Dental implants for the entire jaw. Full dental implantation. What implantation methods are possible for an edentulous upper jaw?

It may seem that there is no difference between upper and lower dental implants. This opinion is erroneous, since the jaws have a different structure and density of bone structures. This is due to physiological characteristics human body: When chewing food, the upper jaw experiences less load than the lower jaw. The jaw bones of the upper dentition have a looser structure and are more likely to thin out with the loss of one or more elements. For this reason, before implantation upper teeth Often surgery is required to augment the missing tissue.

The main danger of implanting upper teeth is that they are located next to the maxillary sinuses. If the length and width of the bone are insufficient during the restoration of the canines and lateral incisors, there is a risk of damage to the maxillary sinuses. For this reason, bone grafting may be required before implantation.

Features of upper row teeth implantation

Let's take a closer look at the features that doctors should take into account when implanting the upper jaw.

The need to create a natural gum contour. If you do not take this rule into account, then the replacement of a natural tooth with an artificial one will be noticeable to others. In order to bring the contours of the implant as close as possible to the natural tissues of the tooth, a one-stage operation is performed with loading the structure with a temporary crown. This is done so that the prosthesis supports the soft tissues and does not allow them to atrophy.

The importance of accurate installation of the restoration structure. This rule especially applies to the restoration of the upper anterior teeth. If the root of the implant is installed in the wrong place, then this will create difficulties in further securing the coronal part of the product. This problem can be eliminated CT scan, which makes it possible to study in detail the bones of the upper jaw.

Selection of implants of a special structure. For prosthetics of missing units of the upper jaw, only implants with a small diameter and a special type of thread are used to reduce trauma to the soft tissue of the gums.

The importance of selecting a material that is suitable for aesthetic characteristics. Instead of metal pins on which the crown is mounted, zirconium structures are used. This is due to the fact that the metal shines through the crown, which can negatively affect the appearance of the entire structure. The material used to create the crown must also meet high aesthetic qualities. For this purpose, ceramics or zirconium dioxide are used.

CT results of the jaw before implantation

Types of implantation for edentulous upper jaw

Two-stage standard surgery for an edentulous upper jaw is rarely used. Usually dental clinics We offer patients the following types of operations:

All on 4 and other types of procedure;
zygomatic implantation.

An important advantage of the methods is that there is no need to increase the missing bone tissue, as well as the possibility of installing a fixed prosthesis immediately after surgery.

All on 4

The prosthesis is placed on 4 or 6 pins implanted into the bone tissue of the jaw. The first option of prosthetics is used to restore the integrity of the row in elderly people and women. Adult men have a higher chewing activity, so All on 6 implantation would be more appropriate for them.

Patients are advised to undergo a CT scan before undergoing surgery. This study allows specialists to bypass areas with the lowest bone density when implanting implants. CT in 98-100% of cases eliminates the need for sinus lift for patients.

Indications for All on 4 surgery:

periodontal disease;
periodontitis;
the need for immediate loading of a removable or fixed prosthesis;
carrying out one-stage implantation;
impossibility of performing a sinus lift for any reason.

The All on 4 and All on 6 methods provide a number of advantages:

the ability to restore missing elements in 1 day;
uniform distribution of chewing load over the entire dentition;
prevention of possible processes of bone tissue atrophy;
the possibility of intervention for diabetes mellitus and cardiovascular disorders.

In the latter case, the operation is possible due to low trauma to soft tissues and the use of local anesthesia.

Let's take a closer look at the stages of implantation using All on 4 technology:

Carrying out diagnostic measures– 3D modeling, CT.
Implantation of pins: frontal teeth straight, lateral teeth – at an angle. The parameters are determined individually for each person, taking into account anatomical features the structure of his upper jaw.
Taking impressions of the jaw to make permanent temporary dentures. Impressions are usually taken by a dental laboratory specialist.
Installation of temporary dentures on abutments screwed to a pin.

After surgery, the patient can eat and drink after 2 hours. However, in the first 2 weeks it is worth reducing the chewing load on the installed structures. To do this, it is recommended to eat chopped food and give up coarse foods.

Zygomatic implantation

Operation Zygoma is used in severe clinical cases:

with thinning of bone structures in all departments;
with complete edentia of the upper row;
in the presence of a history of maxillofacial injuries and benign neoplasms.

