Dental crowns on implants are an excellent method of eliminating tooth loss. How is implantation performed? How to place a dental implant after extraction

29.09.17 Korostelev Egor Dmitrievich Source: Clinic "Don't Hurt!"

Very often, patients ask this question: "Which crowns to do if they are located next to each other, interconnected or separate?"

Based on my more than 20 years of experience, I can say with confidence: it is better to make a combined common prosthesis for two teeth.

Although it is logical to assume that the crowns need to be made separate. After all, by nature, a person’s teeth are not connected together, but each is independent of neighboring teeth.

Why do we often recommend installing double crowns together rather than separately?

The nature of the functioning of the teeth of natural teeth

Let's take a look at what happens to teeth over the course of a lifetime. Each tooth has a life of its own. The teeth are not rigidly fixed in the jaw, but have a small, normally microscopic, physiological mobility, which compensates (absorbs) the load during chewing.

Also, when chewing, in addition to the pressure load of the teeth on each other, there is a natural abrasion of the teeth by antagonists, that is, teeth upper jaw rubbed against the teeth mandible.
Due to physiological mobility, the teeth can move slightly from their original position on the jaw, and, as it were, adjust to each other for perfect closure when chewing. After all, they were a little worn out, and the relief of their chewing surface became different, and if they were motionless and remained in the same position as before erasing, the contacts between the upper and lower teeth would be much worse, and the food would be worse rubbed by them.

In addition to the teeth of antagonists, the tooth interacts with neighboring teeth. The contact of a tooth with adjacent teeth, also called the "contact point between the teeth", has a very complex shape. After such a shift, it is not disturbed, a gap between the teeth is not formed, and food does not get stuck between the teeth. And this is the most important point to which you need to pay attention.

Features of the functioning of teeth with crowns

What happens to a tooth after an artificial crown is placed on it? The material from which the crown is made is harder than a natural tooth. The crown is practically not subject to abrasion during chewing.
And their teeth without crowns continue to wear out. And the adjustment of the teeth for ideal occlusion with the help of a shift continues. In a tooth with a crown, this shift is due to the lack of physiological process abrasion, slightly more than that of a natural tooth. And since, no matter how hard the dentist with the dental technician, even using all modern technologies, it is impossible to reproduce the shape of the contact point on an artificial crown, as on a natural tooth with 100% accuracy, then due to the shift of the tooth with the crown, a gap will form between adjacent teeth.

The development of a gap between the crowns, solidification of food, bleeding, bad breath with two separate crowns side by side

If there is a tooth without a crown next to the crown, this process will be slow and possibly not disturbing the person, because one of the teeth has a natural, “correct” contact point. But if next to the same artificial crown, then the resulting gap can become a problem. At first, not big: sometimes food gets stuck, because of this it hurts a little and the gum bleeds a little. Then the problem grows, food gets stuck constantly, after eating, the gums and teeth ache, bleed from the slightest touch, it is more and more difficult to clean this place, a pathological periodontal pocket is formed. This place hurts almost constantly, there is a smell from the mouth. All this is aggravated by the fact that the materials from which the crowns are made are smoother than a natural tooth, and food slips between them more easily. And as time goes by, these symptoms get worse and worse. All in all, sheer pain.

The only way to get rid of this problem is to remake the crowns. But to avoid this, it is enough to initially make crowns connected together.

The situation described above may or may not occur. It is possible that you will be lucky and you will not have such a problem. Many people walk around with split crowns and don't have this problem. But in my practice, I have come across such complaints very, very often from patients, and I had to redo several crowns at a time.

Common arguments against double crowns and our responses to them

1. If something happens to one of the teeth, and it needs to be treated or removed, all connected crowns will have to be removed

If it is necessary to treat one of the teeth under the crowns, then this can also be done through the crown by drilling a small hole in it, and then closing it with filling material. This is a completely acceptable technique and if everything is done correctly, such a crown will last for many years.

If one of the teeth under the crowns needs to be removed, then it can simply be sawn off from the rest of the crowns and removed. But even if such a tooth were not connected to neighboring crowns, then most often standing crowns would need to be redone. After removal, the gum sags heavily, and the edges of the crowns near the removed place no longer go under the gum, and the tightness of the teeth under the crowns is broken. And because of this, such a tooth can begin to deteriorate and gradually collapse.

2. With a double crown, it is impossible to clean between the teeth with floss (thread)

There is no need to floss the junction of the crowns, because nothing gets stuck there.

3. Jointed crowns look unnatural

If the crowns are made by a competent doctor and dental technician, then the connected crowns will look like free-standing ones.

