Implantation is becoming more and more popular and affordable.
Despite the sea of information on the Internet, patients are concerned about many issues – from the life of the implant to contraindications to its installation.
Alexander Akhtanin, an orthopedist, a dentist-implantologist at the Family Dentistry clinic, collected 11 most frequent questions that he had heard from patients over the years of practice, and gave detailed answers to them.
"For how long can you postpone implantation?"
Many patients are sure that after the loss of a tooth, you can wait a year, two, three or even more. But when a tooth is absent for a long time in the workplace, the bone in this area begins to dissolve. As muscles without training, the bone without proper chewing load simply "leaves."
Thus, the patient himself creates a problem – instead of simply installing the implant, the doctor must perform various additional procedures, such as surgical bone building, before that. Moreover, these procedures are usually more traumatic than installing an implant, they take a long time to restore the patient and, also importantly, additional money. So, if you have lost a tooth, do not delay – contact the implantologist immediately.
“If you postpone implantation until later, then nothing terrible will happen to your teeth?”
The main problems arise not for those who came immediately after losing a tooth, but for those who postponed implantation for many years. One of these difficulties – the occurrence of tilt teeth. If one or several teeth are missing for a long time, then their neighbors begin to bend down or move toward the gaping void. As a result, instead of simply putting implants, doctors have to pick up braces, and the patient, instead of a single operation, must undergo a long-term orthodontic treatment.
Of course, patients often turn for implantation after they have bridges brought in for decades, which is not surprising – for a long time about any implantation in our country was out of the question. In this case, the doctor selects the tactics of treatment individually – depending on the volume of the surviving bone (it may initially be so much that even the remaining amount is enough for successful implantation).
If the volume is very small, then the doctor carefully selects bone grafting methods or implants (for example, from Straumann), which will allow to perform the operation even with a minimum of bone.
Most often, the patient is offered two treatment options and explains the advantages and disadvantages of each of them.
“Is it possible to remove a tooth and immediately install an implant?”
Yes, you can – now there are techniques that allow such an operation. Moreover, implantologists actively apply them. Such operations are called single-stage implantation or, in some clinics, express implantation.
In this case, the risks of treatment are generally minimal. There are also techniques by which the doctor can install a temporary crown on the implant immediately on the day of surgery. This is especially true when the implantologist restores the smile area. In any case, the patient does not have to walk with a gap between the teeth.
You can also install a temporary crown on a chewing tooth, but it is important to remember: you cannot chew it right away! The crown serves to eliminate discomfort, and some patients begin to lisp in the absence of a tooth.
But, nevertheless, until the implant takes root, you cannot chew on the temporary crown. It takes 4 to 6 months, with the implant taking root in the lower jaw more quickly.
“The implant is a nail with a tooth, right?”
No: the implant is a separate product. The crown, which is installed on it, is also created separately, in the dental laboratory, while the clinic itself does not do implants, but buys them from manufacturers.
Sometimes patients even worry about how they will walk with the implant sticking out of the gums. But we hasten to reassure – nothing will come out of the gums, the implant is inside the bone. Yes, it takes time to take root, but there are no protruding parts.
Patients rarely pay attention to what kind of implant they put. Here it is best, firstly, to choose a doctor who can be fully trusted, and, secondly, to give preference to well-known manufacturers of implants, which are among the top 10 global companies.
This approach will give more reliable results, because These companies have been on the market for decades, they have conducted many years of research, and if necessary, there will always be components for their products.
“Why read something about implants, aren't they all the same?”
This is also not true: yes, implants in general look similar, like peas from one pod, but they cannot be called absolutely identical in their characteristics.
The doctor selects them based on a variety of factors — the patient’s individual characteristics, the place where the implant will be, and so on.
Crowns are also different – for example, they are made from different materials. There is an old wicked classic – metal ceramics, when a ceramic layer is applied on a metallic dark base. And there are the most modern and aesthetic – from zirconium dioxide. This is the best option for implantation.
“Does it hurt during implantation? Do they always do it under general anesthesia? ”
The implantation procedure is completely painless. General anesthesia, as a rule, is not required, rather local. There are patients with a very strong gag reflex or panic fear of treatment. There are also cases where general anesthesia is necessary due to the patient’s health condition. But most often during implantation they can do without it – over 95% of operations are performed under conditions of local anesthesia, which is more than enough.
This is due to the fact that the bone does not have nerve endings and does not feel pain, and it is easy and not for long to anesthetize the gum. For comparison, the removal of a tooth is more traumatic and requires stronger anesthesia than the installation of an implant.
