention to implantation techniques so that you have an understanding of which of them are the most reliable for patients who give a minimum percentage of complications (for example, such as - and / or rejection of implants).

The best implant models: statistics

The statistics of the popularity of implants from different manufacturers among specialists (implant surgeons), as a rule, speaks quite clearly about their quality. We deliberately took the statistics of the popularity of different implant models not in Russia, but in Europe - for one simple reason. The fact is that European statistics are many times larger. For example, in Germany alone, more than 1 million implants are installed in 1 year, which is many times more than in the entire territory of Russia.

In addition, we deliberately focus on the choice of implantologists, because they approach the choice of an implantation system consciously, and it is extremely important for them to receive positive results from their work. Reviews of dental implantation by patients are always more subjective, for the reason that the patient cannot distinguish what caused the unsuccessful implantation - a doctor's mistake or the insufficient quality of the dental implant itself.

Most popular implant models in Europe –

Important : Of the leaders in this rating, NobelBiocare and Straumann implants are the most represented in Russia, and AstraTech are somewhat less common. But as you will see below in the section "Prices for dental implantation in Moscow" - the models of these implants are not budget. When choosing them, the cost of a turnkey tooth implantation will start at least from 70,000 rubles. Implants from Korean and Israeli manufacturers (for example, Osstem, MIS, AlphaBio) are distinguished by a more affordable price, which we will also discuss below.

Reviews for implantation and clinical studies -

Numerous clinical studies show that success in implantation (i.e. the achievement of engraftment of the implant to the bone) is achieved in 95-98% of cases. Moreover, the percentage of successful operations in the lower jaw is higher than in the upper jaw. The latter is due to the fact that the bone tissue of the upper jaw is softer and more porous, and therefore it is more difficult to achieve good primary stability of implants in it. But it is precisely the tight contact between the implant and the bone at the engraftment stage that is one of the most important conditions for the success of the operation.

Thus, rejection occurs only in 2-5% of cases. And most often this happens for two reasons - 1) in patients at risk, for example, heavy smokers, hypertensive patients, patients with chronic diseases, 2) due to errors by the implant surgeon when planning and performing the operation, including violation of asepsis rules, if rules for working with bone tissue and soft tissues of the gums around the implant. True, there is another group of errors associated with errors during prosthetics.

Patient reviews for dental implantation depend to a greater extent on the experience and qualifications of the implant surgeon, however, the second important point is the characteristics of the implant itself (surface, shape, nature of the thread). It should be noted that almost all negative reviews appear after implantation in the aesthetic zone (in the area of ​​the front teeth), and relate to the poor aesthetics of the gums at the site of its attachment to the implant neck. Most often this is due to the fact that within 1 year after prosthetics, bone atrophy occurs around the implant neck, the value of which, depending on the implant model, can be from 0.2 to 3.0 mm.

What does bone atrophy around the implant neck look like?

Firstly, the greater the amount of bone atrophy, the more pronounced the cyanosis of the gums around the implant neck. Secondly, over time, the gum will also sink, exposing the metal neck of the implant, and all this will be visible with a smile. Different models of implants give different amounts of bone atrophy around their neck (which depends on the design of the thread in the implant neck, the characteristics of its surface, and the nature of the distribution of masticatory pressure from the implant to the bone). And when installing an implant in an aesthetic area, as well as in any area with a shortage of bone volume, this is critically important to consider.

In addition, more expensive and high-quality implants require less time for engraftment and earlier prosthetics are possible on them. The quality of osseointegration (engraftment of the implant to the bone) depends primarily on the characteristics of its surface. After all, metal and bone cannot grow together, and in order for the implant to be securely held in the bone, its surface must be microporous (Fig. 5). This allows the bone tissue to grow into the pores, mechanically holding the implant. The surface of the implants is made porous by plasma spraying, sandblasting, anodizing, acid etching, or a combination thereof.

What does the implant surface look like under a microscope?

To improve the speed and quality of implant attachment to the bone, some manufacturers make their surface ultra-hydrophilic, others apply fluorine ions, phosphate or hydroxyapatite crystals to the implant surface, which also allow bone tissue to grow faster into pores on the implant surface. Below we will give examples of the highest quality implants from different price categories, but first of all, it will depend on the choice of the implant manufacturer - how much it costs to implant one tooth on a turnkey basis.

Dental implantation: types and turnkey prices

It should be noted that for dental implantation, the cost of restoring a single missing tooth is now almost comparable to the cost of traditional prosthetics with a metal-ceramic bridge (if inexpensive implant models are used). Below you can find the best implants in the premium segment - with prices in Moscow on a turnkey basis for 2020. The data was collected based on the analysis of price lists for economy class clinics and the average price segment of Moscow.

