What is one-stage dental implantation. Stages of dental implantation in the classical way. What does one-stage implantation give?

The concept of one-stage implantation with immediate functional loading

Ongoing scientific and technical research in the areas of treatment plan development, implant design, the use of various surgical techniques, materials and experience in predicting treatment success has made edentulous rehabilitation a reality in many clinical cases today. At the dawn of the development of implantology, implants were loaded with a temporary structure on the day of surgery or in the first days after it, and then after some time with a permanent structure. Most often, the implants were rejected, or fibroosteointegration of the implant with bone tissue occurred. The reasons for the failures lurked in the mismatch of materials, which, due to their biomechanical and chemical properties, did not contribute to the osseointegration of the implant. In the last twenty years of the 20th century, the Branemark dogma prevailed, according to which success in implantation depends on a phase called osseointegration, which occurs under the cover of the mucosa, without microbial contamination and without functional load. The timing to reach this phase is supported by scientific arguments and long-term clinical results. However, some implant systems that offer a one-stage concept also achieve a high success rate without a full implant immersion period in the presence of a healthy oral mucosa. The Branemark protocol is defined as the “classic osseointegration protocol” and refers to a 2-stage implant placement technique where the first stage is the fixation, the mucosa is sutured, and the second stage takes place after 3-6 months depending on the jaw, and only after that a functional load. Delayed loading with biologically inert materials, justification of the design of the implant and denture allowed to significantly reduce the failure rate. The method of achieving osseointegration is well known, no one doubts the concept anymore. The achievement of osseointegration has become an indicator of product quality - a "trademark" for manufacturers. There are many types of osseointegrated implants on the market today, and all of them show a high success rate. To understand such an abundance for practicing doctors is not easy. A change in function entails anatomical and structural rearrangements of organs and tissues (Wolf's transformation law). The function determines the shape, structure of the bone organ and its structure. Structural reorganization of the bone under functional load is compensatory osteogenesis. If the load on the bone is dosed and alternates with sufficient rest, then it has time to rebuild and adapt to new conditions. Early functional load stimulates reparative processes in bone tissue and promotes re-adaptation of masticatory muscles. With immediate functional loading, dosed vertical forces pressing on the implant cause stimulation of bone tissue growth, however, the presence of any lateral force is detrimental to the stability of the implant. It is important that with proper immediate implantation and temporary restoration, a directed formation of the oral mucosa occurs, optimal conditions are created for achieving aesthetic results in the process of postoperative rehabilitation, which makes life easier for patients. The one-step concept allows you to intelligently use the physiology of the body, achieving stable, predictable and long-term results, taking into account all the requirements of aesthetics.

One-stage implantation is not possible if the patient requires osteoplasty (bone augmentation).

Problems that arise when using 2-stage implantation

1. Late detection of implant failure
   • Sometimes the doctor discovers the lack of osseointegration only at the second stage of surgical treatment, 3-6 months after the operation. Late detection of failure complicates both treatment and the relationship between patient and doctor.
2. Osteomucosal loss after extraction
   • When using 2-stage implantation, restoring the original mucosal profile (papilla) is not always easy.
3. Bone loss and peri-implant crater formation at cervical level
   • Immediately after functional loading, bone loss occurs with the formation of a crater in the area of ​​​​the junction of the implant and abutment. Manufacturers do not attach special importance to this, and some authors consider it the norm. Clinico-radiological examination shows interosseous loss and mucosal pockets. Peri-implant pockets are a breeding ground for colonization and proliferation of bacteria that complicate treatment.
4. Waiting for healing time
   • Wearing a removable prosthesis is an obvious inconvenience for the patient, and temporary restoration (restoration of a tooth or teeth) during healing is the cause of numerous patient visits and postoperative irritations.

Benefits of Immediate Implantation

Immediate restoration after installation of a one-stage implant eliminates all of these problems.

• This fundamental discovery in modern implantology makes it possible to install a temporary or permanent prosthesis immediately after implant placement (without a healing period).
• Allows the doctor to solve the problem of implantation and prosthetics in one visit.
• Provides comfort and moral satisfaction to the patient.

The advantages of the one-stage concept can be divided into surgical, orthopedic, physiological, psychological and economic:

1. There are no months of waiting to achieve ossification of the post-extraction alveoli and the formation of the alveolar ridge to the extent necessary for two-stage implantation.
2. Possibility of regulating the reduction of atrophy of the alveolar ridge.
3. The possibility of predicting the post-implantation structure of the alveolar ridge.
4. Possibility of predicting the state and structure of soft tissues (papilla).
5. Reducing the stages and volume of surgical interventions and, as a result, a decrease in the volume and quantity of anesthesia and preventive drug therapy.
6. There are no or significantly reduced periods of adentia.
7. There is no psychological “toothless complex”.
8. Chewing efficiency remains virtually unchanged.
9. Absence of global multiple neuromuscular remodeling associated with intermediate stages of two-stage implantation.
10. No changes in the external contours of the face associated with two-stage implantation.
11. Reducing to a minimum the use of osteoreplacement substances.
12. General comfort and no reduction in performance during treatment for patients.
13. Monolithic structure of the cheek and anchor part of the implant made of titanium.
14. The absence of a period of adaptation to a temporary removable prosthesis, as well as its correction.
15. There is no need for additional X-ray examination and, therefore, additional exposure of the patient.
16. Reducing the cost of treatment for the patient.

The design features of a one-stage implant make it possible to control the atrophy of the alveolar ridge by filling the resulting post-extraction alveolar space with the anchor part of the implant. The immediate loading protocol includes one-step implantation and gentle functional loading. Installation of one-stage implants in the post-extraction hole allows you to get:

• excellent primary stability for any type of bone,
• elimination of the waiting period for patients to install fixed prostheses,
• a significant reduction in the rehabilitation period and a reduction in the cost of treatment for the patient,
• maintaining chewing efficiency without a period of using removable dentures,
• a high degree of predictability of the results of implantation treatment with direct loading, in the absence of bone atrophy and the preservation of the natural structure of the mucosa surrounding the implant,
• high indicators of the quality of life index of patients, due to the need for a single surgical intervention.