Completely edentulous upper jaw

The essence of the intervention is that a long implant is fixed in the tissues of the cheekbone. This area is chosen because it is not susceptible to atrophy. 3D modeling allows you to plan the course of the procedure and take into account important nuances.

Advantages of the implant used during Zygoma surgery:

smaller diameter of the pin cylinder, which reduces the invasiveness of the intervention;
the ability to align the bridge support to the required axis.

How long does it take to implant an implant? The average period is 4-6 months. Secondary stabilization requires about another 4-5 months. The duration of rehabilitation depends on the patient’s health status and his ability to follow the doctor’s recommendations. The implant takes the longest to survive in people suffering from diabetes. The recovery period is prolonged by bad habits and failure to comply with personal hygiene rules.

To restore missing elements in the upper jaw, mini-implants can be used, which differ from conventional products in having a thinner rod. This simplifies the operation and shortens the recovery period.

Methods for restoring upper front teeth

The upper dentition is restored using a classic two-stage puncture. This restoration method allows you to achieve optimal aesthetic results. At this type During the operation, the doctor takes into account the smallest details and adheres to the following algorithm actions:

evaluates the thickness and strength of the bone tissue of the upper jaw;
recommends a sinus lift if the quality of the jaw bones is insufficient;
implants titanium pins into the bone, which are substitutes for the natural root system;
installs a gum former to correct the appearance of mucous structures;
forms a prosthesis.

A significant disadvantage of two-stage implantation is the duration of the procedure (up to 18 months). People who have a history of a lack of thickness of the jaw bone tissue and other diseases that prevent them from fixing the prosthesis ahead of time will have to spend the most time on restoring the teeth of the upper jaw.

If a sinus lift is not performed if the quality of the jaw bones is poor, then the following dangerous consequences may occur after implantation:

falling out of the structure from the hole;
injury to the maxillary sinuses;
meningitis.

Restoration of chewing teeth

The main purpose of this group of elements is to grind food. Upper teeth more susceptible to destructive processes compared to the lower ones. When restoring the chewing upper teeth, dentists often encounter problems with jaw atrophy, in the presence of which patients are offered one-stage implantation. Using this technique, it is also possible to restore row end defects.

End defect of the dentition

One-stage implantation of upper teeth provides a number of advantages:

the ability to avoid sinus lift;
maintaining health oral cavity;
possibility of eating food 2 hours after the intervention.

Stages of the procedure

The operation to install an implant on the upper jaw has its own functional and aesthetic nuances. Difficulties during intervention are associated with insufficient bone density of the upper jaw. For this reason, specialists try to use only modern technologies to perform the operation. The patient is also prescribed additional preparatory measures:

CT examination;
consultation with an otolaryngologist.

With help modern technologies Aesthetic problems that may arise due to incorrect gum contour or placement of the implant at the wrong angle are also solved. Computer models make it possible to correctly determine the area of insertion of the pin and the parameters of the crown part of the prosthesis (color, shape, size).

Implantation may involve the restoration of one or a number of elements. The optimal type of intervention is selected by a specialist after conducting all the necessary diagnostic studies.

Implantation of teeth in the upper jaw can be one- or two-stage. In the first case, installation titanium rod is performed immediately after tooth extraction; in the second, up to 4 months can pass between the removal of the original and the installation of the artificial element.

When restoring the anterior elements, it is important that the artificial prostheses appearance did not differ from adjacent natural teeth. In this case, the dental technician must work together with the implantologist.

Disadvantages of implantation

Doctors have to solve a fairly wide range of problems when performing a procedure to restore the integrity of the upper row. The specialist also needs to be extremely careful during the operation in order to prevent dangerous consequences of the intervention. Despite the advantages of implantation, the procedure also has a significant drawback - the price. This is a more expensive method compared to prosthetics, due to the high cost of the materials used and the long service life of the implants.

After surgery on the upper jaw, complications are observed much more often. However, in general, negative consequences after the intervention are noted in extreme cases. This is due to the fact that the technique of restoring teeth using implants has been well developed and studied.

Consequences usually occur due to insufficient qualifications of the doctor who performed the operation and when the patient does not comply with recommendations in recovery period. Complications manifest themselves as:

jaw pain;
bleeding gums;
swelling of the soft tissues of the mouth;
numbness of the mouth and lips;
rejection of the materials from which the product is made;
seam divergence;
increased body temperature;
mobility of the artificial tooth.