Conclusion

The problem of choosing between two crowns side by side and a double crown is very complex and requires individual approach. Dental system human complex mechanism in which all elements are interconnected. Therefore, a solution that is suitable for one person is absolutely not acceptable for another.

Based on many years of experience, we tried to substantiate the advantages that the option of treating two patients side by side provides. standing teeth by installing a single double crown.
If after reading this note you have any questions, I will be happy to answer them.

The absence of two teeth in a row is a common defect in dental practice. Dental implantation solves this problem by fully restoring the functionality and beauty of lost teeth.

When is multi-tooth implantation indicated?

• The last 2 or 3 teeth in the row are missing.
  In case of end defects of the dentition, install bridge prosthesis impossible due to lack of support on one side. The problem is solved with two implants with crowns or one implant and a bridge.
• 2 teeth are missing in the front of the jaw.
  Implants with ceramic or zirconium crowns completely restore the aesthetics of a smile, as they practically do not differ from natural front teeth.
• Multiple defect is located between healthy teeth.
  Implantation allows you to save adjacent healthy teeth - they do not need to be ground and depulpated as when installing a classic prosthesis.
• Teeth removed recently.
  Implantation prevents irreversible atrophy bone tissue and jaw deformity.

Implant options

Problem: missing two teeth.

Solution: 2 implants with independent crowns or a bridge made of zirconium dioxide or metal-ceramic are installed. In the same way, the problem of end defects of the dentition is eliminated.

Problem: more than two teeth are missing.

Solution: The number of implants is determined individually. To save money, you can install two pins and fix a bridge prosthesis with the required number of crowns on them.

Why not delay implantation?

The longer teeth are missing, the more intense the process of bone resorption, which means the lower the chances of successful implantation in future. This problem is especially relevant in the upper jaw, where the tubular bone atrophies faster than in the lower.

Another bad moment due to the fact that the remaining teeth are gradually shifted towards the formed space. Because of this, the bite worsens, the gaps between the teeth increase, and the natural oval of the face is disturbed.

How is the implantation of two teeth in NovaDent dentistry

In 90% of cases, we install implants according to the classical two-stage technique. This technology, known as delayed loading implantation, is mainly used for the restoration of posterior teeth.

The essence of the method: At the first stage, an operation is performed to implant the titanium rod into the bone. At the second stage, usually 2-5 months after the first operation, the prosthesis of the pin is carried out with crowns on ceramics and zirconium dioxide.

When restoring teeth in the smile zone, a different method is used - one-stage implantation with immediate prosthetics. In some cases, the immediate loading of implants with crowns is also prescribed to restore the lost units of the masticatory group.

The essence of the method: Temporary acrylic crowns are placed on the implant immediately after the operation. Thanks to this, the patient enjoys a confident smile in just a few days.

At the NovaDent clinic initial consultation and preparation of a treatment plan are free of charge.

Prices

The cost of implantation of several teeth depends on the type of implant system and the number of additional manipulations.

The price does not include: installation of gum formers, anesthesia, temporary and permanent crowns.

When is implantation not possible?

• With insufficient volume of bone tissue, especially in the area maxillary sinus;
• Diabetes in the stage of decompensation;
• Blood diseases and oncology;
• Immunodeficiency states;
• Diseases of the joints and bones.

If the contraindications described above are found, the elimination of a multiple defect in the dentition is carried out using clasp or lamellar prostheses.

In case of insufficient volume of bone tissue, it is preliminarily performed bone grafting or sinus lift surgery.

You can get acquainted with examples of the work of our implantologists.

The service life of implants is determined by:

• the quality of the doctor's work,
• individual characteristics of the body,
• the price of a dental implant,
• caring for artificial teeth.

According to statistics, rejection occurs in less than 10% of patients. The most common cause of this problem is ignoring medical recommendations.
The manufacturer guarantees the implants. Usually it varies from 10 to 20 years, but can be lifelong. If high-quality implants are bought in Moscow, you can be sure that they will last more than 25 years.

Implant technology

The presence of modern computer technologies greatly facilitates the work of implantologists. One of the latest technical innovations is the Nobel Guide, a program developed by the world's leading manufacturer of implants.

Oral preparation

In dentistry "Doctor Lopatin" the implantation procedure is always preceded by a preparatory stage. It includes:

• Assessment of the state of bone tissue and teeth (tomography, radiography).
• preparation oral cavity to surgical treatment (elimination of caries, periodontitis, periodontal disease, periodontitis), orthopedic preparation (if previously installed prostheses need to replace).
• Explanation of the rules for caring for implants (if the patient does not want to comply with them, it is not advisable to carry out implantation on a turnkey basis - it is better to give preference to removable dentures).