Rating and prices for premium segment implants -

Prices for implants in the economy segment -

How to choose the right type of implant

When choosing a dental implant, it is especially important to take into account the planned atrophy of the bone around its neck, which will definitely occur within 1 year from the moment the implant is loaded, i.e. since prosthetics. And this is especially important when it comes to front teeth. When implanted in the aesthetic zone (especially with a gingival type of smile), unfortunately only more expensive implants that practically do not give bone atrophy will be optimal - after the implant begins to experience chewing load.

If you would like to shorten the healing period of the implant in order to be able to place a crown on it earlier, then it is advisable for you to choose implants that have an ultra-hydrophilic surface (preferably with phosphorus molecules or fluorine ions deposited on it). The same ultra-hydrophilic implants are recommended for patients at risk groups - smokers, patients with osteoporosis, diabetes mellitus, aged patients, hypertensive patients. You can read more about the choice of implants in the review at the link below.

Dental implantation: types of techniques

There are several classifications of implantation techniques, but the classification that takes into account the timing of implant loading is considered generally accepted (the term “implant loading” means the timing of prosthetics). There are 3 types of load on the implant -

It is best if the plastic crown is made by milling (CAD / CAM technology). This will create an ideal gingival contour around the implant and reduce the risk of peri-implantitis. This technique is used infrequently, because. it requires ideal bone conditions (volume and density) and more expensive implants with an ultra-hydrophilic surface.

Thus, different types of implant loading imply the use of different implantation techniques. From the foregoing, it turns out that there are three such techniques - these are two-stage and one-stage techniques, as well as a one-stage implantation technique. And now we will tell about them in as much detail as possible.

1. Two-stage dental implantation -

This is the most reliable method of implantation, with the least cases of implant rejection. Prosthetics with this technique is usually carried out after 3-4 months, but if bone grafting was performed in parallel, usually after 6 months. The term "two-stage dental implantation" suggests that the surgical intervention will be divided into 2 stages (see photo and video below).

• During the first stage –
  you will be implanted into the bone, the upper part of the implant will be closed with a cap screw, and then the mucous membrane will be tightly sutured over the implant. Thus, engraftment will occur under the mucosa tightly sutured over the implant.
• During the second stage –
  at the end of the engraftment period, you will be prescribed a second minor operation, during which a small hole is simply made in the mucous membrane above the implant, the cap screw is unscrewed and the gum shaper is screwed in instead. The latter is necessary to form a gum contour around the implant before starting prosthetics, and 14 days after that, it will be possible to start prosthetics on the implant.

Clinical Case #1(two-stage technique) -
1) first stage of surgery:

2) second stage of surgical intervention + prosthetics:

Two-stage dental implantation: reviews

We repeat once again - this is the most reliable type of implantation, because. the implant is completely isolated from oral bacteria by a tightly sutured mucosa over it (during the entire period of implant healing to the bone). Accordingly, there is a very low risk of developing peri-implantitis. But the downside is that the patient needs to undergo a second minor surgical intervention, which is still unnecessary discomfort for patients.

When should this method be preferred?

• If late loading of the implant is planned (after 3-6 months).
• : if you smoke, then this is one of the 2 safest implant methods that can be used in smokers (the second is the basal implant method).
• With a high concentration of pathogenic bacteria in the oral cavity: with irregular oral hygiene, with chronic inflammation of the gums, chronic tonsillitis, etc.
• If you are planning a large volume of bone grafting or the use of a barrier membrane for guided bone regeneration.
• If you have thin gums (less than 2 mm thick) and therefore you need to increase the volume of the soft tissues of the gums around the implant, for example, by replanting a mucous flap taken from the palate. With thin gums, this is done so that there is no subsequent gingival recession and exposure of the implant neck.

Two-stage dental implantation: operation video

2. One-stage dental implantation -

One-stage dental implantation (not to be confused with one-stage implantation, in which the operation and prosthetics are carried out in 1 visit) - involves surgical intervention not in 2 stages, but only in 1 stage. It looks like this - after the implant is installed, the mucous membrane above it is NOT sutured tightly, and a gum shaper already screwed into the implant will protrude from under it. The purpose of this is to form a contour of the soft tissues of the gums around the implant - even at the stage of its engraftment to the bone.

Therefore, after the engraftment of the implant is completed, the doctor immediately proceeds to prosthetics, because the gum contour has already been formed. And for this you only need to unscrew the cap sticking out above the mucous membrane. There are only two advantages to a single-stage operation. Firstly, this saves 2 weeks of time, which, with a two-stage operation, is needed to prepare the gums for prosthetics. The second plus is a little more psychological comfort due to the lack of unnecessary surgery.

