People are often interested in how the implantation of the front upper teeth is carried out. This topic is popular because they are easy to lose or break during an injury while playing sports or an unsuccessful fall. Implantology is an innovative direction in dentistry, which makes it possible to create a completely new tooth based on an artificial root and restore a beautiful smile.

An artificial support is introduced into the jaw tissue, on which the artificial tooth will be held. The structure, embedded in the bone tissue, later fuses with it, performing the function of the tooth root.

The technology for installing an implant instead of a front tooth in the upper jaw is not much different from replacing any other tooth. The main material for the manufacture of the implant is titanium. It is the most durable and malleable metal, from which products of small sizes and shapes are easily obtained. This is a very important point, because it is not difficult for an implantologist to choose the optimal shape that suits the patient's jaw bone tissue. There are also materials with the addition of zirconium, but they are used less frequently.

But the desire of the patient alone is not enough to carry out such an intervention. Permission for implantation can only be given by a dentist after examining his health and examining the condition of his teeth. Contraindications include diseases such as:

• hypertension;
• diabetes;
• oncological;
• blood diseases;
• ischemic heart disease;
• the patient's age is up to 16 years;
• elderly age;
• Implants are not recommended for smokers.

Implantation of the upper jaw is postponed if a person suffers from diseases of the ENT organs until complete recovery.

Dental implantation refers only to the implantation of a support into the tissue. At the request of the patient, a crown will be fixed on it, which can be made of different materials: metal ceramics, ceramics, gold and plastic. The crown is fixed in 2 ways - screwing and cementing. The choice depends on the situation and the patient's ability to pay.

Dmitry Sidorov

Dentist-orthopedist

Studies conducted in the field of dentistry on the implantation of dental implants have shown that when using medicines against heartburn, the structures do not take root. This is due to the effect of these drugs on the absorption of calcium in the intestine.

Features of the installation of the implant on the upper jaw

The upper and lower jaws differ from each other in anatomical structure and in functional features. This is taken into account when implantation of the teeth of the upper jaw is performed. When chewing food, the load falls more on the lower jaw, so its bone tissue is much thicker and stronger than the upper one.

The maxillary sinuses are tightly attached to the bone of the upper jaw, which an inexperienced doctor can damage when installing a pin, they can become inflamed and greatly complicate the operation process.

Let us consider in detail how implants are placed on the upper jaw. The design of an artificial tooth itself consists of a support (the implant itself), a crown and an abutment (an intermediate part between the support and the crown, which plays the role of a link).

Installation steps:

1. Installation of the intraosseous part of the implant. This process is performed under local anesthesia and an implant is inserted into the cavity of the missing tooth. Its engraftment to the bone tissue of the jaw lasts about six months.
2. Abutment installation. The base for the crown is attached to the implant with the help of a screw, on which the artificial tooth will be held.
3. At the time of engraftment of the pin, the doctor installs a temporary crown, which is held on the abutment screwed to the implant. It is usually made from plastic.
4. Installation of crowns. This is the final formation of the tooth 6 months after the operation.

Dmitry Sidorov

Dentist-orthopedist

When implanting the anterior upper teeth, emphasis is placed on the most accurate installation of the pin, since when forming the contour of the gums, the axis of the implant must be set evenly.

After successful insertion of the implant into the bone tissue and installation of the abutment, the gum is sutured with temporary threads. The patient is given a short course of antibiotics to avoid complications.

After the operation, aching pain is also possible, but this is a temporary phenomenon and after a few days, when the tissue begins to regenerate, these symptoms will disappear.

Materials for the manufacture of crowns of the anterior upper teeth are selected on a metal-free basis, since these teeth are very light and are in full view. Zirconium and aluminum oxide are mainly used, which also serve for a long time, and their color can be made indistinguishable from the enamel of other teeth. They are very light, do not injure the gums, are hypoallergenic and have high thermal conductivity.

The service life of such an implant depends on the health of the patient, but on average they can last from 10 to 25 years.

Comparison with the installation of a prosthesis

If we compare the implant with removable dentures, bridges and single-root tooth substitutes, then we can say with confidence that this is the only design that meets both functional and aesthetic requirements, which is important for the teeth of the smile zone. It is securely fixed in the jawbone and withstands any load during chewing.

The implants function correctly, which cannot be said about the prostheses installed on the natural roots of the teeth. And their service life is short - about 5-8 years. After some time, the dentures begin to loosen, and bacteria and food penetrate under them. As a result, an unpleasant odor appears and it is necessary to go to the prosthetist for a new prosthesis. This is associated with additional costs and loss of time.

Another advantage of implants is that there is no turning of adjacent teeth, which is mandatory when installing bridges. There is no loss of healthy teeth when using implants.

Dmitry Sidorov

Dentist-orthopedist

The disadvantages of implantation include a high price and a long installation period (up to six months). But recently appeared, which is carried out much faster. It looks like in the video below, who is afraid of the sight of blood - do not watch.

Possible problems

Let's see what problems might arise. The most common is the lack of bone tissue. When inserting the implant, at least 1 mm of bone must remain on all sides to ensure the strength and durability of the instructions. Dentists have learned to solve this problem by performing bone grafting simultaneously with the implant.

Many patients are concerned about the survival of the implant. Both the high professionalism of the surgeon and the individual characteristics of the body can play a big role here. Although titanium is hypoallergenic, there are still cases when the body rejects the implant.

Poor engraftment or complete rejection can also occur due to an implant made of poor quality material. Therefore, if you decide to install such structures, it is better not to save. Titanium is the only material that the body does not perceive as a foreign body.