If there is a surgery to install a very large number of implants (for example, 12-14 pieces, which happens in specialized clinics for implantation every week), even patients of the 30s-40s of birth undergo local anesthesia.
Why not give anesthesia?
This is an additional burden on the body, firstly, and secondly, most often anesthesia is given through a tube that is inserted into the nose or throat. This creates a lot of difficulties – a person cannot communicate with a doctor or even cough, because is unconscious. There is a risk of blood leakage to the lungs, etc.
If the patient needs to rest or becomes ill, then under local anesthesia he will let the doctor know, and the doctor will immediately begin to take action. So the absence of anesthesia is rather a plus than a minus.
“How long will implants last for me?”
Now there are observations of patients whose implants are 20-25 years old – however, these are products of Swiss and German companies that occupy top positions.
Patients with Straumann implants installed in the late 90s, still feel great. Implants are firm, no problems do not deliver, and this is already an indicator of quality.
In Russia, mass work with implants started in the early 2000s. So, although there are isolated observations of patients who installed implants more than 30 years ago, so far we can only talk about 20 years of constant observations. But, as practice shows, the implant can serve the patient a lifetime, because even after 20 years of wearing does not cause the slightest discomfort. The main thing is to choose a manufacturing company that has reliably established itself and has been working for decades (for example, 50-60 years).
Sometimes it is necessary to change the crown – and in order not to do this very often, you need to use zirconia products.
By the way, when changing a crown, the easiest way to do this is if the implant itself is made by a company that has been in the market for decades.
“How difficult is it to care for implants?”
Implants do not require any procedures of incredible complexity. But hygiene should be regular and very thorough. This is, in principle, the key to successful engraftment and long service implant.
The gum area around the implant is more delicate than around the natural tooth, requires more care, so daily tooth brushing in the morning and evening is a must. Additionally, you should use floss (dental floss).
Wooden toothpicks are strictly forbidden – they cause harm to natural teeth, and in the presence of an implant – trouble is guaranteed, up to rejection.
If there are many implants, the doctor recommends a home irrigator – a device that, under pressure, supplies a stream of water and cleans teeth and interdental spaces.
“Why do I need bone buildup and what is it all about?”
The implant is implanted in the jaw bone, which means that the bone tissue should be sufficient for its stability, also need blood vessels that will nourish it. If the tooth was lost a long time ago, or when a bone was removed, a lot of bone was lost, then bone plastics will be required – building up the bone at the implantation site (especially when working in the smile area – for an aesthetic and natural looking result).
It is better to remove and place the implant with one doctor – then he will try to keep the bone maximum.
Of course, there are indications for building bones, but in modern dentistry doctors try to choose techniques that can do without this procedure: it is traumatic, quite expensive and requires additional time costs.
There are two types of such an operation – with artificial bone material or bone tissue of the patient himself. Naturally, if we are talking about implantation all over the jaw, doctors refuse to build up, because it is very difficult, traumatic and creates additional risks.
"Implants can not be put in a very old age and in the presence of many diseases?"
Implantology continues to evolve rapidly. Operations today can be carried out in the presence of diseases that ten years ago were considered an absolute contraindication – diabetes, thyroid disease, osteoporosis. Even hypertension is no longer an obstacle – innovative technologies make implantation accessible to all more people. The same applies to elderly patients – both those who have such diseases and those who are simply afraid of implantation due to age. But now the installation of the implant is available even for people aged 80-90 years – and passes without complications or any difficulties.
"And what about women who drink hormones?"
It is no secret that many women doctors prescribed hormones as part of treatment. Of course, these patients have concerns – how will the constant use of hormonal drugs affect the engraftment of the implant? Can I put it at all?
There are several options for the development of the situation. For example, women in the postmenopausal period often experience increased bone fragility due to hormonal age-related changes. After diagnosis, doctors prescribe them, including hormones. And here the implantologist usually advises to postpone implantation for a while, because these drugs cause serious complications.
But in other cases, the use of hormonal agents is in no way connected with the state of the bone tissue, which, in fact, concerns the implantologist. Such drugs will not affect implantation. By the way, for problems with the thyroid gland, the doctor will refer the patient to an endocrinologist to correct the situation. The most important thing is to inform the implantologist that you are taking any hormonal medications.
But if a woman is planning a pregnancy, then the implantation is definitely delayed until the end of the breastfeeding period. After installing the implant, the patient will be prescribed a mandatory course of antibiotics, which is highly undesirable during pregnancy or during feeding.