Jaw pain is often noted immediately after the anesthesia wears off. The symptom is considered normal and is associated with damage to the soft tissues of the gums and bone structures of the jaw during implantation. If the operation went without complications, the sign disappears on its own within 3-4 days. To reduce the intensity of pain, you need to take an analgesic. Discomfort that persists for more than 4 days is a reason to consult a doctor again.

Swelling is also a reaction to soft tissue damage during implantation. IN in good condition the sign may be observed for about a week after the intervention. Dangerous symptom– an increase in edema in size and its spread to adjacent tissues. At home it is necessary to apply problem area cold compress. It will allow you to relieve some discomfort before visiting a specialist.

Numbness of the jaw is observed in the first 4-5 hours after the end of the anesthetic drug. Prolonged numbness should not be ignored

Bleeding in the first days after surgery to insert an artificial tooth is a normal reaction of the body. The appearance of the symptom can also be triggered by taking medications aimed at reducing blood clotting. Severe bleeding that does not stop within 2-3 hours - alarm signal, indicating possible development hematomas, vascular damage.

Hyperthermia in the first days after the intervention is also not considered an abnormal sign. Reason to consult a doctor – persisting for more than 3 days heat(more than 38.5 degrees). This condition indicates possible infection of the surgical site or rejection of the artificial tooth.

The likelihood of developing complications depends not only on the skill of the doctor, but also on the patient’s behavior in the postoperative period. After surgery, it is necessary to more thoroughly clean the oral cavity of food debris and plaque to avoid infection of the sutured gum. Hygiene measures will also minimize negative impact, exerted on the implant.

The cost of the operation is influenced by several factors:

the need for bone grafting;
quality of materials used;
clinic pricing policy;
doctor's professionalism.

The cost of the procedure in Moscow without bone grafting is 30-70 thousand rubles, with sinus lifting – up to 120 thousand rubles. To this cost it is necessary to add the price of crowns: metal ceramics - from 10 thousand rubles, solid ceramics - up to 50 thousand rubles, zirconium - up to 35 thousand rubles.

Dental implantation of the upper jaw is a complex procedure that requires high competence and professionalism from the doctor performing the operation. Negative consequences after the procedure rarely appear, but basically they are all associated with improper human behavior in rehabilitation period or a doctor's mistake. Signs that require a second visit to a doctor are: profuse bleeding from surgical field, intense pain for 4 days, high fever for more than 3 days, severe swelling of the soft tissues of the mouth.

From this article you will learn:

rating of dental implants,
dental implantation techniques - types and turnkey prices (for 2020),
contraindications to implantation.

Dental implantation is a method of restoring lost teeth, which consists of implanting so-called (implants) into the bone tissue of the jaws, which then serve as a support for subsequent permanent prosthetics with crowns and bridges, or can be used as an additional factor in the fixation of removable dentures. This method allows you to avoid grinding down adjacent teeth for crowns (next to missing ones), and also to obtain a completely permanent prosthesis even on a toothless jaw.

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

Dental implantation in dentistry –

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

Below you can see the rating of the most reliable implants, which presents both premium and fairly high-quality economy-class implants. Special attention In this article we will focus on implantation techniques so that you have an understanding of which of them are the most reliable for patients, giving a minimal percentage of complications (for example, such as - and/or implant rejection).

The best implant models: statistics

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

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

Implant models most popular in Europe –

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

Reviews on implantation and clinical studies –

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

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

Patient reviews of dental implantation depend largely on the experience and qualifications of the implant surgeon, but the second important point is the characteristics of the implant itself (surface, shape, thread type). It should be noted that almost all negative reviews appear after implantation in the aesthetic zone (in the area of the front teeth), and concern the poor aesthetics of the gums in the area where it adjoins the neck of the implant. Most often, this is due to the fact that within 1 year after prosthetics, bone atrophy occurs around the neck of the implant, the amount of which, depending on the model of the implant, can be from 0.2 to 3.0 mm.

What does bone atrophy around the implant neck look like?

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

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

What does the surface of an implant look like under a microscope?