Also, the operation may be performed poorly or large blood vessels and nerves of the face will be affected. As a result, a hematoma is formed or facial numbness occurs. This issue should be resolved in advance by contacting an experienced specialist, and not trusting the first one that comes across.

What to do after implant placement

To avoid trouble, it is important to follow all the doctor's prescriptions regarding hygiene, rinsing the mouth and taking a course of antibacterial agents.

After the implants are installed, it is important to observe the following rules:

1. During the day, it is necessary to periodically apply ice to the upper lip so that edema does not form and bleeding slows down. The specialist will tell you about the frequency of the procedure.
2. After 2-3 hours after the operation, you can eat, provided that the food is liquid or puree and does not fall on the site of the operation.
3. The temperature of the food taken should be low.
4. In order not to damage the seams, it is necessary to chew food from the opposite side of the mouth.
5. After eating, you should rinse your mouth (at first, preferably with an antiseptic solution).
6. Implantation of the upper teeth has one feature: at first, you should try not to sneeze or blow your nose in order to avoid pressure on the maxillary sinuses.

Swelling of the face and gums lasts about 3 days, after which it gradually disappears. Pain can be relieved with analgesics, which the doctor will advise.

Dmitry Sidorov

Dentist-orthopedist

With the appearance of temperature, incessant bleeding from the wound, increased blood pressure and other abnormalities, you should consult your doctor.

And remember, any surgical intervention is a colossal stress for the body, therefore, having decided on implantation, it is important to prepare for it psychologically as well.

Every person dreams of having a beautiful smile. But what if the front teeth are lost or have an unaesthetic appearance?

Implantation will help to solve this problem, a unique technique that allows you to restore the integrity of the dentition and restore the patient's self-confidence.

case feature

Restoration of anterior teeth is one of the most complex operations in implantology, requiring compliance with a number of important requirements:

• The specialist must have advanced manual skills. The frontal zone requires accurate installation of the implant at a certain angle - only under this condition can an effective prosthetic result be achieved.
• In the frontal zone, the issue of aesthetics is acute therefore, the restoration of the natural gingival contour requires jeweler's skill, which will make it possible to achieve a natural and beautiful smile.

The peculiarity of the front teeth is that they are practically not subject to chewing loads, but are designed to have an ideal appearance.

The thinness of the jawbone in this area requires filigree work from the dentist. To minimize tissue trauma, incisor implants are made in a thinner form. Therefore, such artificial units are inferior in strength to titanium screws.

The implantation of incisors is distinguished by the importance of the aesthetic moment. The specialist must ensure that the restored unit is indistinguishable in appearance and anatomical form from the rest of the teeth.

Indications and limitations

Implantation of the frontal zone is indicated for the complete or partial loss of the anterior teeth associated with a significant carious lesion or a breakaway of the crown part of the unit.

The procedure for implanting an implant into the jaw bone tissue is not only complicated, but also has an impressive list of contraindications to its implementation:

• psychoneurological diseases (slowdown of the nervous apparatus);
• all stages of diabetes;
• hypertension;
• the presence in the body of malignant tumors that are life-threatening;
• hemophilia (blood clotting disorder);
• all forms of tuberculosis;
• cardiovascular diseases;
• excessive tension of masticatory muscles (hypertonicity);
• a positive test for HIV or AIDS;
• atrophic gingivitis (reduction in gum volume);
• individual intolerance to the constituent substances of the anesthetic drug used to reduce sensitivity during the operation.

In addition to absolute contraindications, specialists identify a number of problems associated with the state of the oral cavity and requiring elimination before implantation:

• inflammatory processes in the gum tissues;
• superficial and deep lesions of the teeth caused by caries;
• lack of bone mass;
• unsatisfactory condition of neighboring units.

The specialist's task is to quickly eliminate the listed problems and prepare the patient's oral cavity for the upcoming implantation.

In case of atrophy of the bone tissue, it will be necessary to resort to a procedure to build it up. Sinus lift of the upper jaw is required in 70% of cases associated with the anatomical features of the jaw and the loss of bone thickness after tooth loss.

After an expensive procedure to create a solid foundation for the implant by replanting natural or synthetic materials, it will take from 3 to 9 months to fully restore the tissues.

During the period of gestation, the teeth of the future woman in labor begin to crumble and fall out. It is possible to implant implants in this phase in the absence of contraindications from a gynecologist who monitors the development of the fetus. Surgery is considered safe after 13 weeks of pregnancy.

Experts do not recommend resorting to the implantation of the front teeth to heavy smokers. Exposure to nicotine rapidly degrades the aesthetic appearance of restored incisors. In the case of an urgent need for implantation, the patient must give up addiction for a long time.

Systems used

Today, healthy teeth in the smile zone, visible during a conversation, are considered a characteristic of a person's social status. For this reason, accurate implantation of incisors requires a rigorous approach to the choice of material for all elements of the prosthetic structure (screw, abutment, crown).

The task of the prosthetist is to achieve the maximum imitation of a natural incisor, paying special attention not only to the strength characteristics, but also to the aesthetic appearance.

Metal-free ceramics has become a separate area in the field of dental prosthetics. Its basic basis is materials such as zirconium dioxide and aluminum oxide.

In the manufacture of an implant for incisors, these materials make it possible to:

• reduce the load on the gum tissue, while maintaining the strength of the entire structure;
• exclude the possibility of allergic reactions, the formation of galvanic currents and ensure high biocompatibility of tissues with an implanted screw;
• achieve full compliance with natural units thermal conductivity, light transmission and color fastness;
• eliminate the loss of soft and hard tissues after tooth loss.

Important! Durable titanium, traditionally used for the manufacture of prosthetic structures, does not suit the aesthetic requirements for the production of prostheses intended for the restoration of anterior teeth.