In the course of preparation, the implantologist examines the mucous membrane of the oral cavity, clarifies its mobility and thickness, examines the features of the jaw, bite. The choice of design of the installed dental implant depends on the width and height of the bone tissue, the nature of the defect.

anesthesia

Anesthesia is one of the most important aspects of dental implantation. If painkillers are contraindicated for the patient, it will not be possible to implant the implant into the bone tissue. There are the following types of anesthesia to relieve patients of pain and discomfort:

• Local anesthesia. The most common method of anesthesia used the best dentistry Moscow. Makes insensitive only the area in which the main work is carried out. At the same time, the patient is conscious and can respond to the requests and questions of the implantologist. Local anesthesia is: - Application (superficial). The treatment area is sprayed with lidocaine. - Infiltration (deep freezing). — Provodnikova (the best solution if bone tissue surgery is planned). The medicine is injected into the nerves surrounding the affected tooth.

- Stem (the strongest). The drug is injected into the base of the skull and affects ternary nerve, does nerve endings jaw completely insensitive.

• General anesthesia. It is not recommended during implantation, as it has a pronounced negative impact on the patient's body, and therefore is not used by doctors of dentistry "Doctor Lopatin".
• Combined method. Provides a combination of any of the above methods of local anesthesia with sedative. Helps the patient to calm down and not be nervous during the implantation, makes it possible to refuse from general anesthesia.

Complications after implantation

Doctor Lopatin dentistry specialists perform dental implantation at the highest level and at affordable prices, so their clients do not have to worry about serious side effects and complications. After the treatment is possible:

• Pain in the area of ​​the implant.
• Edema, the development of the inflammatory process.
• Increase in body temperature.
• Local hemorrhages.

If the patient follows the doctor's instructions exactly, all these side effects pass very quickly. Important immediately after surgery:

• apply cold to the jaw,
• for a week to abandon intense physical activity,
• try to stop sneezing and coughing,
• do not overheat and do not overcool,
• gently flush out
• do not puff out your cheeks.

In the first two weeks after dental implantation, it is advisable to forget about smoking and drinking alcohol.

Sensations of the patient during implantation

In the dental clinic "Doctor Lopatin" dental implantation is carried out qualitatively and inexpensively. According to patient reviews, there is no significant discomfort when an artificial root is placed in the gum.
Anesthesia helps clients of the center to avoid pain. Unpleasant sensations occur only at the time of administration of the anesthetic drug, but they are minimal.

Implant Care

Despite the fact that dental implants are made of high quality artificial materials, they require the same meticulous care as natural teeth. Therefore, those who have undergone a turnkey implantation procedure in Moscow should remember the following rules:

• Brush your teeth twice a day with a medium-hard brush.
• To clean hard-to-reach places, use an irrigator.
• Rinse your mouth with antiseptic solutions during the engraftment period.
• Clean interdental spaces regularly with dental floss.
• Once a year, do professional teeth cleaning, remove tartar.

Implantation - pros and cons

If you study the reviews of patients of dentistry "Dr. Lopatin", it becomes clear that you should not be afraid of dental implantation. This procedure allows:

• replace decayed teeth and avoid gum atrophy,
• avoid injury to adjacent healthy teeth,
• solve the problem of missing teeth for at least the next 25 years.

The disadvantages of implantation are:

• a large list of contraindications,
• high cost(the fact is that it is not entirely reasonable to put the cheapest implants in Moscow - they are likely to be of poor quality).

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Implantation in case of loss of several neighboring teeth

When two or even more neighboring teeth are missing in the mouth, this is more than serious reason take care of their restoration. the main task treatment - to return the function and appearance lost teeth. Most often artificial teeth are part of a bridge that rests on healthy, turned teeth. If there are few natural teeth left and they cannot cope with additional load, make removable dentures: plate or clasp. The options described are traditional methods prosthetics and have certain disadvantages compared to more modern method manufacturing prostheses on implants. Therefore, dentists consider implantation as the most appropriate method of treatment.

What is wrong with classical methods of prosthetics?

An alternative to implantation to close a defect in the dentition can be considered the manufacture of a bridge. The bridge consists of crowns along the edges and an intermediate part - artificial teeth. Before installing a bridge, healthy teeth that are covered with crowns must be significantly grinded and depulped, that is, the nerve must be removed from them. All chewing pressure is transferred to the supporting teeth, which also accelerates their wear. At the same time, with an increase in the number of extracted teeth, the number of necessary supports increases.