History of one-stage implantation

The one-stage concept of implantation is based on the possibility of immediate loading and temporary prosthetic support, followed by the replacement of a temporary prosthesis with a permanent one. This concept is confirmed by scientific literature, which proves that functional stimulation of the bone, achieved by immediate loading, gives restructuring of the bone beams, as well as a directed orientation of the physiology of bone trabeculation. The one-stage implantation protocol was proposed by the ITI (International Team for Oral Implantology) system and is characterized by a high success rate: 1981 Schroeder; 1983 Babbusch; 1986 Bruggenkate. In 1991 Buser placed 54 ITI implants in 38 patients with a success rate of 96.2%. These results introduced a grain of doubt into the thesis about the possibility of an exclusively 2-stage concept. Obviously, the two-step protocol is not a panacea for achieving osseointegration. Since 1985, the study of a new protocol for the immediate installation of implants (technique, shape, materials) gives favorable results with immediate implantation (Anneroth 1963; Atwood, 1963; Sarnachiaro, Garenini, 1979; Weiss, 1981; Hodosh 1979; Putter 1986; Denissen, Groot , 1979; Karagianes 1982; Block and Kent, 1986; Block 1988; Brose 1987; Schulte, 1984; Stanley 1977,1981; Todescan 1987; Ettinger 1993; Gotfrendsen 1993). These articles were based on the results of experiments on animals (Barzilay 1988; Knoxetcoll, 1991; Lundgren 1992) as well as on patients (Lazarra, 1989; Lundgren 1992; Werbitt and Goldberg, 1992; Gelb, 1993; Lang 1994; Becker 1994). All these studies convince of the expediency of one-stage implantation. Brunski in 1993 notes that immediate loading of implants is possible if micro-movements can be controlled. Salama 1995 criticizes the disadvantages of the Branemark protocol. The same author proposes the bilateral combination of several implants to stabilize the primary stability, as well as the optimal scheme of gentle loading. Tarnow in 1997 writes that the immediate loading of several implants when they are combined is a reliable method of treatment.

To date, one of the most effective methods of restoring the dentition is implantation. Restoration occurs by implanting a special implant into the gum or periosteum, thereby creating a denture completely identical to the natural tooth.

Depending on individual characteristics, dental implants are installed in one or more stages.

One-stage implantation is a non-surgical implantation that allows you to form a new tooth as soon as possible. At the same time, a patient in need of urgent dental care gets the opportunity to lead a normal life - smile and eat your favorite food.

How is one-stage implantation performed?

The one-stage implantation process includes:

Preparatory stage

Before proceeding with the installation of the implant, a special impression is made to create a temporary crown. With the help of an impression, the dental technician makes an orthopedic structure, which will later be used to recreate the tooth.

Implant placement

Thanks to modern techniques, this procedure lasts no more than an hour. The implant is placed under local anesthesia on an outpatient basis. Since this type of implantation is also called minimally invasive, that is, it implies minimal tissue injury, the head of the denture (abutment) does not completely sink under the mucosa, but is located slightly higher above the edge of the gum.

Completion of implantation

When the temporary implant has taken root, a permanent denture is installed instead of the temporary crown.

What does one-stage implantation give?

1. The waiting time for the formation of bone tissue (“ossification”) and the healing of the hole after tooth extraction (“post-extraction alveoli”) are reduced, which saves the patient’s time
2. Full formation of the bone bed on which the teeth are located, the so-called formation of the alveolar ridge in the amount necessary for two-stage implantation, is not required.
3. Surgical intervention is minimized, which in turn means a reduction in the volume and quantity of medications and anesthetics used
4. Thanks to modern diagnostic devices, it becomes possible to predict the condition and structure of soft tissues (papilla), as well as the post-implantation structure and atrophy of the alveolar ridge
5. Externally, the denture does not differ from the “real tooth”, due to which there are no external changes in the contour of the face and the patient does not experience any external psychological complexes
6. The denture fully performs its chewing function, which allows the patient to lead a normal life.
7. Reducing to a minimum the use of osteoreplacement substances
8. In general, the installation of the implant is relatively comfortable and does not affect the patient's performance.
9. The single design of the neck and anchor part of the implant consists of titanium, which guarantees a long life and safe use of the denture
10. A single surgical intervention avoids the period of adaptation to a temporary crown and its correction
11. Installation of a permanent denture occurs as soon as possible, which allows the patient to maintain the quality and comfortable standard of living
12. One-stage implant placement guarantees the patient a “new tooth” of high quality with a small amount of time and money spent on visiting the clinic

In what case is a patient offered a two-stage implantation?

Only two-stage implantation is suitable for the client in cases where:

• Obvious signs of osteoporosis of the jaw bone are observed
• In the area of ​​implantation of the denture, inflammations are found that are incompatible with the one-stage installation of the “new tooth”
• Diseased teeth are located near the implant installation area, due to which an inflammatory process may begin
• The patient has a weak immune system

In this case, the patient will be offered a two-stage implantation, which involves the gradual installation of a denture.

How does a two-stage implantation work?

Installation of the intraosseous element

Since there are different types of implants (cylindrical, screw), it is necessary to prepare the bone bed before the first installation procedure. To do this, first make an incision and cut off the mucoperiosteal flaps. After that, a small depression is made in the tissue. Then a guide channel is installed in the bone tissue. After the final formation of the bone bed, an implant is placed in it. Next, an intraosseous element and a plug are placed in the bed. The mucoperiosteal flaps are returned to their place and the incision is sutured. The whole procedure takes about an hour. The patient does not experience sharp pain, as the operation is performed under local anesthesia.

Healing stage

The patient undergoes a healing period in order for the root-shaped implant to be firmly fixed in the bone tissue. The healing period is individual and can take from three months to six months.

Installing an abutment (support head)

After the healing period, the next stage of implantation begins. The mucous membrane is incised again, the position of the implants in the extraosseous part is determined. After that, the plug installed earlier is removed and the gum shaper is inserted. After about a month, when the so-called gingival cuff has formed, the gingiva former is replaced by a support head (abutment). The healing phase lasts another week.

Crown installation

The last stage of implantation is the removal of casts and the manufacture of a denture identical to the lost tooth. When the crown is ready, it is placed on the implant.

What does two-stage implantation give?

1. The phased introduction of implants allows you to achieve an excellent cosmetic effect.
2. The construction is of very high quality and long service life
3. High results of engraftment of dentures
4. The ability to restore a lost tooth, even in cases where the installation of an implant in one stage is not possible

Work results

Some of the latest results of implantation work. Click on the image to see the full "before" and "after" photos:

Prices for dental implantation at Telmana 41 Medical Center

Prices for dental implants depend mainly on the implants. We try to work exclusively with high-quality implants, be it relatively low-cost solutions (for example, Renova implants from Altracore Biomedical (USA) with a 5-year warranty). or those that pay for a more well-known quality and a slightly different level of applied technology (for example, Zigoma 45 'by Nobel biocare).