This material is ideal in all respects for the implant itself, and the abutment and crown are best made from materials that are among the gold standards in prosthetics - zirconium dioxide and aluminum oxide.

Given the fact that the front teeth are little involved in the chewing process, implantation in this area has an aesthetic focus.

For this reason, for the manufacture of crowns experts prefer materials that have the maximum similarity with the enamel of the replaced object.

Consider a few popular options:

• Ceramics. Implantology has long appreciated the advantages of this material. First of all, these are aesthetic indicators.

  The color of the ceramic structure almost completely matches the shade of the enamel of natural incisors, which ensures maximum naturalness of the smile.

  The smooth surface of such a product serves as a kind of protection against the growth of bacteria and infectious agents. Ceramics do not darken over time, but are relatively fragile.

  Due to the lack of distribution of the masticatory load on the frontal part of the teeth, this drawback can be considered insignificant.

• Acrylic. Acrylic material has been used to restore the integrity of the dentition quite recently. Compared to ceramics, it is predominantly distinguished by its low cost and reduced rejection rate.

  Acrylic-based compositions do not cause allergic manifestations, inflammatory processes, or the development of pyogenic bacteria.

  The surface of the product is porous, which allows it to retain its original appearance for a long time, even in the absence of regular care. The service life of acrylic structures is at least 15 years.

• Metal. It is rarely used in the implantation of the anterior teeth, due to the unnatural shade.

  The use of the material is appropriate only when there is an urgent need for an emergency restoration of the dentition, and the patient does not have the opportunity to spend money on a more aesthetic option.

  Metal implants have the most affordable cost, but the strength characteristics of such structures are very high. A metal crown does not require replacement for about 25 years.

• Metal ceramics. In fact, this design is a metal crown coated with a thin layer of ceramic.

  This combination of materials allows you to achieve not only strength and long-term operation of the product, but also an impeccable appearance. The disadvantage of crowns is their high cost.

Remarkable! In case of damage, only the crown must be replaced. The titanium rod is inserted into the gum for the entire life of the patient.

An exception may be a special clinical case, when the material used to make an artificial root caused allergic reactions in the body.

The peculiarity of the structure of the gums in the area of ​​the location of the incisors puts forward a number of requirements for the systems used:

1. The materials used in the manufacture of all elements of the prosthetic structure must have a high biocompatibility index.

   This will avoid rejection of the implant, prevent staining of soft structures and neutralize the possibility of allergies.

2. A small working area requires special parameters of the propeller to be introduced. In diameter, it should be thin, and in length sufficient for reliable fixation in the gum tissue.

   It is desirable that the thread for fastening the rod has a unique design (small on top and larger towards the bottom), and the coating material has an improved composition.

In combination, the presence of all these important features makes it possible to achieve rapid engraftment of the implant and accelerate the recovery of tissues damaged during the operation.

Physiological differences in the structure of both jaws require the use of short products on the movable jaw and long ones to replace the anterior upper object.

The reverent attitude of patients to the front teeth and their constant visibility oblige to quickly restore the damaged or lost unit. Therefore, implantation in this area is often performed by dentists in one stage..

If, in the process of replacing lost frontal teeth with implants, the rules for choosing a design and its installation are followed, a pronounced cosmetic defect can be avoided.

Preparatory stage

Preparation for implantation can take several weeks, as the specialist needs to assess not only the condition of the oral cavity and jawbone, but also the health of the body as a whole.

Consider all the preparatory steps in more detail.

Step 1 - the first visit to the implantologist

The consultation consists of a visual examination of the dental units and oral mucosa, taking an anamnesis and identifying contraindications for the operation.

At the first visit, the specialist also determines the possibility of implanting an artificial root, the approximate dimensional parameters of the future structure, and gives recommendations on how to prepare for the restoration of the dentition by the patient himself.

This includes regular brushing of teeth, rinsing with antiseptics, giving up bad habits.

Step 2 - assessment of the state of hard tissues by X-ray diagnostics

Since the screw is implanted directly into bone structures, the assessment of their condition is an important procedure for a specialist.

The volume, density and thickness of bone structures is determined by several methods:

• Spot radiography. Shows the height and density of bone masses, the state of the root system of units adjacent to the working area.
• Panoramic x-ray. Allows you to study the state of bone tissue, determine the position of neighboring teeth, maxillary sinuses, bundles of nerve fibers, blood vessels.
• CT scan. Radiation diagnostic method with a three-dimensional image. It makes it possible to assess the parameters of hard tissues and their quality, as well as to identify the presence of diseases and formations in the paranasal sinuses.

After receiving all the pictures, the specialist processes the information received and draws up a plan for further actions.

Together with the patient, the issue of choosing an orthopedic design, a type of implant is decided, taking into account the individual characteristics of the clinical picture.

Step 3 - testing

However, there is a mandatory list of tests that allows you to accurately and fully determine the state of the body before implantation:

• clinical blood test;
• endogenous enzyme ALT;
• endogenous enzyme AST;
• bilirubin;
• total protein;
• erythrocyte sedimentation rate;
• hepatitis of all groups;
• tests for HIV and syphilis;
• blood plasma protein;
• sugar;
• pancreatic amylase;
• an enzyme involved in the transport of phosphorus (alkaline phosphatase);
• indicators of chemical elements that make up the blood;
• creatinine (an indicator of the excretory ability of the kidneys);
• prothrombin index;
• cholesterol;
• fibrinogen (an important element of the blood coagulation system).