One-stage dental implantation: a clinical case
1) surgical placement of the implant (together with the gingiva former):

2) prosthetics 4 months after surgery:

One-stage dental implantation: reviews
in general, this is a fairly effective and safe technique, which is especially often used when early loading of the implant is planned (2-6 weeks after surgery), and also if there is no shortage of bone volume in this area. But with this technique, there is always a slightly greater risk of bacterial infection, ie. development of peri-implantitis. This is due to the fact that the zone of osseointegration is not completely isolated from the aggressive bacterial environment of the oral cavity due to the presence of a healing abutment protruding through the mucosa.

Accordingly, this technique is contraindicated in patients with irregular oral hygiene, as well as chronic inflammatory diseases of the gums, tonsils. The second big minus is that it cannot be used in smokers, as well as in patients with a reduced immune status (in particular, with compensated diabetes).

One-stage dental implantation: video

3. Simultaneous dental implantation (immediate) -

This is the fastest dental implantation, which implies immediate loading of the implant. Thus, the crown is fixed on the implant either immediately after the operation or within the first 72 hours. That is why patients often call this method the term "express dental implantation", but the implantologists themselves use the names - "immediate dental implantation" or "immediate loading protocol implantation".

Immediate dental implantation - feedback from implantologists suggests that this method is especially suitable for restoration singly absent anterior teeth. Its advantage is that after the end of the implantation operation, a temporary plastic crown will be immediately fixed on the implant (see photo below). Thus, you will not have an aesthetic defect at all, and you will be able to smile normally throughout the period of implant healing to the bone.

One-time dental implantation: photo
1) first stage: installation of an implant with a temporary crown -

In addition to single missing front teeth, there is another indication for simultaneous implantation in the partial absence of teeth. We are talking about the absence of 3 or more teeth in a row, but in this case only basal-type implants will be used (for example, "Roott Basal" or Roott "Compressive"). Within 72 hours after the operation, a non-removable metal-plastic bridge is fixed on the implants, which can immediately be chewed normally.

By the way, after 1 year, the metal-plastic bridge can be replaced with metal-ceramic or ceramic (but if desired, this temporary bridge can be used for a total of up to 3 years). All of the above methods of implantation were considered by us in relation to the situation of partial absence of teeth. Next, we will talk about which methods are suitable for full implantation of teeth on edentulous jaws.

Full dental implantation in Moscow: prices

There are a large number of methods of implantation in the complete absence of teeth. Let's start with the fact that there is a classic option, when 6-8 implants are placed in your jaw using the two-stage implantation method. The engraftment period will last 4-6 months, during which the patient will wear a temporary removable prosthesis. After the specified period, fixed prosthetics are performed on the implants with a horseshoe-shaped bridge prosthesis.

But there are other methods that allow you to get a fixed prosthesis immediately after surgery. Both basal-type implants (basal implantation technique) and classical ones (All-on-4 or All-on-6 implantation techniques) can be used here. More about them below.

1) Method of basal implantation -

It is characterized by a special shape, as well as a carving of the root part. Unlike classic form implants, they are installed exactly in a deeper dense basal bone, which immediately gives the implants a very high degree of stability in the bone. Not later than 2-3 days after the operation, a non-removable metal-plastic bridge is fixed on the implants. The turnkey cost for 1 jaw with prosthetics (with the installation of 8-10 Roott Basal or Roott Compressive implants) is from 270,000 rubles.

Basal implantation technique: video

2) One-stage implantation according to the "All-on-4" protocol -

Techniques developed by the Swiss company NobelBiocare are used in patients with a complete absence of teeth in the jaw. These protocols mean that within a few hours after the operation you will receive a fixed bridge prosthesis, which will be fixed on 4 or 6 implants, respectively.

Advantages of the method -

• only 4 or 6 implants are required,
• prosthetics already on the day of surgery,
• the prosthesis is completely fixed,
• does not require bone grafting and sinus lifting in case of insufficient bone volume.

The turnkey cost for 1 jaw with prosthetics will be from 370,000 rubles (when using original NobelBiocare implants).

3) Conditionally removable dentures on implants -

This is the most budgetary type of prosthetics on implants. In this case, implants are used not to fix a fixed bridge prosthesis, but to improve the fixation of a removable plastic prosthesis. In this case, it will be a typical acrylic prosthesis with push-button attachments to 2-4 implants on the lower surface. It is possible to remove such a prosthesis only with a special effort. Its turnkey price will be from 110,000 to 130,000 rubles (depending on the number of implants).

Dental implantation: contraindications and complications

Contraindications to dental implantation can be absolute (categorically impossible) and relative (possible, but subject to a number of conditions).