All stages of dental implant installation are as safe and painless as possible for the patient if the operation is carried out in a good dental clinic using high-quality equipment and modern materials. This type of prosthetics consists in restoring not only the crown, but also the root of the tooth., which helps the entire jaw system to function normally. By resorting to implantation, you can save the jaw bone from atrophic changes without injuring the remaining healthy teeth.

How implants are made, their structure

Implant or implant (in English -implant) is a pin shaped like a tooth root. It is made of a medical metal alloy and is placed in the jawbone. Then an abutment is installed on the prosthesis, and a crown is placed on it, which can be changed without removing the implant.

Before prosthetics, the dentist evaluates the feasibility of installing an implant, taking into account the physiological characteristics of the patient's body, his state of health.

You can learn more about how implants are made from the video:

Indications and contraindications

The classic indications for implantation are:

• terminal defects of the dentition;
• complete and incomplete absence of teeth;
• intolerance to removable dentures due to allergies or gag reflex;
• a defect in functional occlusion (jaw closure) after tooth extraction or improper dental treatment.

Absolute contraindications include:

• tumors (if implants are inserted, they will begin to grow);
• increased tone of masticatory muscles;
• blood clotting disorder;
• pathologies of the nervous system and mental disorders;
• childhood;
• immunodeficiencies;
• diabetes mellitus (especially uncompensated type);
• tuberculosis;
• osteoporosis;
• some forms of stomatitis;
• allergy to anesthesia;
• chronic forms of diseases of various internal organs;
• rheumatism.

Relative contraindications for dental implant surgery:

• pregnancy at all stages;
• breastfeeding period;
• pathological bite;
• bruxism;
• poor oral hygiene;
• carious cavities (the prosthesis is inserted only after complete treatment of caries);
• mucosal inflammation;
• cachexia;
• pathology of the temporomandibular joint;
• smoking.

The patient must inform the doctor about all existing chronic diseases in order to exclude the possibility of complications.

How dental implants are placed

How many implants are needed depends on the number of dental units that need to be restored. If one tooth is missing, one implant is placed. If two or three molars are missing, then two or three prostheses are placed respectively. It is not advisable to limit yourself to one implant, since it may not withstand the increased load during chewing. In the case of complete adentia, the number of prostheses is determined by the doctor, depending on the expected interdental distance.

Types of implantation:

• Intraosseous installation of dental implants is characterized by the introduction of the prosthesis into the bone tissue. This technology is the most popular and in demand all over the world, because it has the fewest possible complications. The dental implant is placed directly into the bone bed.
• Basal implantation is indicated for bone deficiency and the absence of several consecutive teeth. Using this technique, implants are installed if it is impossible to build up bone tissue. But it is dangerous with possible side effects and complications. In addition, constructions made according to the basal type are not very reliable, therefore, the basal installation of dentures occupies a modest place in modern implantology.
• Intramucosal technology is most often used in removable prosthetics for convenient and reliable fixation of the false jaw. In this case, the implant is inserted directly into the gum.

Dental implants can be divided into three types:

1. One-stage implantation allows you to place an artificial root and crown in one visit to the dentist.
2. A two-stage installation is done in 2 times:
   • At the first stage, a metal pin is implanted into the jaw.
   • At the second visit, a crown is placed.

1. Mini-implantation is used to imitate premolars or in narrow parts of the jaw and is characterized by the installation of small prostheses.

Installation of a dental implant: stages and timing

The standard procedure for installing a dental implant is carried out in several stages. Their duration depends on many factors, including the state of health of the patient and the level of techniques used.

Preparatory stage

Installation of a dental implant is a serious surgical procedure for implanting a foreign body into the jaw, so the doctor who performs the operation must be sure that the patient is ready for the procedure.

Prosthetics is a stress for the body, which activates diseases that were previously in a vegetative state. Before the operation, the dentist must make sure not only that the implant will take root, but also that the patient's body can withstand this load, so the process of dental implantation begins with a basic diagnosis. To do this, the following procedures are carried out in a planned manner:

• visual examination of the mouth;
• examination by a cardiologist, allergist, neurologist and endocrinologist (the need and sequence of visits to doctors is determined by the therapist);
• delivery of tests;
• ENT examination (if you need to install an implant in the upper dentition);
• sanitation of the oral cavity;
• hardware research;
• bone augmentation.

Testing

As part of dental implantation, a number of important studies are done, these include a general blood test with additional parameters:

1. Coagulogram or blood coagulation test - determination of the level of fibrinogen, prothrombin and thrombin time.
2. Determination of the level of glucose in the blood.
3. Biochemistry or the study of blood composition for:
   • amylase;
   • total and direct bilirubin;
   • cholesterol;
   • transaminases;
   • electrolytes;
   • total protein;
   • alkaline phosphatase;
   • urea;
   • creatinine;
4. HIV and hepatitis testing.
5. Aticardiolipin test for syphilis.

You will also need to pass a general analysis of urine, and if there are pathologies of the gastrointestinal tract, an analysis of feces. In the absence of chronic diseases, testing will take little time.

hardware research

The following types of examinations are necessary to determine the anatomical structure of the jaw, the quality of bone tissue and its pathologies:

• Radiography. Allows you to make a detailed high-quality picture of the studied part of the jaw, due to which the state of the bone tissue and existing roots can be traced.
• Orthopantomogram. Gives a detailed view of the quality of the bone and possible pathologies due to the three-dimensional panoramic image.
• CT scan. Helps to obtain a three-dimensional picture of the bone, which allows you to determine the structure and density of the jawbone.

Without these examinations, not a single implantation of teeth takes place, since when implanting a prosthesis into a bone, there is a high risk of hurting nerves and important blood vessels, and panoramic images help to avoid such problems. This rule applies to all forms of prosthetics.

Bone augmentation

Dental implants are placed only if there is sufficient bone tissue. If, as a result of hardware studies, it is found that the volume of the jawbone is not enough for high-quality prosthetics, then in the absence of contraindications, bone tissue grafting is performed. Various methods are used for this:

• Guided regeneration. It is characterized by an increase in bone volume due to the implantation of natural or artificial material.
• Bone block grafting. It is carried out during bone resorption, within its framework, tissue is taken from another part of the body and transplanted into the jaw.
• Sinus lifting. Elevation of the mucous membrane of the lower part of the maxillary sinuses, due to which the volume of the upper jaw increases.

Bone augmentation

Dental implantation does not occur immediately after bone augmentation, but several months after the completion of the dental operation.

Surgical stage

After complete preparation of the oral cavity, the operation itself takes place. The process of installing a dental implant does not take long. The time interval depends on the quality of the diagnostic work performed, the complexity of the technique used and the physiological features of the structure of the patient's jaw apparatus. A standard dental implant is placed in about 90 minutes.– as long as a regular dental appointment lasts.