If an artificial tooth root is implanted in a woman, she will need to pass a number of additional tests:

• thyroid-stimulating hormone (controls the work of the endocrine system);
• free thyroid hormones;
• estradiol (the most active female sex hormone);
• parathyroid hormone (its indicator is used in the diagnosis of diseases of the endocrine system, bones and kidneys).

If the anamnesis data require additional research, then the specialist can prescribe allergic tests, obtain the conclusion of an allergist and a cardiologist.

Step 4 - improving the oral cavity

Before implantation, the doctor performs complex dental procedures aimed at improving all tissues of the oral cavity. These include the elimination of identified diseases, and the use of preventive measures that prevent the appearance of new problems with teeth and mucous membranes.

The specialist must:

• remove stones and visual plaque from the surface of the teeth;
• eliminate acute complications and inflammation;
• clean gum pockets and interdental spaces;
• treat hard tissue defects, including carious lesions;
• apply anti-inflammatory therapy on the gums and tongue;
• remove units that are not amenable to therapeutic treatment;
• correct the bite problem and remineralize the enamel.

Manipulations can be carried out in full or in part, strictly observing the order.

Therapeutic measures are applied without the participation of antibiotics, since the bacterial flora of the oral cavity quickly begins to show resistance to them.

The suppression of foci of infection takes place under the action of antimicrobial agents. More often it is ointments, gels, rinses.

Operation progress

Modern methods allow implantation of the front teeth in two visits to the clinic with an interval of about 30-50 days. During the first surgical intervention, the specialist is engaged in the implantation of an artificial root.

To do this, he performs the following manipulations:

• the introduction of an anesthetic drug;
• aseptic processing of the working area;
• detachment of the gingival flap (a scalpel or laser is used);
• exposure of the jawbone;
• bed formation (drills up to 0.5 mm in diameter, taps, depth gauge are used);
• screwing the rod into the bone structures (the implant is treated with a special medicinal component, which promotes the fusion of the metal alloy with the bone masses);
• fixation of the connecting link (abutment);
• the imposition of suture material;
• installation of a temporary crown.

At the second appointment, the patient is fitted with a permanent crown. In the future, a visit to the dentist may be required to replace the orthopedic structure or receive care recommendations.

Implantation methods

The implantation of the teeth of the frontal zone can be carried out in one or two stages. The choice of method depends on several factors:

• prescription of loss of a dental unit;
• age category of the patient;
• condition of bones and soft tissues.

The device is being introduced:

• in a one-step way- using the results of computed tomography, the specialist forms a model, according to which the final design is made. The screw is screwed into the gum and sutured using a standard technique;
• in a two-stage way- a bone cast serves as a model for the future prosthetic construction. Next, the jawbone is exposed, the prosthetic bed is formed, the system is fixed, and the wound area is sutured.

Due to a number of advantages, the first option is recognized as the most optimal way:

• A temporary orthopedic structure is immediately attached to the fixed abutment, which allows the patient to immediately return to their usual way of life and feel confident in society.
• 5 hours after the operation, all food restrictions are removed.
• Biting problems are excluded. The orthopedic construction, installed in accordance with the regulations, forms the most ideal occlusion.
• The absence of a second operation eliminates the need for repeated radiographic diagnosis.
• One-stage implantation has a democratic cost.
• The gum incision is performed once, so tissue healing takes place in one stage.

Advice! One-step implantation will be most effective if it is scheduled immediately after tooth extraction.

Laser application

Modern implantology is constantly being improved, and in recent years it has begun to actively use the laser.

Dental implantation with a laser made it possible to abandon the traditional use of a scalpel during the operation and to dissect the mucous membrane and gums with a light beam.

The surgical stage, carried out in this way, makes it possible to obtain an excellent functional and cosmetic result. During the procedure, the patient does not feel pain, and there is no discomfort in the postoperative period.

Advantages of using a laser:

• bloodlessness of the operation, which allows you to quickly access the working field and prevent the possibility of bleeding during the recovery stages;
• sterility of the procedure by minimizing contact with the wound;
• bactericidal effect light beam accelerates the healing of the wound area;
• duration of surgery is halved;
• painkillers are used in limited quantities, which makes the treatment more gentle;
• the possibility of aesthetic problems due to the displacement of the edges of soft structures completely excluded;
• low chance of rejection implant.

The high cost of laser implantation is due to the short recovery period.

Possible Complications

Complications can develop not only during the operation, but also after it. The negative consequences of surgical methods at the stages of the procedure are more often associated with medical errors.

Complications during the recovery period are due to the individual characteristics of the body.

Complications during implant placement:

• Pain. It can make itself felt with incorrect selection of anesthesia. Pain can be relieved by administering additional painkillers.
• Nasopalatine bundle injury. There is a risk of bleeding and impaired integration of the screw into bone structures. The problem is eliminated by hemostatic agents.
• Damage to the floor of the nasal cavities. The complication may contribute to the infection of the lower point of the screw. Eliminated by suturing the damaged area.
• Implant heating. It happens at the stage of preparation of the head of the rod. To avoid overheating of the working surface, the specialist must periodically irrigate the preparation area and the bur itself.

Complications during the rehabilitation period:

• Pain, swelling, bruising.

  The appearance of consequences depends on the individual anatomical features of the tissue structure, its ability to regenerate and the level of irritation caused to the nervous system. It can be stopped by means that suppress pain activity and ointments that relieve swelling.

• Increase in body temperature.

  A normal reaction of the body that does not require medication and medical intervention. With a prolonged change in temperature, it is necessary to visit the clinic to identify the source of inflammation.

• Inflammatory process in tissues.

  This complication often occurs in patients with osteoporosis. If protective measures are not taken in time, the design will be rejected. Long-term antibiotic treatment is required.