Absolute contraindications –

Relative contraindications –

• with poor oral hygiene,
• in the presence of diseased teeth,
• when smoking
• with pathological bite,
• at ,
• with osteoporosis (this condition is a relative contraindication, because there are implant models designed specifically for bone tissue with reduced density).

Important for smokers: smoking contributes to the development of complications and rejection of implants. However, a reduction in the incidence of complications in smokers can be achieved, among other things, by choosing the right implantation technique. Their preference would be -

• if 1 or several teeth are missing in a row, then a two-stage implantation technique is optimal, in which the implant will heal under the mucous membrane tightly sutured over the implant (within 3-6 months),
• if more than 3 teeth are missing in a row in the lateral parts of the jaws, then the basal implantation technique would be a good option.

Complications after implantation –

The use of modern implantation techniques and high-quality implants has made it possible to increase the success of this method over the past 20 years. On average, the survival rate of implants for 7-10 years is now at the level of 95-98% success. Moreover, the success rates in the lower jaw are higher than in the upper. This is due to the fact that the mandibular bone is denser, which gives good primary stability to the implants immediately after they are placed.

Thus, rejection of implants is usually very rare, and the main reason for patient dissatisfaction is the deterioration of the aesthetics of the fit of the gums to the implant. At the initial stage, it may look like a barely noticeable cyanosis of the gums, which will gradually increase. In the future, gingival recession and exposure of the implant neck may occur (Fig. 16). We hope that our article on the topic: Dental implant types and prices - turned out to be informative for you!

Sources:

1. Add. professional ,
2. Personal experience of a dental surgeon (implantologist),
3. American Academy of Implant Dentistry (AAID),
4. National Library of Medicine (USA),
5. The National Center for Biotechnology Information (USA),
6. "Dental implantology: surgical aspects" (Michael S. Block),
7. https://www.realself.com/.

Implantation of the upper and lower teeth is the most modern method of dental prosthetics, during which lost teeth are replaced with artificial ones. The operation is carried out quickly and safely. Implants serve as a base that supports crowns and various prostheses, both removable and non-removable.

Testimony for the installation of implants are:

1. Single defect in the dentition.
2. Loss of 2-4 teeth in a row.
3. Absence of chewing teeth.
4. Complete edentulous.

Implantation of teeth in the upper jaw is more difficult than in the lower jaw, since they are subject to high aesthetic requirements. In addition, the maxillary bone is softer, requiring the surgeon to use longer implants. They can be installed in several ways:

• in areas near the maxillary sinus;
• in augmented bone tissue;
• in the jaw with increased height by reducing the volume of the sinuses (sinus lift).

Implantation of the teeth of the lower jaw is preceded by an assessment of the location of the lower part of the trigeminal nerve. To implant prostheses, bypassing the nerve, computed tomography is used.

Implantation in the lower jaw involves determining the location of the trigeminal nerve.

There are 2 main ways of carrying out the operation. The method of installation in the anterior region is used in the absence of all teeth. In the future, it is possible to install conditionally removable ones. In other cases, an increase in the height of the lower jaw is carried out using the technique of bone tissue restoration.

Dental implant cost

Implantation of the upper and lower jaw is not cheap. The price for the installation of one prosthesis, excluding the cost of the material, starts from 333 $ . The final cost is formed based on the specific method of implantation of the implant.

How is implantation performed?

Expert opinion. Dentist Govorukhin R.L.: “At the moment, there are 2 methods of jaw implantation: one-stage and two-stage. carried out as quickly as possible and is considered the most effective. After the tooth is removed from its root, dimensions are taken with a laser, then an implant is made and implanted. The whole procedure lasts no more than 1 day.

When the implant is first installed, and then it is given time to take root. This may take 2 or more months. Finally, an abutment is placed and prosthetics are performed.

Advantages of the method

Implantation of the lower and upper teeth has an impressive list of advantages in comparison with other methods of prosthetics. The main advantages of this operation are:

1. Eliminate the risk of injury to healthy teeth.
2. Non-allergic.
3. Reliable fixation of prostheses.
4. In appearance, teeth on implants are identical to real ones.

Modern implants allow you to fix the prosthesis without a gum mask made of plastic. This is especially important for allergy sufferers. In addition, an important advantage of implantation is that this method can restore any number of lost teeth, even if they are completely absent.

Complications

Complications after implantation in the upper jaw are more common than in the restoration of the lower jaw, but in general, complications after this operation appear very rarely. Currently, the technology of implantation of implants is clearly developed, and problems usually arise due to insufficient qualifications of the dentist. The most common causes of complications after dental implantation are the failure to identify contraindications and non-compliance by the specialist with the technology of the operation.