Surgical intervention begins with a patchwork incision and exfoliation of the gingival and periosteal tissue, as a result, an area of ​​\u200b\u200bthe bone is exposed. A milling mark is installed on it to form an artificial root bed. Then, in this place, the doctor drills a thin channel along the length of the implant. After reaching the desired depth, the channel is expanded using special drills.

After obtaining the required width, a thread is made in the canal that matches the thread of the prosthesis. Due to it, dental implants are installed. That is, they are simply screwed into the resulting hole, after which they are closed with a screw-in plug. Then the mucous and periosteal tissue is placed on the implant and sutured with simple sutures adopted in surgery.

Postoperative period

Dental implants are placed quickly, but their engraftment takes a long time. During the first 5 days, swelling and soreness may be observed, then unpleasant symptoms should disappear. In the postoperative period, stressful situations, physical exertion, visiting saunas and baths, as well as chewing on the side of the wound surface should be avoided. It is necessary to treat the oral cavity with antiseptic preparations and do everything possible so that the implant takes root. Otherwise, the material will be rejected.

Signs of rejection

Signs that the implant has not taken root:

• redness of the gums;
• swelling at the site of the prosthesis;
• severe pain in the jaw (does not go away even after taking strong painkillers);
• mobility of neighboring teeth;
• temperature rise.

If you experience any unpleasant symptoms, you should immediately contact your dentist.

Stage of gum formation

To form a natural contour of gum tissue, instead of the existing screw plug, a special screw titanium cylinder is installed, which is called a gum shaper. Its installation takes place 3-6 months after the introduction of the pin.

Within 15 days after the shaper is placed, a natural gingival fold will form around the implant, which plays a key role in holding the artificial root.

Abutment installation stage

The abutment is the intermediate part of the implant that connects the root to the crown. It is inserted instead of the gum shaper after the formation of a mucous roller around the future artificial tooth. The procedure lasts not a few hours, but only 15-20 minutes.

Stage of prosthetics

After the dental implant has healed, an artificial crown is placed. First, casts will be taken from the jaws so that the prostheses made have the desired shape, do not interfere with the patient's bite and help restore chewing function. Then the resulting crown is placed on the abutment using an adhesive material.

Stage of rehabilitation

After all stages of dental implantation, the rehabilitation period begins. Its term depends on the method of the dental procedure and the physiological characteristics of the body. During this period you must:

• gently and thoroughly clean the oral cavity;
• use aseptic rinse aids;
• visit the dentist regularly (at least once a month);
• reduce the amount of solid food you eat.

The joint work of the dentist and the patient at all stages of the installation of a dental implant guarantees a good engraftment of the dental prosthesis and a complete restoration of chewing function.

If you haven’t heard about what one-stage dental implantation is, then you missed a lot. This method of treatment is not without drawbacks, but it can be called unique in its kind, because it becomes a real salvation in the case of partial, multiple, complete adentia, or even when, it would seem, the situation is very difficult: you suffer from diabetes, periodontitis or periodontal disease, have lost your teeth for a long time, you have an impressive smoking experience.

The article below is a must-read for anyone who rationally approaches the solution of any life situations and wants to get the result with the maximum benefit for themselves and their health.

About the types of one-stage implantation

One-stage implantation with immediate loading of the prosthesis means not one, but several different protocols that allow you to quickly and permanently solve the problem when there are no teeth left at all. We are talking about techniques such as , all-on-4 (), and . You can read about each treatment option in detail in separate articles on our website. Also see the summary table, from which it is clear what features the methods have.

On a note! The advantage is that according to the individual characteristics of the patient, his financial capabilities, expectations, with this approach, you can always find a suitable option that meets the highest requirements and quality standards. When choosing any of the protocols, you get a fixed and functional prosthesis almost instantly. According to the chosen protocol, the construction can be based on 3 or 4, 6 or even 8-12 artificial roots.

All options are suitable for solving issues of complete absence of teeth. Less often - partial. This is due to the fact that, firstly, implants need a place for attachment, because sometimes they are placed at an angle. Secondly, the smaller the bone, the more implants are needed. Accordingly, the more of them and the better they are fixed in the bone, the better the prosthesis will be attached. It is also important that the implants are placed on both sides - it is in this situation that the prosthesis, due to the metal base, will fix them in a certain position as reliably as possible. That is why, with partial adentia, this group of protocols cannot always be applied (precisely from the point of view of immediate loading of the prosthesis).

Is it possible to carry out one-stage implantation of one tooth

We have already mentioned that instant implant methods are predominantly suitable for people with a large number of missing teeth or who are completely edentulous. In this section of the article, it would be fair to consider this type of treatment for patients who have single defects, because they also want to solve problems without putting it off indefinitely. Consider several situations from which you will understand when it is realistic to carry out treatment in this way, and when it is not.

The first situation: you need to remove a tooth

You went to the dentist and found out that the tooth cannot be restored, and the only right decision is to remove it. I don’t want to go with “gaps” - this is quite logical. If the situation with the removal is not urgent, then one-stage implantation is quite suitable for you (it can be called partly a synonym or even a kind of one-stage method). In this case, the doctor will remove the diseased tooth in one visit and simultaneously replace it with an implant (this manipulation can be applied to all one-stage implantation methods).

Depending on the clinical situation, such implantation may involve both immediate and delayed loading of the prosthesis. An important role is played by the quality of the bone tissue and how good the primary fixation is of the implant. It is also important how simple and non-traumatic the procedure for removing a living tooth was.

In the best case, the artificial root can be loaded immediately or after 2-4 weeks with a lightweight fixed crown, which will be removed from the bite - this is done so that the load during the engraftment of the artificial root is minimal. At worst, the entire period of osseointegration of the implant into the bone (approximately 3-6 months) will have to wear a removable immediate prosthesis.

Important! Requirements for immediate loading during a single-stage restoration of one tooth: the presence of natural or artificial teeth of the patient around the implant (it is necessary to reduce the masticatory load on the artificial root, to protect the structure from displacement), high primary stability of the implant, good quality of the jawbone.

The only drawback of the method is that the patient does not always have the opportunity to prepare for the procedure, and it is impossible to do without high-quality preparation for implantation. Often, the removal procedure has to be carried out urgently, which is a direct contraindication to this implantation protocol.