• Shaky tooth.

  The implant fully takes root to the bone tissue for about 20 days, so its slight mobility during this period is considered normal.

• Sensitization.

  It is a feature of the body to respond to the influence of the external and internal environment. In this case, the reaction is due to surgical intervention. The effect resolves spontaneously within 7 days.

In order to reduce the risk of developing negative postoperative complications, it is important to strictly follow medical recommendations:

• pay special attention to oral hygiene;
• do not eat too cold or hot foods;
• refuse solid food for the entire recovery period;
• quit smoking;
• every six months to have a professional cleaning at the dentist;
• exclude intensive chewing load on implanted artificial organs.

Price

The final price tag for implantation of incisors consists of a number of factors. This is the regional location of the clinic, its status, the share of the doctor, and, of course, the cost of the implant itself.

The most budget options are products from manufacturers in China and Israel. German and Swiss brands set the highest price barrier for their products.

Consider the average pricing policy on the example of a table.

Frontal implantation is considered a costly procedure., however, the patient always has the opportunity to reduce the total cost by choosing a budget material for the manufacture of structural elements.

The video provides additional information on the topic of the article.

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

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

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

Relative contraindications:

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

What is the complexity of implantation in the upper jaw

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

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

How much will it cost on average in Moscow

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

• scope of planned work;
• used materials, medicines;

On the upper jaw, this is a rather complex dental procedure that requires a high level of skill. The increased difficulty is associated with the structure of the upper jaw, or rather, with its structural features. The operation requires a highly qualified doctor, so it costs much more than alternative methods of restoring the upper teeth. But despite all the difficulties, in modern dentistry, such operations are regularly performed.

Features of the procedure

Many people believe that there is no difference between the implantation of the lower and upper teeth, but this is not true. The main difference lies in the bone density, which is very important in the process of restoring the upper teeth. When a person chews food, there is a slight load on his upper jaw, which cannot be said about the lower jaw. Therefore, the density of the bone tissue from above is low, and after the extraction of the tooth, the bone atrophies rather quickly.

Not far from the upper jaw are the maxillary sinuses, which only complicates the process. In order not to damage it during installation, doctors perform a special procedure - a sinus lift. This is one of the types of bone grafting, during which the osteoplastic material fills the bottom of the maxillary sinus. Only after that, the specialists install the implant into the bone tissue.

Note! It began to be used everywhere relatively recently, but according to archaeological research, this dental direction was studied many centuries ago. Then people used different materials to make implants, such as precious stones, wood or ivory. Sometimes the teeth of the dead were used as implants.

Benefits of dental implants in the upper jaw

Implantation in the restoration of the teeth of the upper jaw, of course, has a number of advantages when compared with this process.

The main advantages include the following:

• reducing the risk of damage to adjacent teeth;
• the likelihood of developing an allergic reaction is almost zero;
• installed prostheses are strong and securely fastened;
• the possibility of carrying out both with a single absence of teeth, and with complete adentia;
• Outwardly, teeth on implants practically do not differ from real ones.

When fixing dentures during implantation, doctors do not use acrylic gum masks, which significantly reduces the risk of allergies.

In what cases is

• violation of the integrity of the dentition. When a tooth is lost, it is not necessary to grind adjacent healthy teeth for installation;

• loss of several teeth at once;
• the patient has “end” defects (if the last teeth are missing in the dentition);
• complete edentulous;

• anatomical features of the structure of the upper jaw, which affect the functional abilities of the entire dentoalveolar system;
• individual intolerance by the body to other types of prosthetics, for example, an allergy to.

The main indications for implantation can also include the destruction of most of the supporting tooth, which acted as a support for the installed crown or prosthesis. In such cases, doctors prescribe an operation to implant the implants.

Contraindications

Almost all problems with teeth can be solved with the help of implantation, but in addition to indications, this procedure has a number of contraindications that must be taken into account. During the preparatory stage, the patient must go through, which will identify possible contraindications, if any.

relative

Relative contraindications, which are also called temporary, include:

• the course of pregnancy and the period of breastfeeding;
• the presence of dental diseases caused by insufficient oral hygiene (, the development of inflammatory processes, etc.);
• development of periodontitis or gingivitis. Doctors do not perform dental implantation in the presence of these pathologies, therefore, they must be cured before the operation;
• anatomical features of the structure of the jaw system, for example, atrophy of bone tissue or its insufficiency,;

• development of acute infectious processes. Implantation of the upper or lower teeth is possible only after the complete recovery of the patient;
• conducting certain types of therapy, such as, for example, radiation oncology (radiation therapy);
• taking certain medications;
• the presence of bad habits, such as smoking, excessive alcohol or drug addiction - these are all temporary contraindications to implantation.

All of the above contraindications are eliminated relatively easily even during the preparatory stage, after which the patient is allowed to carry out implantation. In order not to face such contraindications that are revealed during the diagnostic examination, experts recommend devoting enough time to oral hygiene, especially for 2-3 months before the planned operation. This will save time on the elimination of identified contraindications.

On a note! Approximately 7-10 days before implantation, you need to stop taking thinning drugs, for example, from "Curantil" or "Aspirin". They can cause heavy bleeding during surgery, which will greatly complicate the procedure.

Absolute

There are also absolute contraindications, which, unlike temporary ones, do not allow implantation at all. In such cases, patients are forced to resort to alternative methods of tooth restoration. These contraindications include:

• the impossibility of carrying out, without which implantation cannot be carried out;
• development of diseases of the central nervous system or mental disorders;
• blood disorders such as hemophilia or anemia;
• malfunction of the immune system;
• heart failure or diseases of other internal organs;
• the presence of diabetes is a strict contraindication for implantation;
• acute form of tuberculosis;
• the presence of malignant neoplasms;
• diseases of the oral mucosa of a chronic nature.