When exposed to any of these factors, the following may develop: complications:

Pain always appears when the anesthesia is removed. Normally, it lasts 2-3 days, analgesics are used to alleviate the condition. If the pain syndrome persists longer, this may be a signal that a nerve has been affected or inflammation has begun. Puffiness is a normal reaction of the body after tissue damage. It persists for a week after the operation, if longer, inflammation may have begun. In order to relieve swelling, it is recommended to apply ice to the operated area.

In the first days after surgery, light bleeding is often observed, which is associated with taking drugs that reduce blood clotting. If the symptom persists for 10 days or longer, it often indicates vascular injury. Subsequently, hematomas develop, which are accompanied by purulent processes and divergence of sutures.

Fever is another normal reaction of the body to surgery, but if it persists for more than 3 days, the inflammatory process is most likely started. Numbness persists up to 5 hours after surgery and is a side effect of anesthesia. If it does not go away after this period of time, the nerve may have been injured.

Exposure and rejection of the implant are serious complications of the operation. The reasons for rejection are hemorrhages, inflammation of adjacent teeth, poor-quality crown and non-observance of personal hygiene by the patient. Rejection occurs in rare cases, it is provoked by a lack of bone tissue, trauma during surgery, an allergy to titanium, smoking, and exacerbation of chronic diseases.

To date, there are various technologies for implantation in the complete absence of teeth, which are used depending on the clinical picture and financial capabilities of the patient. What are the features of these methods? How to choose the optimal technology? How much does a full dental implantation cost in Moscow at NovaDent dental clinics?

Full implantation with adentia - the best method of restoring teeth

You can restore chewing function with complete adentia using:

• removable acrylic or clasp prostheses, fixed on the gums and on the upper palate by vacuum or with a special corrector cream;
• conditionally removable or non-removable prostheses based on dental implants.

Removable dentures are relatively inexpensive, but they create a lot of inconvenience, ranging from the mobility of the prosthesis during chewing and ending with increased sensitivity and an aggravated feeling of nausea.

Prosthetics of all teeth on implants completely solves these problems. Moreover, implantation improves the quality of life of the patient, because:

• prevents further atrophy of bone tissue;
• improves chewing function, protecting against diseases of the stomach and duodenum;
• restores the aesthetics of a smile;
• provides reliable fixation of prostheses;
• returns a sense of naturalness and makes you forget about these problems for decades.

In the absence of contraindications, such as diabetes mellitus, tuberculosis, oncology and hemophilia, implantation is the best way to restore teeth with complete edentulous upper and lower jaws.

Prices for implantation in the complete absence of teeth

Included in cost:

• Diagnostics (initial consultation);
• 3D modeling of implantation;
• Implant surgery (tooth extraction, installation of 4 or 6 root-shaped implants);
• Anesthesia;
• Removal of casts and production of a temporary fixed prosthesis from metal-plastic;

X-ray examination - paid separately.

Attention: at the NovaDent clinic you can pay for dental implantation on credit and for complex treatment in installments.

Technologies and stages

Implantation in adentia does not imply the installation of a separate implant for each defect in the dentition, as this is expensive and not always possible. Depending on the situation, from 4 to 10 implants are placed on one jaw, on which a bridge prosthesis of a conditionally removable or fixed type is then fixed.

In our dental center, implantation in the complete absence of teeth is carried out in several stages:

1. Diagnostics- includes examination, questioning of the patient, computed tomography of the jaw and referral for a blood test (clotting factors, allergic tests for plastics and metal). The purpose of the medical examination is to determine the condition of the bone tissue, the anatomical features of the jaw system, and contraindications for implantation.
2. Planning– is carried out using 3D modeling, which allows you to select the optimal parameters of implants, determine the angle of inclination and their positioning in the jawbone.
3. Operation– Implants are screwed into the bone in one visit to the dentist. Whenever possible, titanium rods are implanted in a gentle method through punctures in the gums.
4. Prosthetics- on the day of the operation or after the removal of the sutures on the gum (after 7 days), temporary bridges made of durable plastic are fixed on the abutments. After 1-3 years, the temporary prosthesis is replaced with a durable ceramic-metal, ceramic or zirconium structure.

Implantation of implants and fixation of new prostheses lasts from 2 to 7 days, after which the patient enjoys a healthy smile and can chew food normally.

Recently, implantology has been moving away from classical approaches in favor of innovative prosthetic technologies on a smaller number of supports. The most popular methods are All-on-4 and All-on-6.