Second situation: the tooth has been missing for a long time

In this case, one-stage implantation with immediate loading of the prosthesis is out of the question. The fact is that almost immediately after the extraction of a tooth, the bone tissue here begins to decrease in volume, i.e. she atrophies. This process is natural, because the bone in this area ceases to receive chewing load, and since. Since its central section consists mainly of spongy substance and capillaries, then the cells cease to receive nutrition. As a result, the amount of spongy matter is rapidly reduced.

Fixing a classic implant in the jawbone in this state of affairs is very problematic (given that it must be completely immersed in the bone), because the process would be fraught with difficulties (risk of injuring nerve endings and nasal sinuses, instability of the artificial root). Even under the condition that the titanium root is fixed, it is not rational to immediately load it with a prosthesis, otherwise it may move, loosen and even be torn off. To begin with, it must properly take root in the bone tissue of the jaw, which will take at least six months.

To summarize, in the first situation, immediate implantation is real, if there are no contraindications to it. In the second situation, when the patient is already missing a tooth, only a classic two-stage implantation with a delayed loading of the prosthesis can be performed. Before the procedure, in most cases, you will also have to resort to.

Requirements for implants used in protocols

Not all implant models are suitable for one-stage implantation of teeth, despite the fact that both one-piece and two-piece structures can be used with this approach. Dental clinics that value their reputation always use those systems for immediate loading conditions that are designed specifically for these protocols. In particular, in the lateral sections they can be implanted at an angle and involve dense and deep, sterile layers of bone tissue (cortical and basal, not just spongy). In addition, due to fixation at an angle, implants make it possible to do without bone grafting, avoid injury to the nerve endings and sinuses in the upper jaw, and increase the area of ​​contact with the jawbone. This approach provides them with reliable primary stability and makes it possible to immediately load the prosthesis.

Important! If one-stage basal or zygomatic implantation is practiced, then models can be used for them that extend beyond the jaw and are fixed, for example, in the cheekbone (zygomatic) or chin region (basal and cortical). Such models are longer than the classic ones. In Russia, brands from (Zygoma),. Also today, progressive implantologists use models from a Belarusian company (ZygoLine).

Artificial roots used in single-stage protocols must also meet other criteria:

On a note! There are different types of surfaces - in the presence of a porous structure, it is very important that the implant is completely immersed inside the bone tissue. Then, in the presence of an inflammatory process, the risks of infection of the tissues around it are minimal. Implants with a smooth surface (or a smooth top) may, respectively, be in contact with the gum or be located closer to it. This allows you to solve the problems of missing teeth in the presence of problems such as periodontitis or periodontal disease.

At this point of the article, it is also worth emphasizing that with single-stage treatment protocols, the implant models used must be of good quality. They should only be original, time-tested and clinically tested, so it’s better to choose manufacturers’ brands that have existed for decades, constantly test their products, certify them, and publish all the data on their official websites.

Indications for the procedure

The absence of any number of teeth and especially complete adentia, osteoporosis, diabetes, recovery from oncology, old age, smoking, the presence of inflammation in the mouth and decayed teeth, as well as pronounced (sometimes even called extreme) loss of bone tissue of any of the jaws. That is, situations where conventional classical implantation cannot help.

Contraindications: absolute and relative

Immediate implantation has a relatively small list of indications, suitable for a large number of patients who have complex clinical cases, but it also has contraindications. Compared to the indications, they are minimal and, in general, standard - this is the presence of diseases that do not allow for surgical intervention and the use of all currently possible methods of anesthesia, including anesthesia and sedation. As well as serious pathologies of the body, in particular, the cardiovascular system, tumors, HIV, AIDS, oncological problems, masticatory muscle tone, decompensated diabetes mellitus.

Doctors distinguish two main groups of contraindications: absolute and relative. All of the above are absolute and do not allow doctors to perform one-stage dental implantation in principle. Patients with these diseases will have to choose alternative treatment options, for example,.

As for relative contraindications, their presence does not mean that the procedure cannot be performed. It just needs to be postponed until the factors that interfere with the high-quality, safe treatment and good engraftment of artificial roots are eliminated. For example, such contraindications include pregnancy and lactation, weak immunity, exacerbation of chronic diseases, inflammation of the maxillary sinuses, age up to 18 years (you need to wait until the final formation of the maxillofacial apparatus and bone structures occurs).

Is it possible to restore all teeth in 1 day

For the first time, having heard about one-stage methods of restoring teeth with the help of implantation, many patients are very skeptical. They think claims of getting a quick smile are nothing more than a ploy by unscrupulous doctors to attract a flood of people. But that's not the case at all. To be convinced of this, you need to understand the mechanism and stages of implementing such an innovative approach from all points of view. And here are some facts about it that have been reliably proven in practice:

• the prosthesis immediately (at least within 6 hours after the installation of implants, maximum - on the fifth day after that): indeed, here the active followers of one-stage dental implantation do not deceive you at all. The rules for carrying out such a technique put a mandatory condition for the doctor - the prosthesis must be fixed as soon as possible immediately after the implants are installed. It is an adequate load on the artificial roots that will help “turn on” the bone around them to work and ensure a quick process of its healing, recovery, that is, rehabilitation. In addition, the prosthesis will guarantee that the implants will not loosen or fall out in the first weeks after the operation, even if you begin to fully eat and chew food (this can and should be done), it stabilizes them due to the strong metal component in configuration,
• preparation for treatment: the technologies that are used today to eliminate risks and errors in the process of treatment itself are very advanced - these are 3D modeling and printers, computed tomography of the jaw, visualization, computer programs. However, a patient who decides to implant according to the immediate loading protocol should understand that the success of the result directly depends on the passage of this stage. Before restoring teeth, according to indications, you may also be prescribed a blood test, a visit to an endocrinologist or cardiologist, and other specialists who can give an accurate assessment of your health. It is not necessary to ignore such measures, especially since it will take you about a couple of weeks maximum.

On a note! Is immediate implantation possible immediately after tooth extraction? Yes. If you have movable, destroyed and to be removed elements in your mouth, then this is not an obstacle to the procedure. The specialist will solve two problems at once in one visit.

We draw conclusions: it is possible to make teeth in 1 day, but we are talking about getting a fixed prosthesis immediately after implantation. Do not forget about the preparatory stage, which is important to go through before the implantation of artificial roots is carried out. On average, you will spend no more than a week on all the manipulations from and to. The doctor will need to visit 2-4 times.

Stages of treatment: how dental implantation works

Hearing the word "one-stage", some patients think that everything will be limited to just one procedure. In order for you to have a clear idea of ​​how the entire treatment process goes from and to, read below about all the stages of one-stage implantation.