The presence of at least one of the above absolute contraindications makes implantation impossible. We are talking not only about the teeth of the upper, but also the lower jaw. In such cases, patients usually choose removable or fixed prosthetics.

How is the implantation

It has already been noted earlier that the implantation of implants in the upper jaw is considered to be almost the most difficult dental procedure. In this case, the dental surgeon must take into account many factors in order to avoid complications and get the maximum effect.

front teeth

In the process, specialists mainly use special implants with instantaneous loading, and the therapy itself is performed according to a one-stage method. This solution allows to reduce the number of surgical procedures to a minimum, so crowns are installed for patients in one session. But when restoring the upper teeth, a two-stage technique, which is considered classical, can also be used.

When choosing implants, you need to be careful, so doctors approach this process with great care. As a rule, designs for these purposes are used with small diameters and with special threads. The presence of a screw thread in combination with the small size of the implant allows the operation to be performed without an additional one, which, in turn, significantly speeds up the process of survival of a foreign body.

chewing teeth

When chewing on molars and premolars, there is a greater load than on the front teeth, so when implanting them, doctors usually perform a two-stage operation. This allows you to implant an artificial root into the bone tissue without its further loss, that is, rejection by the body. In most clinical cases, the implant is successfully engrafted.

Some dental clinics offer patients the installation of compression implants in place of chewing teeth. They allow you to immediately start prosthetics if there is a sufficient amount of bone in this place. In the process of implantation of compression implants, doctors can install temporary plastic crowns within 2-3 days from the moment of implantation, as well as after removal of previously applied sutures.

Even complete adentia is not a sentence for a person, since he can always turn to specialists for implantation. In such cases, the patient may be offered the installation of bridge structures or individual ones based on implants. Also, in the complete absence of teeth, conditionally removable structures can be used. This is one of the cheapest and at the same time effective methods of restoring teeth.

If we compare the implantation of the upper and lower jaws, then in the first case, various complications occur much more often. But even despite this difference, such complications after implantation are extremely rare. It's all about the precise implementation of the procedure for implanting implants according to the technology. Therefore, complications mainly appear not because of the procedure itself, but due to the fault of the inexperience or insufficient level of qualification of the doctor who performed the implantation.

Note! The most common reasons for the appearance of serious complications after dental implantation include non-compliance by the doctor with the technology of the procedure or a poor-quality diagnostic examination, due to which the contraindications present were not identified. To avoid such troubles, you need to contact only real masters.

Dental implantation - the main stages

Under the influence of certain factors, implantation of teeth, including the upper ones, can result in the following complications for the patient:

• painful sensations;
• swelling of the gum tissue and the development of the inflammatory process;
• heavy bleeding in the area of ​​implantation;
• increase in body temperature;
• divergence of the superimposed seams;
• implant rejection;
• numbness of the gum tissue.

Immediately after recovering from anesthesia, the patient experiences severe pain, which persists for several days after the operation. To relieve pain, doctors prescribe analgesics. But if the pain does not go away for more than 4 days, this may indicate nerve damage and, as a result, the development of an inflammatory process.

Cost of the procedure

The price of implantation depends on the cost of not only the implants themselves, but also the full denture, dental crowns and a special bone plate. You also need to take into account the city and clinic where the operation will be performed. Below are approximate prices for dental services.

Table. The cost of implantation of the upper teeth.

If the patient's budget does not allow the installation of expensive crowns, then he can choose cheaper options, for example, metal-plastic or metal (if lateral teeth are being restored). This will save a lot, but the possibility of developing an allergic reaction to cheap materials cannot be ruled out.

How long will implants last?

The main advantage of implants is their durability, and therefore the cost of the procedure is quite high. As a rule, each manufacturer gives a certain guarantee for their products, but if you choose the average service life, then for budget products it becomes 10-15 years, and for more expensive products - from 20 years and more. These figures depend not only on the manufacturer, but also on the specialist who performed the implantation, the individual characteristics of the body and compliance with medical recommendations.

If the patient after the operation correctly monitors the condition of his teeth, observing the rules of oral hygiene, then he will not be afraid of any complications after the operation. In addition, proper oral hygiene will significantly increase the service life of the implant set by the manufacturer.

Video - Installation of implants in the upper jaw

More and more patients are turning to the dentist to restore all their teeth, or one jaw completely. Ordinary removable dentures, clasp dentures and extended metal-ceramic bridges do not meet the high requirements for convenience, aesthetics and durability. All these goals can be achieved with the help of dental implants.

The technique of jaw implantation in the complete absence of teeth differs significantly from implantation in the absence of only a few teeth. For example, the obvious fact is that it is not necessary to install 32 implants to restore all teeth. All the details of full dental implantation are outlined in this article.

Methods of prosthetics on implants in the complete absence of teeth

Prosthetics on implants in the complete absence of teeth can be divided into 3 types: removable, non-removable and conditionally removable.

Removable prosthetics on implants is suitable for those patients who have already used a removable prosthesis, but could not get used to it. Any option of removable prosthetics on implants will greatly improve the quality of life of such patients.

However, if you have never used a removable prosthesis, then psychologically it will not be easy to get used to such a design.
In this case, the best option would be fixed or conditionally removable prosthetics on implants. Conditionally removable means that the prosthesis is fixed with screws. Only a dentist can remove it, the patient uses it like his own teeth.

Implantation of both jaws with simultaneous loading with plastic crowns

More details about each method of treatment are set out later in this article.