Removable prosthetics although it restores lost teeth, it is no different high efficiency and comfort for patients.

Another important disadvantage classical prosthetics in the fact that the physiological chewing pressure disappears in the area of ​​the extracted teeth, and this leads to pathological changes in the bone tissue and its irreversible atrophy. Over time, the “shrinkage” of the jaw occurs, the gap between the artificial teeth of the prosthesis and the gum increases, and removable dentures cease to be fixed.

Methods of implantation of several missing teeth

The choice of implantation method largely depends on the number of missing teeth. So, if 2 adjacent teeth are removed, it is necessary to install two implants in their places and crowns on them. And in the absence of three teeth, options are possible: three implants with crowns or two implants and a bridge prosthesis on them.

In the absence of several anterior teeth, preference is given to the classic two-stage implantation, which will perfectly restore the appearance of the anterior teeth and the contours of the gums. The load in this case is delayed, it is possible only after the implants are fully engrafted - this means that for some time before the manufacture of permanent prostheses, the patient uses a temporary structure.

For implantation of several teeth in a row, one-stage implantation with immediate loading is also suitable, which will restore the dentition in less than one week. However, it should be noted that with such fast method the emphasis remains on the restoration of chewing pressure and the functionality of the teeth, while the aesthetic side is relegated to the background.

In any case, it will be possible to choose the appropriate implantation option, taking into account individual characteristics and the state of the oral cavity, only after consultation and examination by a specialist.

Advantages of multi-tooth implantation

Healthy adjacent teeth- they remain unaffected, they do not need to be drilled and depulped. In addition, the masticatory load remains the same, artificial teeth of the bridge are not hung on them.

Excellent appearance - dentures on implants completely restore the aesthetics of natural teeth.

Prevention of shrinkage of bone tissue - implants provide a physiological transfer of pressure on the bone in the same way as the roots of the teeth, which prevents its atrophy.

Durability and reliability - due to the special strength of the titanium base, the implants themselves serve for 20-30 years. Durable cermets and zirconium dioxide are also intended for implant-based prostheses. If it is necessary to remove and replace the prosthesis, the implants remain firmly fixed in the bone and are suitable for supporting new prostheses.

Taking into account the described advantages, implantation is the most rational way to restore several adjacent teeth.

Cost of multiple dental implants

When calculating the cost of installing implants, their number is of great importance. Ideally, you need as many implants as there are missing teeth. But you can choose the option when one of the artificial teeth is not fixed on its own implant, but is part of the bridge prosthesis on adjacent implants. With the loss of three teeth, it is possible to make a bridge of three teeth on two implants.

Also on total price restoration of teeth is influenced by the selected material of the prosthesis. At the same time, excessive savings have a bad effect on the quality of the structure and its durability. Therefore, experts recommend making a choice in favor of proven and reliable materials for crowns.

It is possible to calculate the cost of implantation of several teeth only after consultation, diagnostics and preparation of a treatment plan by an implantologist. The specialist will talk about options and select the most suitable in each specific situation. In addition, for the benefit of patients, promotions for dental implantation are regularly held, which allow you to win in price with consistently high quality work.

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How is implantation performed?

Preparatory stage

• The patient is examined, anamnesis is collected and an action plan is drawn up. The presence of contraindications to the operation is revealed. The patient is scheduled for an X-ray examination to determine anatomical features bones and the possibility of placing implants.


• Sanitation of the oral cavity in order to exclude the source of infection.
• A mandatory procedure at the preparatory stage is professional cleaning whitening teeth. This is necessary both to ensure oral hygiene and to select the shade of teeth for subsequent prosthetics.
• If there is not enough bone tissue for implantation of implants, then it is built up.

Operation

• Implantation is carried out under local anesthesia.
• The doctor makes an incision in the gums and, using a special tool, drills a hole in the jawbone that strictly corresponds in shape to the implant being implanted.
• A plug is screwed into the implant, then the gum is sutured. After the gums have healed, the sutures are removed.
• The operation takes approximately thirty minutes.

Healing period

• It lasts from three to six months. The healing time of the implant depends on the characteristics of the bone tissue.
• After successful osseointegration, a small gingival incision is made, the plug is removed, and a gingiva former is placed.
• After one to two weeks, an impression is made and a denture is made.
• Installation of an abutment with further prosthetics.