First stage: preparation. At this stage, you will need to take blood tests, undergo computed tomography, visit highly specialized specialists if necessary (for example, for elderly patients, a cardiologist's opinion may be required, for patients with diabetes, control by an endocrinologist is mandatory). That is, no installation on the day of the visit - this can be very dangerous! After the doctor receives all the data, it will be necessary to exclude absolute, and then relative contraindications. Preparation can take from a couple of days to several months - it all depends on the severity of the case, as well as general health.

Second phase: treatment planning. Here, the minimum is required from the patient, because all the main work at this stage is performed by the doctor. In order for everything to go smoothly and without complications, with minimal risks, it is better if specialists use advanced technologies. For example, 3D modeling of the treatment process on a computer, making surgical templates for accurate positioning of implants, using 3D printers to create lithographic models of the patient's jaw and "rehearsal" of the surgical stage. Only after choosing the ideal implant model for you and determining the exact location of its positioning in the jawbone, you can proceed to the next step. Planning takes from a couple of days to a week - it all depends again on the complexity of the clinical case, the workload of the doctor and his assistants.

Third stage: insertion of implants. Surgical manipulations, depending on the complexity of the clinical case, on the number of implants to be installed, can take from 1 to 4-5 hours. However, the patient should not worry about this, because. high-quality anesthesia (narcosis or sedation is also possible) will help to make the whole process completely painless and survive it calmly. In the classic version, the doctor first exfoliates the mucosa, and then screws the artificial root into the bone, after which sutures are applied. But when using single-stage protocols, a different approach is often practiced, involving a minimally invasive intervention. Through the surgical templates, the implant actually pierces the tissue and is screwed into the allotted place, which eliminates the need for massive sutures, and makes the rehabilitation period easier and more comfortable.

Fourth stage: installation of an adaptive prosthesis. Within 72 hours after the implantation of artificial roots, the doctor will install a prosthesis for you (multi-unit abutments will be used for implants in the lateral sections). Such a prosthesis will be made of lightweight materials (for example, metal-plastic), based on a metal base. The design stabilizes the implants and allows you to start eating almost immediately. After 4-6 months (or a maximum of 2-3 years), a lightweight adaptive prosthesis can be replaced with a permanent one, but for those patients who want to bypass the stage of reprosthetics, there is an alternative. You can choose a ceramic composite prosthesis, it is light and beautiful, and can last more than 15 years. However, its cost is higher.

Fifth stage: permanent prosthetics. Metal-plastic prostheses must be replaced with stronger and more durable structures within the first three years after implant placement. The fact is that the plastic layer grinds off rather quickly, which can lead to an undesirable change in bite and a violation of aesthetics. It is better if such a prosthesis is replaced with a permanent one immediately after the implantation of artificial roots in the jawbone (i.e. after 6-12 months).

How are single-stage protocols different from two-stage protocols?

Speaking of one-stage, one cannot fail to mention the two-stage implantation. If you are one of those who are tormented by the question of what is better to choose, then this section of the article is just for you. We will outline several fundamental differences that will help you understand the difference in approaches and, accordingly, make your choice.

1. Number of missing teeth

Classic is good and justified for single restorations, while immediate loading is optimal for people with missing 3-4 or more teeth.

2. Bone augmentation

With a two-stage approach, it is in most cases necessary for further treatment. An operation to increase the missing bone volume may be required in case of a long absence of teeth or the presence of inflammatory processes in the periodontal tissues. The procedure requires recovery - it will take from 3 to 6 months of rehabilitation.

Implantation with immediate loading in 90% of all cases does not require bone augmentation due to the design features of the implants used. For example, such as two-part, or one-part. All of them can be installed at an angle in the lateral sections, have an active porous or antibacterial coating, depending on the selected model, so not only are they perfectly fixed right away, but they also quickly grow into the bone. In the remaining 10%, the build-up is carried out in conjunction with the implantation of implants and, again, avoids the waiting period for new teeth.

Important! It is noteworthy that specially designed Nobel and Straumann models are also used for classical treatment protocols. They have unique characteristics that make it possible to speed up the time for obtaining new teeth by reducing the rehabilitation period and the rapid engraftment of bone tissue cells with artificial roots.

3. Terms of obtaining new teeth

Features of prosthetics with a one-stage implantation technique are such that, as mentioned above, you get a smile, and as a bonus to it, the ability to chew food with new teeth immediately. This is the main advantage. But with the classic two-stage treatment, the expectation is inevitable: there are bad teeth - you will have to remove and wait for the holes to heal for about 2-4 months, poor bone quality - spend another 4-6 months of time additionally (with individual characteristics of the body, it can even take up to a year), installed implants - wait another 6 months for them to take root. And only after 10-20 months the result will finally be achieved.

“One-stage and two-stage dental implants are two completely different approaches. There is only one thing that unites them - equally high-quality and long-term results in the event that the treatment was carried out by an experienced doctor, and the patient approached the process responsibly and did not violate the recommendations. Otherwise, the methods are different regarding the conditions of engraftment of implants, the conditions of loading on them and prosthetics. Of course, one cannot but agree that the immediate loading method wins in terms of aesthetics, functionality, time, and price. However, it also has disadvantages, the main of which is an acute shortage of professional personnel practicing the methods. In Russia, they are still considered innovative, although in Europe they have long been successfully used in medical practice. Therefore, the main task of the patient is to choose a doctor who really knows the techniques at a high level,”- says the maxillofacial surgeon,.

4. Issue price

One-stage implantation is a profitable solution for those who need not only to regain their beauty, youth and the ability to enjoy life, but also to calculate their expenses in advance. Advanced clinics prefer to set the price for this approach on a turnkey basis for the peace of mind of their patients. Those. you will know in advance how much the expenses will be with the maximum of services rendered (but it is better to check what is included in the complex in advance, do not hesitate to discuss this issue with your doctor). With the most economical approach, they will not exceed 250 thousand rubles for the restoration of all teeth in one of the jaws. But keep in mind that the cost will directly depend on the number of implants to be installed, their brand, and facing materials for the prosthesis.

In comparison, two-stage treatment, even with the restoration of one tooth, can be very unpredictable in terms of price, because you may need bone grafting, gum plastic surgery, you will have to visit a doctor an unlimited number of times and take consultations - all this is not only time, but also money. And for the restoration of a full row of teeth, prepare 400 or more thousand rubles.

Summing up: advantages of the one-step method

• there is no need to increase the jaw bone tissue even with severe atrophy and the presence of inflammatory processes,

On a note! Practice shows that only three out of a hundred patients simultaneously with one-stage dental implantation, according to indications, require bone grafting. All other patients successfully do without this procedure. In addition, doctors' reviews today indicate that instead of osteoplastic surgery, in this case it is much more effective to use platelet-rich fibrin membranes, which specialists obtain from the patient's blood plasma.