Implantation of the lower jaw

The lower jaw is denser in structure than the upper jaw, so in most cases 2 to 6 implants are enough to restore all teeth. The integration period for implants in the lower jaw is 3 months.

Removable prosthetics on implants in the lower jaw performed on 2-4 implants. The most common option is to install 4 implants with spherical attachments (or locators). The advantages of this method are good fixation of the prosthesis, easy oral hygiene, simplicity of design, and, as a result, its low cost. A removable prosthesis on 2 implants with attachments is used in cases where there is not enough bone tissue to install 4 implants, the fixation of the prosthesis in this case is worse. The disadvantages of this method of treatment are that the prosthesis distributes the load not only on the implants, but also on the gum. Under the pressure of the prosthesis, the gums atrophy, so it is necessary to reline the prosthesis on average once a year. The fastening on attachments is also weakened, it is necessary to periodically replace the holding matrices. The service life of the prosthesis itself is about 5 years.

Removable prosthesis on 4 implants with spherical attachments on the lower jaw

The second option of a removable prosthesis on the lower jaw- this is prosthetics of the lower jaw on the beam on 4 implants. In this case, the load is distributed mainly on the implants and much less on the gum. The fixation of the prosthesis is very tight, the prosthesis feels almost like your own teeth. The prosthesis itself is made of plastic. It completely restores aesthetics and chewing function. The fact that the prosthesis is removable simplifies oral hygiene. A plastic prosthesis is not as rigid as a ceramic-metal or zirconium one, so it is easier for those people who have problems with the temporomandibular joint to get used to it. The disadvantage of this method of treatment is that a correctly made beam prosthesis is comparable in cost to a fixed structure.

One of the main conditions for the long-term functioning of such a prosthesis is that the beam that unites the implants must be very accurately connected to them. For this, multi-unit abutments are used, which provide an accurate connection of the implant with the bar, the bar itself must be made on a milling machine. Unfortunately, often patients are offered a bar prosthesis made without multi-unit abutments, or made by casting rather than milling. In this case, the bar will be fixed to the implants with tension, which will lead to a negative result, possibly even loss of the implants due to their overload.

Removable prosthesis on the fixation beam on the lower jaw

Fixed prosthetics of the lower jaw performed on 6 implants with classical implantation. It is also possible to restore teeth on 4 implants using the all-on-4 method, in which case 2 out of 4 implants are placed at an angle of up to 45 degrees. The technique has its pros and cons. About All-on-4 will be written later in this article.

Fixed prosthetics completely imitate their own teeth and are the easiest to tolerate psychologically. For the period of implant integration, the patient uses a temporary removable prosthesis, or implantation of teeth is carried out with a one-time load of a non-removable plastic prosthesis.
The service life of a plastic prosthesis is 1 year. It can be replaced with metal-ceramic or zirconium after complete healing of the implants. On the lower jaw after 3 months. The implants themselves are not affected.

In the case when a permanent prosthesis is made on screw fixation, we are talking about conditionally removable prosthetics on implants. Conditionally removable means that the prosthesis can only be removed by a dentist. The patient cannot remove it on his own, it feels and functions like his own teeth.

Fixed prosthesis on the upper jaw on 6 implants, on the lower jaw on 6 implants

Upper jaw implantation

The bone tissue of the upper jaw is less dense than that of the lower jaw, so more implants are needed for complete prosthetics on implants in the upper jaw - from 4 to 8. Implants in the upper jaw heal within 6 months.

Removable prosthetics of the upper jaw performed on 4-6 implants. On 4 implants, it is possible to install a covering prosthesis with ball-shaped attachments. A covering prosthesis has the same boundaries as a conventional removable prosthesis, it completely covers the palate. For the manufacture of a prosthesis on the upper jaw without a palate, 6 implants must be installed. Spherical attachments, locators or a beam can be used as connecting elements. The best fixation of the prosthesis is achieved on the bar. However, the cost of such a prosthesis is comparable to a fixed structure.

For fixed prosthetics of the upper jaw it is necessary to install from 6 to 8 implants. It is also possible to install a fixed prosthesis in the upper jaw on 4 implants using the all-on-4 method. It will be written about later in this article.

Installation of 6-8 implants in the classical way is the most studied and reliable option for implantation of the upper jaw. The number of implants is determined by the presence of bone tissue and the shape of the upper jaw. During the healing of implants, the patient uses a temporary removable prosthesis, or implantation is carried out with a one-time load with a non-removable plastic prosthesis.

The service life of a plastic prosthesis is 1 year. It can be replaced with metal-ceramic or zirconium after complete healing of the implants. On the upper jaw after 6 months. The implants themselves are not affected.

As well as the lower jaw, on the upper jaw it is possible to make a permanent structure on screw fixation - conditionally removable prosthetics. Only a dentist can remove a screw-retained prosthesis. The patient uses it like his own teeth.

The advantages of screw fixation are that the prosthesis can be removed if necessary. Unlike cemented prostheses, which cannot be removed without sawing them. However, the complexity of the design, and as a result, the cost increases.

Different options for implantation in the complete absence of teeth. 8 implants in the lower jaw, 6 implants in each jaw, 8 implants in the upper jaw

All-on-4

The All-on-4 technique (all-on-four) was developed by Nobel Biocare. It involves the installation of 4 implants on one jaw with a simultaneous load with a fixed screw-retained prosthesis. 2 extreme implants are placed at an angle of up to 45 degrees, which allows you to bypass anatomically difficult places: the maxillary sinuses in the upper jaw and the exit point of the nerve in the lower jaw.