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

Dental implantation: types and turnkey prices

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

Rating and prices for premium segment implants –

Prices for economy segment implants –

How to choose the right implant type –

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

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

Dental implantation: types of techniques

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

–
in this case, a temporary crown or bridge is fixed immediately after installation of the implant, or within the first 72 hours after surgery. The implantation technique, which uses early prosthetics, is called one-stage dental implantation (site). The advantage of this technique is that you get a permanent bridge or crown immediately, but it will be temporary (it will be made of metal-plastic or plastic). –
in this case, prosthetics are performed 2-6 weeks after installation of the implant, and surgical stage will involve a technique called one-stage dental implantation (i.e., when the implant is installed immediately with the gum former). Thus, already 2-6 weeks after installing the implant into the bone, a temporary crown made of plastic or composite material is fixed onto it.

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

–
late loading means that prosthetics are usually performed either 3-4 months after installation of the implant, or after 6-7 months (if the doctor performed bone grafting in parallel with the installation of the implant). There are two implantation methods that use late loading on the implant - one-stage or two-stage dental implantation.

Thus, different types of load on the implant imply the use of different methods implantation From the above, it turns out that there are three such methods - a two-stage and a one-stage method, as well as a one-stage implantation method. And now we will tell you about them in as much detail as possible.

1. Two-stage dental implantation –

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

During the first stage –
they will install an implant in your bone and close it top part implant with a plug screw, and then the mucous membrane is tightly sutured over the implant. Thus, engraftment will occur under the mucous membrane tightly sutured over the implant.
During the second stage –
at the end of the engraftment period, you will be prescribed a second small operation, during which a small hole will simply be made in the mucous membrane above the implant, the plug screw will be unscrewed and a gum former will be screwed in instead. The latter is necessary to form the contour of the gums around the implant before starting prosthetics, and 14 days after that it will be possible to begin prosthetics on the implant.

Clinical case No. 1(two-stage technique) –
1) first stage of surgery:

2) second stage of surgery + prosthetics:

Two-stage dental implantation: reviews

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

When should you give preference to this technique?

If late loading of the implant is planned (after 3-6 months).
: If you smoke, then this is one of the 2 safest implantation methods that can be used in smokers (the second is the basal implantation method).
With a high concentration of pathogenic bacteria in the oral cavity: with irregular oral hygiene, with chronic inflammation gums, chronic tonsillitis, etc.
If you are planning a large volume of bone grafting or using a barrier membrane for guided bone regeneration.
If you have thin gums (less than 2 mm thick) and therefore need to increase the volume of soft gum tissue around the implant, for example, by adding a mucous flap taken from the palate. With thin gums, this is done to avoid subsequent gum recession and exposure of the implant neck.

Two-stage dental implantation: video of the operation

2. One-stage dental implantation –

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

Consequently, after the end of the implant’s healing, the doctor immediately begins prosthetics, because the gum contour has already been formed. And to do this, you just need to unscrew the cap sticking out above the mucous membrane. There are only two advantages to a one-stage operation. Firstly, this allows you to save 2 weeks of time, which in a two-stage operation is needed to prepare the gums for prosthetics. The second plus is a little greater psychological comfort due to the absence of unnecessary surgery.

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

2) prosthetics 4 months after surgery:

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

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

One-stage dental implantation: video

3. Simultaneous dental implantation (immediate) –

This is the fastest dental implantation, which involves immediate loading on the implant. Thus, the crown is fixed to the implant either immediately after surgery or within the first 72 hours. That is why patients often call this method the term “express dental implantation,” but implantologists themselves use the names “single-stage dental implantation” or “implantation using an immediate load protocol.”

Single-stage implantation teeth – reviews from implantologists indicate that this method is especially suitable for restoration single absentees front teeth. Its advantage is that after the implantation operation is completed, a temporary plastic crown will be immediately fixed to the implant (see photo below). This way you won't have any aesthetic defect, and you will be able to smile normally throughout the period of implantation to the bone.

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

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

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

Full dental implantation in Moscow: prices

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

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

1) Basal implantation technique –

Characteristic special shape, as well as the thread of the root part. Unlike classically shaped implants, they are installed precisely in the deeper, dense basal bone, which immediately gives the implants a very high degree stability in bone. No later than 2-3 days after the operation, a non-removable metal-plastic bridge prosthesis is fixed to the implants. The turnkey cost for 1 jaw with prosthetics (with the installation of 8-10 Roott Basal or Roott Compressive implants) starts from 270,000 rubles.