• a beautiful smile within seventy-two hours after the installation of artificial roots: the prosthesis has an artificial gum that hides mucosal defects, on which there was an inflammatory process or destructive changes associated with a long absence of teeth. The advantage of artificial gums is that you are spared the need to undergo mucosal plasty procedures,
• the ability to fully chew food: the basis of the prosthesis is a metal bar that connects and stabilizes the implants, and also allows you to eat food without the risk of damaging or displacing them even at the very early stage of osseointegration,
• versatility: Immediate loading implantation is suitable for a large number of patients. For example, the method of basal implantation with immediate loading will solve the problem of adentia even in the presence of periodontitis and periodontal disease, there is no age limit for it (the main thing is that the patient is healthy and has no absolute contraindications),
• fast rehabilitation process: implants are installed only after a thorough study of the treatment in 3D and the creation of surgical templates. Through such surgical guides, they are easily fixed in the bone in a strictly designated place, which avoids unnecessary trauma, the involvement of a large number of tissues, incisions and sutures, severe bleeding and pain,
• savings: firstly, you save time (the treatment will take no more than seven days in total), and secondly, you save money compared to classical implantation.

What to look for if you want to get teeth quickly and safely

Remember that regardless of the choice, the work should be performed by a professional implantologist, preferably an oral and maxillofacial surgeon, whose practice is certified and supported by positive reviews. But as for the classical technology of implantation, it is practiced today by many due to the conservative approach: in order to learn how to use it in practice, you do not need to go abroad and constantly acquire new equipment, improve your skills.

But the one-stage one requires compliance with completely different conditions: this includes studying abroad, including constant confirmation of one's professional status, and working with a variety of implant systems and implantation techniques. Plus, add to this the ability to work with the latest generation of computer equipment, the ability to "see" the result of treatment in advance and in the future, to work out all the nuances even before the installation of artificial structures.

One-stage protocols are the highest level of responsibility to your patient and the absence of the right to make a mistake, which not all doctors decide on. And this is perhaps the biggest disadvantage of this approach. In addition, in order to carry out their work quickly, the specialist must have all the material and accessories necessary for these purposes - the same implants and abutments that are right for you. Today, uninterrupted interaction with manufacturers of high-quality models, perhaps, is carried out only in the capital's clinics in Moscow, where clinical bases and service centers of such world brands as Nobel, for example, are located nearby. So draw your own conclusions.

On a note! Based on the surveys conducted, researchers have identified the expectations that patients themselves place on dental implantation: quick results, painlessness and safety, the use of the latest technologies in treatment, aesthetics of a smile close to natural, affordability. All these expectations are justified when using one-stage options for restoring teeth in comparison with two-stage ones.

If you really want to get teeth quickly, then remember that this is more than realistic today, but choose a specialist very carefully, consider different options, contact different clinics and compare approaches, conduct a comprehensive analysis. Well, do not rely only on the doctor. Remember that 10% success also depends on you - clearly follow all the instructions of the specialist during the rehabilitation period. This will allow you to achieve what you want and in a week you will be able to communicate, smile, eat and receive envious glances from others.

Video review of the patient after surgery

1 Kishchenko V.A. Indications and contraindications for one-stage implantation. Medicine and healthcare, 2006

Terminology

Peculiarities

Planning

Surgical technique

Prosthetics

Conclusion

conclusions

Pavel Polupan, Russia Moscow

The active spread of the method of dental implantation forces practitioners and scientists to develop more rational methods of its application, while remaining within the framework of operation protocols confirmed by experience.

Currently, defects in the dentition are found in almost 75% of the population of the Russian Federation. Federation of working age. In modern society, this makes the problem of adentia more and more relevant, forcing us to look for new, more effective ways to treat it. The problem of rehabilitation of patients with adentia with the help of dental implantation is devoted to many works, which discuss the issues of surgical techniques, methods of prosthetics, patient management tactics, etc. According to studies, the demand for the installation of orthopedic structures on implants should exceed the demand for all other types of dental care.

There are a large number of brands and manufacturers of dental implants (implants), both domestic and foreign, which provide diversity and the ability to choose one or another design (Fig. 1).

Rice. 1. Implants of different designs and examples of chewing load distribution.

It is practically impossible to determine a clear leader in this market today, and the prevalence of implantation systems depends primarily on the marketing efforts of manufacturing companies, and not on clinical results. Dentists choose their preferred system more often for economic reasons than for medical reasons.

The variety of configurations and design differences does not play a significant role in treatment tactics. All systems of traditional two-stage implants do not differ fundamentally, there are no significant advantages and differences between them. And the effectiveness of treatment depends not only on the manufacturer and trade mark (brand), but also on the level of performing skills of the surgeon and orthopedic dentist.

The fundamental difference in treatment tactics is the use of a one-stage concept. To date, a one-stage surgical protocol has proven itself well in world practice and the use of one-stage implants is spreading. In the literature, there are more and more works devoted to the one-stage protocol and one-stage implants.

Terminology

The "gold standard" of implantation is the use of titanium screw implants with a rough surface.

It is necessary to distinguish between the protocols of dental implantation (one-stage / two-stage), as well as different designs of the screw implants used (monolithic / collapsible). In view of the existing confusion, we will analyze these basic concepts in more detail.

The two-stage protocol of implantation surgery, the most common in the world, has also become a classic. This technique involves a surgical intervention consisting of 2 stages:

Stage I – implant installation operation;
- Stage II - implant opening operation.

According to this protocol, only collapsible implants are installed, consisting of an intraosseous (implant itself) and an extraosseous (abutment) part.

In the one-stage protocol (single-stage implantation), the second stage of the operation, the opening of the implant, is excluded from the surgical part, and the extraosseous part (abutment) is positioned immediately during the implant installation operation. Healing in this case takes place transgingivally. Both one-stage (monolithic) implants and two-stage (collapsible) implants can be installed in one stage, immediately fixing the gingiva former or abutment on them.

A one-stage implant has the same parts as a two-stage implant - intraosseous and abutment, but they are connected monolithically (Fig. 2).

Rice. 2. An example of a one-stage implant, a brief implantation protocol.

One-stage implantation should not be confused with one-stage and mini-implantation.

Immediate implantation - the installation of an implant immediately after tooth extraction. It can be performed using either a one-stage or a two-stage protocol.

Mini-implants are called implants of small diameter (up to 2.5 mm), which, as a rule, are installed "bloodless", i.e. without incision (exfoliation of the flap). Unfortunately, this method of installation often leads to their loss due to the “blindness” of positioning in the alveolar ridge.