Initially, the All-on-4 technique was positioned as minimally invasive, without bone grafting. However, for successful functioning, it is necessary to install sufficiently long implants, because. 4 implants must carry the load for the entire dentition. Unfortunately, not all patients have the required height of the alveolar ridge. The installation of shorter implants may lead to the fact that, due to the increased load, one of the implants will not take root. And then all-on-four will turn into nothing on three. That is why patients are offered “all-on-4 modifications”, for example, All-on-6 (all-on-six implants), because. the installation of an additional 2 implants significantly reduces the risks.

After 3-6 months after implantation according to the All-on-4 method, gaps appear between the prosthesis and the gum, because. for this is the remodeling of the gums after implantation. It is necessary to either rebase the existing prosthesis, or replace it with a permanent one - ceramic-metal or zirconium.

Bone grafting for jaw implantation

The more implants are installed, the more likely it is that the available bone tissue will not be enough for the installation of implants and it is necessary to build it up. Bone deficiency can be either in thickness (very thin bone) or in height (close to the maxillary sinuses in the upper jaw, nerve in the lower jaw).

With a slight shortage of bone tissue in thickness, one-stage bone grafting with implant placement is possible. It is also possible to perform a sinus lift (a type of bone tissue growth with insufficient distance to the maxillary sinus) with one-stage implant placement.

With a large deficiency of bone tissue, operations are first performed to increase it (open sinus lift, bone block sampling and grafting), and after 3-6 months, implantation. In this case, the total duration of treatment can be from one year to one and a half years.

How to avoid bone grafting?

There are proven methods that allow you to reliably restore teeth in one or both jaws without additional operations to build up bone tissue.

First of all, it is worth mentioning the positions in which the implants are installed.
In total, a person has 32 teeth, 16 teeth in each jaw. The 2 extreme teeth are wisdom teeth, they do not carry a functional load, therefore they are not restored during prosthetics. Of the remaining 14 teeth (7 on each side), the sixth and seventh teeth are the most problematic in terms of restoration (counting from the center). They are located close to the maxillary sinus in the upper jaw and to the nerve in the lower jaw. Just for the restoration of the sixth and seventh teeth, long-term osteoplastic operations are necessary.

According to the recommendations of the International Association of Implantologists ITI - International Team for Implantology, in the complete absence of teeth, it is necessary to restore the dentition up to the sixth tooth inclusive (12 teeth in each jaw). This method completely restores both the function of the jaw and the aesthetics of the smile. At the same time, additional risks associated with the close location of anatomically important formations (maxillary sinuses and nerve) are avoided.

In this case, the implants are installed in the anterior part of the jaw, and the extreme ones in the area of ​​the fifth teeth (the so-called Frankfurt University Protocol). In the future, a one-piece non-removable prosthesis is installed on them. The combination of all implants into a single design compensates for lateral chewing loads and ensures the full functioning of the entire jaw with only 6 implants in the lower jaw and 6-8 in the upper jaw.

Another problem is the deficiency of bone tissue in thickness ( thin bone). To avoid bone grafting in this case, it is possible to use thin implants. However, not all systems guarantee that their thin implants are able to withstand the load of full jaw prosthetics. Such guarantees give German Ankylos implants, also a company Straumann has developed a special alloy of titanium and zirconium, which allows thin implants to function without building up bone tissue, it is called Straumann Roxolid.

And finally, with a deficiency of bone tissue both in height and width, a possible way out is to install short and thin implants, but in larger quantities. Instead of 6 standard ones - 8 short ones. The total length of the implants in this case will be equivalent.

Which implants to choose?

Today, there are more than 3,000 implant systems in the world. However, not all of them can boast a long history of observation and clinical trials around the world. There are also some implant systems, which, despite their reliability, are not very common in Russia. This can lead to difficulties in terms of delivery of original components of implant systems.

It is worth choosing only generally recognized implant systems used by different, independent doctors. Otherwise, the patient runs the risk of being in a situation where no one can help him.

An important point when choosing an implant system is the type of implant-abutment connection. It depends on how long the implant will last. The most reliable today is the implant-abutment conical connection with the effect of platform switching. It is able to withstand greater loads compared to a flat connection, has tightness and does not cause bone resorption around the implant.

The engraftment of implants is affected by the purity of the titanium from which they are made. The most common is Grade 4, which is commercially pure titanium. Grade 1,2,3 alloys are even cleaner. Grade 5 - less pure, contains impurities of vanadium and aluminum.

The surface of each implant is a unique patented technology. It is on the surface of the implant that osseointegration occurs - the fusion of the implant with bone tissue. Serious implant manufacturers conduct a lot of research, proving that their implants are integrated not only in standard situations, but also, for example, in people suffering from diabetes or blood clotting disorders.
The following systems meet all these requirements: Straumann (Switzerland), Ankylos (Germany), Astra tech (Sweden), Nobel biocare (USA/Sweden). Osstem implants (South Korea) can be distinguished from inexpensive systems. They have proven themselves worldwide as a reliable and economical implant system.

How much does implantation cost in case of complete absence of teeth

Despite the apparent high cost of implantation in the complete absence of teeth, it can be more profitable than restoring already hopeless teeth. In addition, the service life of implants is unlimited. Treatment is carried out in stages and paid too.

So, the price of jaw implantation in the absence of teeth depends on the type of construction (removable, non-removable) and the implant system.
For example, the cost of jaw implantation according to the classical method with a one-time load with a fixed plastic prosthesis is from 350,000 rubles.

The price of a zirconium prosthesis on implants of one jaw is from 200,000 rubles.

Author of the article Akhtanin Alexander Alexandrovich. Dentist-implantologist, orthopedist. For a long time he trained in Berlin, Germany. Member of the International Association of Implantologists ITI - International Team for Implantology.