Prosthetics on 4 implants using All-on-4 technology

All-on-4 technology (all-on-four) is the most economical method of implant placement, developed and patented by the Swiss company Nobel Biocare. The technique concludes that 4 root-shaped implants are implanted into the jaw with a simultaneous load. Titanium rods are installed according to the following scheme:

• 2 implants - in the frontal part of the jaw parallel to the patient's natural teeth;
• 2 implants - in the region of 5-6 premolars at an angle of 30-45°.

Thanks to this arrangement of artificial roots, full jaw implantation provides high primary stabilization of the prosthesis and does not require bone augmentation surgery. These factors allow you to immediately proceed to prosthetics.

In the NovaDent center, 4-on-all jaw implantation is performed with dental implants: Nobel, Astra Tech, Osstem, Dentium, Mis, Ankylos.

Prosthetics on 6 implants using All-on-6 technology

All-on-6 technology (all-on-six) is another Nobel Biocare development, which consists in the installation of 6 implantable supports in the jaw with an instant load. The rods are implanted in the same way as in the case of All-on-4.

The lower jaw, as you know, is the only mobile area on the face, thanks to which we are able to communicate, talk, eat and perform any active actions associated with opening the mouth. It is very strong, the bone here is unusually dense, strong and wear-resistant. But the work of the mandibular joint cannot be called fully complete if there are completely or partially missing teeth. After all, their loss directly affects the health, functionality of the alimentary tract and articulation of the speech apparatus, attractiveness, and even external changes in the appearance of a person's face.

In order to prevent negative consequences and continue to live a familiar life, you need to think in time about the qualitative restoration of lost units. And one of the best ways will be the implantation of the lower teeth, the features of which we propose to talk about in the material presented below.

Implantation of the lower and upper teeth: fundamental differences

As practice shows, the implantation of the teeth of the lower jaw is much more successful than the lower one, the implants from below fuse faster with the bone tissue, they have an initially more stable position. And everything is explained quite simply:

• the mandibular bone is denser and more voluminous than the maxillary one: this is due to anatomical features and predestination - the teeth from below take on all the main burden of chewing food, while the top ones serve more for the aesthetics of a smile. It is not so easy to lose the lower teeth, they are rarely injured, their root system is firmly held in the bone tissue, the same principle then works during implantation - in some cases, a minimum number of implants is enough to fix the prosthesis, if we are talking about a complete adentia of the jaw. And at the same time, much fewer restrictions on nutrition and diet are imposed during the rehabilitation period than after the restoration of the upper,

On a note! The longer a person delays with the restoration of lost teeth, the more the bone sags and dissolves from above, while from below it is able to maintain its good quality and volume longer. Accordingly, in the future, during implantation, the patient is more likely to do without bone augmentation procedures, but it all depends on the chosen treatment protocol, of which quite a lot has been provided today.

• there are no nasal (maxillary) sinuses from below: there is always a risk of injuring these cavities. However, do not forget that the lower one also has its own characteristics - a rather massive trigeminal nerve passes here, which, with insufficient preparation for treatment or the doctor's incompetence, can also be affected, which will lead to complications after the implantation of the lower teeth. In particular, we are talking about trigeminal nerve paresis, the patient may experience prolonged numbness and severe swelling after implanting a tooth in the lower jaw.

Classical technology or two stages of treatment

Implantation of the anterior lower teeth, especially when they are missing in a minimum number (from 1 to 4), is best carried out according to the standard classical two-stage canons of treatment: it assumes the presence of the necessary volume of bone tissue in the area of ​​​​installation of artificial roots or its growth in case of lack. Please note that bone blocks are transplanted from below, but in most cases it is used from above, which is never carried out on the lower jaw during implantation. After all, this operation involves the displacement of the sinuses or maxillary sinuses.

Important! If, with a two-stage restoration of the front tooth in the lower jaw, you are shown a bone augmentation operation, then keep in mind that after that you will have to wait up to 6 months before you can proceed directly to the procedure for installing implants. The same feature also applies to the case when there are destroyed teeth in the mouth: if there are indications for their removal, classical implantation should be postponed until the holes heal. However, if you take care of the issue in advance, it will be possible to place the implant immediately in the hole - there really is such an opportunity today.

Despite the fact that when restoring lower teeth, it is not necessary to achieve the highest aesthetics, as in the upper frontal zone of a smile, professional doctors also strive for a high-quality result - with a classic approach, beauty will be at the highest level, from the teeth to the mucosa. It will be very tight around the crown and look very natural.

But it is worth emphasizing that the most unpleasant feature of the classical approach is that you will not be able to immediately use new teeth in the work, namely, chew them, which is why the method is called “two-stage”. After the implants are installed, they cannot be loaded with a prosthesis until the surrounding tissues are completely engrafted. On average, this period is 3 months, but in the lower jaw, osseointegration is faster, especially if high-quality brands such as or were chosen as artificial root analogues.