Options for implantation

• In the case of installing one tooth, one implant is installed.
• If two adjacent teeth are missing, two implants are recommended.
• If three teeth are removed in a row, three or two implants can be placed. The number of structures to be installed depends on the distance between adjacent teeth. The exact number of implants required for installation is determined by the doctor.
• If there is complete edentulism or if a large number of teeth are missing, the patient may be offered various options installation of implants.

Implant placement methods

• One-stage implantation. The installation of the implant and the crown is carried out on the same day in one visit to the doctor.
• Two stage dental implants. Produced in two stages. At the first stage, the implant is implanted. After its engraftment, an abutment is installed and prosthetics are performed.
• Mini implantation.

Video: "Implants: how to restore the dentition"

How to place a dental implant after extraction

There are several approaches in implantology.

Classic approach:

• Removal of a tooth.
• Filling the hole with bone within two months.
• Implant placement.

Carrying out immediate implantation:

Tooth extraction and implantation is carried out in one visit to the doctor.

Immediate implantation with immediate loading:

• Implant placement immediately after tooth extraction.
• At the same time, a temporary crown is placed.

Answers to frequently asked questions

Why is restoring lost teeth so important? How can you save your nerves, time and money?

Experts answer these and other questions:

• Question: How long after the loss of a tooth should implantation be carried out?

Answer: You can install the implant after two to three months. It is not worth pulling longer, because without load, atrophy of the bone tissue occurs.

• Question: Is implantation an extreme solution when it is no longer possible to install a dental crown?

Answer: There are a number of indications and contraindications for implant placement. Each specific case must be considered individually.

• Question: Does the implant need to be tightened periodically or is it attached with a special compound?

Answer: The implant fuses with the jaw bone, and there is no need to twist anything. Adhesive compositions for fixing the implant are not used.

• Question: What determines the service life of implants? How do you know when it's time to change them?

Answer: The service life of structures depends on various factors - the presence of stress, the state immune system, place of residence, standard of living, smoking. Great importance has the quality of the installation and the implant itself.

• Question: How many minimum implants should be in the lower jaw, in the absence of teeth?

Answer: Everything is decided on an individual basis. The minimum number is at least two. But for better fixation of a removable prosthesis, at least four are recommended.

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One-stage implantation

The technique involves the following sequence of actions that are carried out at one time:

1. Incision and exfoliation of the gums.
2. Preparation of the implant bed using special cutters.
3. Installation of the implant by screwing in, while its head rises slightly above the mucosa.
4. Installing a temporary crown.
5. Suturing the gums around the supragingival part.
6. permanent crown in about 3-6 months.

The entire procedure is performed on an outpatient basis, using local anesthesia and usually takes no more than an hour.

Advantages and disadvantages

Benefits the one-stage technique has a lot:

1. Save time as only one step is required for installation.
2. Saving money.
3. Aesthetic component: immediately after tooth extraction, the dentition is restored.
4. Preservation of the contours of the gum, which begins to form immediately after installation and retains its natural shape.

At the same time, doctors talk about shortcomings techniques that often make it impossible to implement:

1. The body must be generally healthy.
2. Bone tissue and gums must be of sufficient height, density and width.
3. Incomplete integration of the implant is possible, since in the first weeks after installation, when the gum is just being formed, microbes enter the surrounding bone from the oral cavity.
4. At first, the implant is held not by integration, but by compression, which tends to weaken over time.
5. Since in Russia the implantation procedure is performed different specialists(first a surgeon and then an orthopedist), finding a rejection error is not easy. In addition, a technician is also involved in the process, who makes the structure according to the cast.

Two-stage implantation

The protocol, which involves the installation of the structure in two stages, is the most common. For this technology, collapsible implants are used, which consist of two parts:

- intraosseous (implant itself);

- periosteal (abutment).

Algorithm doctor's work is as follows:

1. At the first stage, a gum incision is made, the bed is prepared, an implant that does not have a supragingival part is screwed into it, after which the gum is sutured, and the implant is completely isolated.

1. At the second stage, a second incision is made, a shaper is installed, the task of which is to form a bed. After 2-4 weeks, the abutment is installed, and after that the crown is made.

Two to six months pass between the first and second stages, during this period it is recommended not to load the gums.

Advantages and disadvantages

The main and most decisive advantage of two-stage implantation is the complete integration of the implant. After installation, there is no contact with the environment, it remains isolated for microorganisms, so the bone tissue grows into gaps on its surface without obstacles. Besides:

– according to statistics, the percentage of engraftment of titanium structures when using this method is the highest;

- the technology allows you to restore both one tooth and several;

- possible atrophy of bone tissue is prevented, its formation around the implant is stimulated;

– after the completion of all work, the aesthetic result is better than with a one-stage operation;

- this method is considered classical, academic, studied in all medical universities world and practiced in all clinics.