Peculiarities

It is known that the biomechanics of the distribution of stresses in the bone tissue during implantation is similar to the distribution of stresses in a single-rooted tooth. And since a functionally monolithic structure is much more reliable than a collapsible one, problems such as unwinding of the abutment, fracture of the fixing screw or implant are excluded, and the very absence of a microgap at the junction eliminates bacterial contamination, the appearance of an unpleasant odor or the development of peri-implantitis.

Single-stage implants are typically root-shaped and have an aggressive thread design. They provide maximum primary stability and distribute the masticatory load evenly over the entire surface area, without causing stress in transverse and longitudinal sections, until osseointegration occurs (Fig. 3).

Rice. 3. Mathematical model for calculating the distribution of masticatory loads by the finite element method.

Stabilization is sufficient even in porous bone with a predominance of spongy structure.

In this case, a monolithic implant is installed with any necessary force, even if it significantly exceeds 50 Ncm, the maximum allowable for all two-stage structures due to the risk of their fracture.

A special feature is that the diameter of the formed bone hole for a 4.5 mm implant is only 3 mm, which allows implants to be placed in a narrow alveolar ridge, avoiding such complex manipulations as bone grafting with its often disappointing results.

It should be noted that the cost of such implantation is quite low. It consists of a minimum set of consumables and related tools, which reduces the cost of the procedure. At the same time, the cost of a crown on a tooth and an implant does not differ.

Planning

Planning in implantology occupies a fundamental place. Success or failure depends largely on this. It must be remembered that the ultimate goal of implantation is precisely the orthopedic structure, i.e. patient's new teeth. The desire to complicate the treatment plan is not always justified clinically, ethically and economically. And if a complex treatment does not guarantee an aesthetic long-term end result, then a simpler and more reliable path is preferable.

At the planning stage, after questioning the patient and identifying his complaints, a clinical examination is carried out using additional research methods (radiography, tomography, rheography, densitometry, the study of control and diagnostic models, blood tests). Together with an orthopedist and a dental technician, an analysis of the data obtained is carried out in order to optimize the occlusal load and a treatment plan is drawn up. If necessary, X-ray and surgical templates are made. After assessing the clinical situation, the number, the most appropriate length and diameter of the implants and their placement are selected.

It should be noted that the establishment of trusting relationships in patient/doctor communication is an integral part of successful treatment, since emotional perception is no less important for the patient than visual or functional.

Surgical technique

According to a one-stage technique, dental implantation is performed according to a standard surgical protocol.

A feature of the surgical stage is the extreme importance of the positioning of implants during installation (installation site and axis direction). Since, even when using navigational techniques, the planned and actual placement and orientation of the implant almost always differ from each other, the operating surgeon needs an independent vision of the future prosthetics. For doctors with orthopedic experience, this does not cause difficulties and is best obtained by implantologists who themselves deal with implant prosthetics (Fig. 4).

Rice. 4. Comparative clinical example of prosthetics on one-stage implants and natural teeth.

During installation, the immersion depth is controlled to a minimum to the border of the rough and polished surface. It is better, given the future traumatic atrophy of the ridge, to immerse the polished neck by 1–2 mm. After that, it is obligatory to check the inter-occlusal height in the position of central occlusion. Dissociation of the abutment and its antagonist in the oral cavity must be unconditional, i.e. visible by 2–3 mm, necessary for a future crown. It should also be remembered about the approximate distances between the teeth and implants, so that the bone septum between their edges is at least 3–4 mm.

Prosthetics

With the correct positioning, prosthetics on one-stage implants are not difficult and are simple and reliable.

8–12 weeks after the operation, silicone gingiva formers are placed bloodlessly (Fig. 5).

Rice. 5. The formation of gums after healing occurs without bloodshed within 1-2 days.

After 2–3 days, a two-layer simultaneous silicone impression is taken using a standard impression tray and plastic transfer caps (“closed tray” technique). The open-tray technique and metal screw-on transfers are not used in this protocol, and a simple direct impression of the abutment is much better than the traditional open-tray technique. For an accurate fit of the soft tissues and the contour of the eruption of the crown, it is desirable to make a plaster model with a gingival mask.

In case of unfavorable inclination, it is necessary to prepare the abutment. This is done either directly in the mouth before taking the impression (in this case, it is removed without transfer caps, as from one’s own teeth), or the abutment analogue is milled by the technician on a plaster model, then a prosthesis and a key for the doctor are made from modeling plastic.

The cost of dental work on such implants is similar to the cost of standard work on natural teeth, since it does not require the purchase of the abutment itself, long procedures for its removal / installation and special cutters (Fig. 4, 6).

Rice. 6. An example of the integration of a one-stage implant with a single missing tooth.

The structures are cemented with permanent cement - glass ionomer, polycarboxylate, zinc phosphate. When installing porcelain-fused-to-metal crowns, plastic cement is also often used for temporary fixation, while this design can always be removed, and the degree of fixation is sufficient if the fabricated design is precision.

Conclusion

Implantation occupies an increasing place in the practice of dentists and is recognized as the most promising direction in the development of our specialty. The one-stage implantation protocol includes the same surgical steps as the two-stage protocol, with the exception of the implant opening operation. It is characterized by simplicity and a minimum of surgical steps and components, without differing in the effectiveness of treatment.

conclusions

The use of a one-stage concept and one-stage implants is an alternative to the generally accepted two-stage protocol and allows in many cases to successfully avoid bone grafting, which is a rather traumatic, long, expensive and insufficiently predictable procedure. This reduces the recovery time for patients.

One-stage (monolithic) implants do not have the disadvantages of two-stage (collapsible) ones, they are easier to prosthetics, but at the same time they require more accurate positioning from the doctor during the operation.

The presence of orthopedic experience in the operating surgeon ensures the simplicity and success of further prosthetics.

The manufacture of fixed orthopedic structures and their cost do not differ from those on one's own teeth.

A one-stage implant is an inexpensive choice, especially in complex clinical cases requiring simple solutions.

Pavel Polupan, Russia Moscow
Manager of his own clinic Dental-Studio, leading. WHITE-CLINIC specialist. He is a clinical resident of the department. Maxillofacial Surgery and Surgical Dentistry GBUZ MO MONIKI them. M.F. Vladimirsky.P. Polupan is also a member of a number of dental associations (European Association for Cranio-Maxillo-Facial Surgery, Moscow Regional Association of Dentists and Maxillofacial Surgeons, Russian-Bulgarian Dental Society) and a consultant doctor of dental companies.