An innovative approach in dentistry or how to start chewing right away

Implantation with complete adentia (when there is a history of a mouth without teeth), in the absence of a large number of chewing and front teeth in the lower jaw, should provide a person with maximum comfort at a minimum cost of time and money. Agree that new teeth in the lower jaw, like the lost ones, should be as functional as possible, suitable for nutrition, for grinding food, their main purpose is to perform active chewing movements. They should also be ready for stress not a year after going to the doctor, but immediately, otherwise how can one even talk about a full-fledged lifestyle.

Fortunately, patients today have such an opportunity - this is a prosthesis, which, by the way, in 90% of all cases makes it possible to do without building up bone tissue at all, even with its poor quality, inflammation or insufficient volume. There is not one method, there are several of them - as they say, for every taste, color, situation and wallet. In general, they differ in the number of supports or implants installed under the prosthesis - the quantity, brand and method are determined by the specialist based on the assessment of the quality of the bone tissue. This is done using computed tomography of the jaw, with 3D modeling of the treatment process - the smaller the bone, the worse its quality, the more implants are required for a successful result.

1. Trefoil or three-implant prosthetics

The technology is presented by Nobel and involves the use of original implants of the Trefoil series, designed specifically for this complex. This is a separate technique that was developed and positioned specifically for the restoration of teeth in the lower jaw. The protocol takes into account the structural features of the mandibular joint, allows the patient to save money and acquire the entire row at once. It uses only three implants and a prosthesis that restores up to 12 units. Artificial roots are installed only in the frontal section, because, as studies have shown, it atrophies the least in this area.

2. Solve the problem with four implants

Two of them are installed in the region of the chewing lower teeth at an angle, two in the frontal zone parallel to each other. The angular location of the lateral roots makes it possible to use a vast area of ​​bone tissue, use only the most dense and non-inflammable layers, avoid bone grafting, and increase the strength of implant attachment to the bone.

Here, patients have several options to choose from, whether it's the Nobel all-on-4 concept or the Straumann Pro Arch. These are the only protocols that have really proven themselves for the restoration of all teeth on exactly this number of implants. By the way, manufacturers do not limit the choice and often offer doctors to add 1-2 more implants, for example, in the frontal zone, if this is necessary and the system will function better.

Also, under the auspices of "prosthetics on four", you can be offered other models, for example, Osstem or Alpha Bio. They are a great way to save money, but be careful, because. the manufacturer does not have such an impressive research base compared to the original developers of the concept. Remember that the miser pays twice!

3. Solution on six implants

This is another protocol - a separate one. In fact, based on the previous one using four implants. The name itself is a registered trademark - the doctors of this particular dentist own the development of the all-on-6 protocol.

The technique is quite universal, because it allows you to restore teeth not only on the lower jaw, but also on the upper one. As the name implies, the number of implants is increased, so this solution is suitable for situations where bone atrophy is more pronounced.

4. Solution for Vivid Bone Atrophy

Here we are talking about increasing the number of implants, because the smaller the bone, the better the support for the implants should be. This applies to any jaw. Therefore, we are talking about a minimum of 8, a maximum of 14 implants. Such a protocol is called Prosthesis, as in any other cases, it is placed immediately. But it is held with the help of cement fastening - it is more reliable. There are many implants, so the prosthesis is fastened with high quality, it is not necessary to relocate it (in other situations, screw fixation is used).

ALL-ON-4® implantation on Nobel implants 6 months after treatment

“Before deciding on a complex lower implantation, I collected information for a long time. I went through a consultation in three clinics, found out the cost, asked about possible methods of treatment in my case. The minimum price was 250 thousand rubles for the immediate installation of the prosthesis and the maximum for a two-stage installation - 560 thousand rubles. As a result, I chose dentistry, where contact and understanding arose with the doctor immediately, where he did not fight off my numerous, meticulous and annoying questions, but gave detailed answers. Well, they treated me with the help of four implants, which turned out to be quite profitable for the price. By the way, they also gave us a payment plan. But in fact, I got a result that justified all the expenses, now I seem to be 7 years younger and I can even chew what was not always possible in my youth, since I always had bad teeth.

Elena Konstantinovna, a fragment from a review on the Stomatology.rf portal

5. Solution for those with periodontitis

The basal protocol is also worth considering for patients with pronounced problems, in addition, of course, adentia: acute lack of jawbone, periodontitis and periodontal disease, osteomyelitis. The method is also indicated for smokers and elderly patients. All this is explained by the fact that the implants have a smooth surface, so even when in contact with the gums, plaque does not accumulate on them. In addition, the coating is antibacterial, which helps to stop the inflammatory process.