To shortcomings methods include:

- the duration of treatment and the period when the implant fuses with the bone;

- higher cost;

- aesthetically, the oral cavity before the installation of the crown (between the first and second stages) looks unattractive, especially if we are talking about the front teeth;

- in postoperative period need to visit the dentist frequently.

Frequently asked Questions

— What tests should be done before implantation? Is there a difference in the list of examinations for one-stage and two-stage implantation?

Expert opinion. Dentist Oprian G.R.: “There is no difference in the list of examinations and analyzes. It includes an examination by an orthopedic dentist, a blood test, computed tomography, and, if necessary, consultations of non-dental specialists to identify contraindications.”

— Is it possible to extract a tooth and immediately put an implant?

The decision should be made by the doctor, based on the degree of inflammation and the amount of bone tissue.

— How does the patient feel during the procedure?

All manipulations, both with one-stage and two-stage implantation, are performed under local anesthesia, so the patient does not feel pain. After the termination of the anesthesia, short-term pain or a feeling of discomfort in the area of ​​​​the installation of the structure is possible.

— What is seamless, bloodless, flapless technology? Are these terms synonymous with one-stage implantation?

In fact, they are the same thing, and we are not talking about new methodology, but about an advertising name to attract a customer. In addition, statistics show that 75% of patients need preliminary osteoplasty (bone augmentation), which cannot be done without incisions in any case.

— What to do, if the seam has come apart on the gum?

As soon as possible, contact the surgeon who performed the operation, and before visiting the clinic, ensure hygiene, rinse the wound with a 0.05% chlorhexidine solution.

— Is it possible to place an implant and perform a sinus lift at the same time?

Most often not, in order to carry out these procedures at one time, two conditions are necessary - very experienced specialist and adequate bone thickness.

— How are crowns placed during simultaneous implantation, when no shaper is used? Do they cover the gum or look like a natural tooth growing from the gum?

The answer to this question should be given by a specialist after the examination. In practice, there are cases when modeling a crown with an overhang is the only possible way her installation.

— Who is better to contact for tooth extraction if implantation is planned in the future - to any doctor or to the one who will put the implant?

It is advisable to carry out both procedures at the same doctor, since the removal often becomes more complex intervention, especially if in place extracted tooth there will be an implant when it is necessary to preserve the bone tissue to the maximum during removal.

— Does it make sense to overpay for laser one-stage implantation?

The laser is just a way to make an incision; it has nothing to do with the actual implantation of the structure into the bone tissue. It is often much more convenient and expedient for a surgeon to make an incision with a conventional scalpel than with a laser, so it makes sense to pay extra. laser technology in this case no.

— What determines the duration of the period during which the implant will take root?

In addition to the professionalism of the doctor and the absence of errors during installation, the term is influenced by individual characteristics. Among them, for example, bone density, and in the upper jaw the bone is always less dense than in the lower. Average term for the lower jaw - up to three months, for the upper jaw - up to six months.

Is it possible to postpone the period of prosthetics and for how long?

You can postpone prosthetics for a maximum of two months. If even then it will not be possible to install a permanent crown, it is advisable to put at least a temporary one in order to avoid loss of bone tissue around the implant.

—How long does it take for rejection to occur?

Rejection can occur up to two years after the installation of the structure. If before prosthetics we can talk about the absence of osseointegration as such, then in more later periods an implant that has already taken root may be rejected. This may be due to incorrect installation(positioning), insufficient docking of the base of the construction with the abutment, overload, poor hygiene, smoking.

—How to understand that the implant has not taken root and what to do in this case?

According to statistics, from 5 to 20 implants out of a thousand do not take root. In this case, a strong throbbing pain is felt, bleeding may occur, the gum swells and changes color. If these symptoms appear, you should contact the doctor who performed the operation as soon as possible.

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The absence of two or more adjacent teeth is one of the most common cases in dentistry. Restoring the aesthetics and functionality of the dentition involves several solutions: you can use removable prosthesis or install a dental bridge based on two or more adjacent living teeth. However, most dentists agree that the most in an efficient way is dental implantation.

Classic options for prosthetics: why not?

In the absence of two or more teeth nearby, the most common method of closing a gap in a row is considered to be the installation of a dental bridge - this is an alternative to dental implantation. In place of the missing teeth there will be "suspended" (middle of the bridge), and along the edges of the bridge there will be crowns resting on the abutment teeth. How more teeth absent, the more abutment teeth are used.