What are the advantages of Immediate Load Implantation?

So, do not forget about the main advantages of one-stage implantation methods with immediate loading of a prosthesis for restoration of teeth in the lower jaw:

• the patient receives the result in a matter of days, and sometimes even hours: the prosthesis is fixed in the first three days after the installation of titanium roots,
• you can chew food right away: you don’t need to be afraid of this, the main thing is to follow the doctor’s instructions. This is very important, because it is chewing that actively grows the bone around the implant body - osseointegration of titanium screws is many times faster,
• the prosthesis that will be installed for you will contain a metal frame that connects the implants together. It will firmly hold them in place, provide the necessary rigidity of the entire structure, and due to an adequate load on the roots, it will also contribute to the activation of metabolic processes in the bone. Show a little patience, start with soft foods in the first days of rehabilitation and in a month you will be able to eat your favorite dishes and chew meat.

Naturally, your diction will also be restored, the oval of the face will straighten out, fine wrinkles will be smoothed out. Well, and most importantly: no headaches against the background of the absence of teeth and excellent work of the digestive organs. You can really start to smile, forget that you need to treat your teeth and constantly visit the dentist.

What are the alternatives if implantation is not suitable for you?

Naturally, many patients tend to first evaluate all the possible risks that may arise during the implantation of the lower teeth. Many are afraid of possible complications. For example, such as loss of implants or divergence of sutures, peri-implantitis, rejection of artificial structures and accompanying acute pain, temperature, moral and physical discomfort, additional expenses.

Important! To avoid difficulties, carefully approach the choice of a specialist, because a successful result depends on him by 90%. Pay due attention to the equipment of the clinic and preparatory measures, as well as the rehabilitation period: the doctor is required to work out the treatment process and a thorough analysis of the clinical picture, the patient is required to take blood tests, visit highly specialized specialists, if there are indications for this, follow the instructions of doctors.

It is against the background of apparent difficulties that some people prefer to restore teeth in the lower jaw with removable dentures or bridge structures. It's cheap, fast, safe, and really a kind of alternative to implantation. However, after all, implantation is not suitable for everyone - there are certain indications based on the state of health, when at the moment (for a while or forever) it is still better to refuse such an approach.

But if for personal reasons you do not want implantation, remember that after installing removable dentures, the mandibular joint will have a large load, as a result of which the structures will quickly begin to wear out and become loose, the abutment teeth will collapse, the bone tissue under the dentures will continue to atrophy, and constant discomfort will begin to torment and rubbing of the mucosa, under the prosthesis, particles and food debris will easily begin to clog. Already after 2-3 years, it will be easier to get rid of such prostheses and install new ones, rather than correct them and fix them with adhesives. And this again will entail new expenses and inconveniences, which, if you have chosen implantation, will never happen to you.

So, you want to start eating well and looking good? It's time to choose a clinic that will solve your problem qualitatively and for many years.

Related videos

Implantation of the upper teeth requires high qualification and professionalism of the dentist. This is due to the anatomical features of the upper jaw, increased requirements for the aesthetics of artificial teeth in the smile zone. Therefore, to avoid serious complications and gain a confident smile, trust implantation to professionals.

NovaDent Dental Center offers effective restoration of upper jaw teeth at a price of 17,990 rubles. Read how dental implantation of the upper chewing, front teeth is carried out? What methods are used, what is the price of implantation of the entire jaw in the NovaDent clinic?

Service price

* Metal ceramics. The cost of installing an implant "turnkey" -.

Features of implants in the upper jaw

The implantation of the upper teeth is considered one of the most difficult tasks of restorative dentistry. When replacing losses in this part of the jaw system, the dental surgeon must take into account many factors.

Difficulty number 1: The condition of the bone tissue.

The roots of the chewing teeth of the upper jaw are located very close to the maxillary sinuses. Since the density of the tubular bone of this jaw is lower than that of the lower one, the absence of roots in this area provokes intensive destruction of the bone tissue up to the complete loss of the original volume.

As a result of bone deficiency, it becomes impossible to install a dental implant without additional manipulations, as the risk of damage or perforation of the maxillary sinus increases.

Solution: Before implantation, we conduct a thorough diagnosis of the condition of the patient's jaw system. Diagnosis includes orthopantomogram, computed tomography of the jaw. Based on the data of a three-dimensional examination, the implantologist assesses the degree of bone tissue atrophy, the location of the infraorbital and facial nerves, and develops an optimal treatment strategy.

With insufficient volume of the tubular bone, a sinus lift is performed - an analogue of bone grafting. During the operation, the volume of the maxillary sinus is reduced, its bottom is corrected, and the resulting space is filled with a synthetic bone filler.