Abutment teeth are subject to depulpation and turning for the installation of a bridge, and this is one of the main disadvantages of dental bridges.

If the living teeth are in poor condition and cannot withstand the load from the prosthesis, the patient has one more option - to close the gap between the teeth with removable dentures.

It should also be remembered that in both cases, under the prostheses, the process of bone atrophy actively continues, which occurs when there is no load on it. Gradually, a small gap appears between the prosthesis and the edge of the gum due to a decrease in bone volume.

Multi-tooth implant options

In the absence of two teeth, an individual implant is installed under each of them, and a dental bridge from the selected material is fixed on top. If more than three teeth are missing in a row, then the number of implants is selected individually, you can install 2 implants and a dental bridge of 3 crowns. However, at the request of the patient, it is also possible to restore each tooth separately with the help of an implant and a single crown. Most often, for the restoration of several teeth in the frontal zone, patients are recommended dental implantation according to the classical protocol, which allows to obtain a predictable result and good aesthetics of the gingival contour. The only drawback of this approach is its delayed loading, a permanent prosthesis can be placed only after the implants have fully healed, while the temporary prosthesis-butterfly will have to be worn for the duration of the fusion of the implants with the bone.

For those who do not want to wait, this process can be shortened by immediate loading implantation, which allows the patient to receive new teeth in the shortest possible time (usually no more than 5 days). However, implantation with immediate loading has an important limitation, its goal is primarily to restore the functionality of the dentition and for some clinical cases the aesthetic aspect will be unsatisfactory. To understand whether this method is suitable, you need an examination by an implantologist.

Advantages of implantation in multiple restorations

• preservation of neighboring teeth: there is no need for preparation (turning) and depulpation of neighboring living teeth, on which a bridge is put on;
• high aesthetics: artificial teeth based on implants are almost impossible to distinguish from natural ones;
• preservation of bone tissue: chewing load is transferred to the bone through the implant, so it “works” in the usual mode and does not decrease in size,
• reliability and durability of implants: implants are made of the strongest titanium, which allows them to withstand high chewing loads and serve for 20-30 years. For prosthetics on implants, it is also better to choose strong, durable structures, such as metal ceramics or zirconium dioxide. If over time it becomes necessary to replace the prosthesis, it is carefully removed and replaced with a new one, while the implants remain in the bone tissue.

Thus, dental implantation is the most effective and aesthetic way to restore two or more lost, previously adjacent teeth.

The cost of implantation of several teeth:

When restoring several teeth in a row, the cost of dental implantation may vary depending on whether each tooth will be restored with a separate implant and crown, or a dental bridge will be installed. For example, in the absence of three teeth, you can install three implants and three crowns, or a bridge of three crowns supported by two implants, thus saving on quantity.

The second important factor affecting the cost of dental implantation is the type of dental crowns, since the difference in price between different materials can be significant. However, when choosing an implantation method and type of crowns, one should not be guided solely by considerations of economy, since the quality of the materials primarily affects the service life of new artificial teeth.

You can learn more about the cost of all manipulations at a free consultation with an implantologist, since only after examining the oral cavity and diagnosing it will be possible to draw up specific treatment plans, choose best options restoration of teeth for each individual case. However, do not forget that in clinics hotline take place regularly special promotions for dental implants, which will allow you to receive quality treatment at a favorable price.

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Support in the amount of one rod for two lost units is rare in dental practice. If the dentist chooses this option, a three-crown bridge will be required instead of two separate implants. The two extreme ones will be used to fix the bridge - one will be attached to a healthy tooth (sharpened in advance for installation), the second to the installed implant.

Disadvantages of the method:

• weakening of a healthy unit as a result of grinding and depulpation;
• under a deaf crown, the process of bone atrophy will continue, which will lead to the formation of a gap between it and the edge of the gum;
• micro-movement of the tooth and strong adhesion of the implant to the bone during joint work create a shock-absorbing effect, which leads to loosening of the bridge prosthesis.

Destabilizing factors ultimately make the design unreliable. You can lose both the reference unit and the implant at the same time.

Can two implants be placed at the same time?

To determine how many rods can be installed at a time, the dentist needs to diagnose the patient's oral cavity. According to the results of the examination and tomography, it is possible to decide on suitable models of titanium roots. The selection takes into account:

• type, width and height of the alveolar ridge;
• distance from the mandibular canal and maxillary sinus to the place for the intended installation;
• the patient's health condition.

You will have to visit the doctor several times even when installing one implant, since it is necessary to consult, do a computed tomography, then implantation and prosthetics. Separately, bone grafting, hygiene and other procedures may be required.

Advantages of implantation of two teeth at the same time

• It is easier to observe the osseointegration of both implants;
• the load will be distributed evenly;
• the bone will not atrophy;
• it will turn out to save a little on the services of an implantologist;
• the number of visits is almost the same as for the implantation of one artificial tooth.

Which models are suitable

Knowing the percentage of survival, statistics of complications after surgery, expiration date, you can calculate the rating of implants. The success of osseointegration depends on the characteristics of the body, the ability of tissues to regenerate, the experience and responsibility of the dentist. Even the most expensive implants in the hands of an inexperienced doctor can cause complications.

The list of the most reliable implant systems includes:

• Nobel Bioca - expensive high quality constructions with a lifetime guarantee. The lineup includes different types implants that can be used for any clinical situation. The conical artificial root is double threaded, special type connections. Nobel Biocare implants have good osseointegration.
• The Swiss company Straumann also provides a lifetime warranty. Implants are of high quality and good survival rate.
• Astra Tech (Sweden) - known for their high level of quality and stability.
• XIVE(Germany) - have a unique thread, due to which good stability is ensured. Suitable even for spongy bone.
• French designs Anthogyr Made from high quality titanium. Resistant to external influences.

For two anterior teeth

Zirconium dioxide implants for the restoration of two front teeth

High demands are placed on implants for the anterior sections, so they must be chosen with the utmost care. They should be:

• small diameter and sufficient length for atraumatic installation;
• equipped with a fine thread at the top and a large one at the bottom for stability;
• made of zirconium dioxide, so as not to shine through the gum.

Proper selection of the implant allows you to save as much bone volume as possible and prevent its loss. For the smile zone, one-stage implantation is used with the installation of temporary crowns or a prosthesis on the day of implant installation.

What is put in the chewing area

In the lateral sections of the jaw, not as thin rods are used as for the anterior ones. The size is selected taking into account the anatomical features, the width of the gaps between the teeth. More often chosen classical implantation which is carried out in two stages. The implant must be able to withstand any chewing load. Crowns or dentures should match the shade and shape of the patient's healthy teeth.

Dental manufacturers offer a variety of premolar and molar implants.

How to put implants: ways if there are no 2 adjacent teeth

It can be carried out according to the classic two-stage protocol or one-stage with immediate loading.

Classical implantation is carried out in two stages:

1. Implants are implanted into the bone. The engraftment period takes from 2 months to six months. During this period, a plug is attached to the implant so that pathogenic microbes do not leak into the implant area, the gum is sutured in this place.
2. Upon completion of the period of implant osseointegration, the doctor proceeds to the stage of prosthetics. The gum is opened, the implant plug is removed, an abutment is installed instead, on top of which the crown is attached.

Before installing the abutment, 7-10 days before prosthetics, an intermediate operation can be performed to install the gum shaper to give it the desired shape.

Classical two-stage protocol for implant placement surgery

This does not mean that the entire operation is performed in two visits. Preliminary diagnostics, treatment dental disease, if necessary, bone grafting. The doctor during the second stage will need to make a cast.

One step protocol

Implantation according to a one-stage protocol is called Immediate Load. Immediately after the installation of implants and abutments, crowns are placed. The entire period of treatment takes from several days to one week, if there is no need to cure or remove neighboring diseased units, eliminate gum inflammation or other diseases.

Main steps:

1. The dentist analyzes the condition of the gums, teeth, and the body as a whole. The patient takes tests, an orthopantomogram is done, CT scan.
2. The doctor chooses a place for implantation of implants, for greater accuracy, surgical templates are created.
3. The implantation procedure, which lasts about half an hour.
4. Impressions are taken for the manufacture of prostheses.
5. Fixation of crowns on dental cement (glue) or screw method.

When and how is bone augmentation and sinus lift performed?

After tooth extraction, atrophic processes begin in the jaw structures, so dentists recommend implanting immediately. If there is a loss of bone tissue, it will be necessary to surgically restore its volume to create reliable support under the titanium rod.

The procedure has several options:

• Sinus lifting. Used to increase bone volume in the upper jaw due to displacement bottom wall sinus. An artificial material is placed in the resulting space.
• Autotransplantation. Transplantation of a patient's bone from another area. The method is attractive in that rejection occurs less frequently.
• Splitting of the alveolar ridge to expand the bone.
• Artificial bone grafting.

The process of restoring the volume of the bone block lasts 4-6 months, after which implantation can be performed.

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