Basal implantation technique: video

2) Simultaneous implantation according to the “All-on-4” protocol –

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

Advantages of the method –

only 4 or 6 implants are required,
prosthetics already on the day of surgery,
the prosthesis is completely non-removable,
does not require bone grafting or sinus lifting if there is insufficient bone volume.

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

3) Conditionally removable dentures on implants –

This is the most inexpensive type of prosthetics on implants. IN in this case implants are used not to fix a fixed bridge, but to improve the fixation of a removable one plastic prosthesis. In this case, it will be a typical acrylic prosthesis, which has push-button locking attachments to 2-4 implants on the lower surface. Such a prosthesis can only be removed with special force. Its turnkey price will be from 110,000 to 130,000 rubles (depending on the number of implants).

Dental implantation: contraindications and complications

Contraindications to dental implantation can be absolute (absolutely not allowed) and relative (possible, but subject to a number of conditions).

Absolute contraindications –

Relative contraindications –

with poor oral hygiene,
if you have diseased teeth,
when smoking,
with a pathological bite,
at ,
for osteoporosis (this condition is a relative contraindication, since there are implant models designed specifically for bone tissue with low density).

Important for smokers: Smoking contributes to the development of complications and implant rejection. However, reducing the incidence of complications in smokers can also be achieved by choosing the right implantation technique. They will prefer -

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

Complications after implantation –

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

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

Sources:

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

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

Features of the procedure

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

Not far from the upper jaw are the maxillary sinuses, which only complicates the process. To prevent damage during installation, doctors carry out special procedure– sinus lift. This is one of the types of bone grafting, during which osteoplastic material fills the bottom maxillary sinus. Only after this, specialists install the implant into the bone tissue.

Note! It began to be used everywhere relatively recently, but according to archaeological research, this dental area was studied many centuries ago. Back then people used different materials for the manufacture of implants, e.g. gems, wood or ivory. Sometimes the teeth of the dead were used as implants.

Advantages of dental implantation in the upper jaw

Implantation when restoring teeth in the upper jaw certainly has a number of advantages when we compare this process with.

The main advantages include the following:

reducing the risk of damage to adjacent teeth;
the likelihood of developing an allergic reaction is almost zero;
the installed prostheses are durable and securely fastened;
the possibility of carrying out both with a single absence of teeth and with complete edentia;
Externally, teeth on implants are practically no different from real teeth.

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

In what cases is it carried out?

violation of the integrity of the dentition. When a tooth is lost while grinding adjacent healthy teeth for installation or not necessary;

loss of several teeth in a row;
the patient has “end” defects (if the last teeth are missing in the dentition);
complete edentia;

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

The main indications for implantation also include the destruction of most of the abutment tooth, which acted as a support for the installed crown or prosthesis. In such cases, doctors prescribe surgery to install implants.

Contraindications

Almost all dental problems can be solved with implantation, but apart from indications, this procedure has a number of contraindications that must be taken into account. During the preparatory stage, the patient must undergo, which will identify possible contraindications, if they are.

Relative

Relative contraindications, also called temporary, include:

the course of pregnancy and lactation;
presence of dental diseases caused by poor hygiene oral cavity (, development inflammatory processes etc.);
development of periodontitis or gingivitis. Doctors do not perform dental implantation in the presence of these pathologies, so they must be cured before surgery;
anatomical features of the structure of the jaw system, for example, bone atrophy or insufficiency;

development of acute infectious processes. Implantation of upper or lower teeth is possible only after full recovery patient;
carrying out certain types of therapy, such as radiation oncology (radiation therapy);
taking certain medications;
Availability bad habits such as smoking, overindulgence alcohol or drug addiction are all temporary contraindications to implantation.

All of the above contraindications are eliminated relatively easily during the preparatory stage, after which the patient is allowed to undergo implantation. In order not to encounter such contraindications in the future, which are identified during a diagnostic examination, experts recommend spending enough time on oral hygiene, especially for 2-3 months before the planned operation. This will save time on eliminating identified contraindications.

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

Absolute

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

impossibility of carrying out, without which implantation cannot be carried out;
development of diseases of the central nervous system or mental disorders;
blood diseases such as hemophilia or anemia;
malfunction of the immune system;
heart failure or diseases of other internal organs;
the presence of diabetes mellitus 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 does implantation work?

It was previously noted that implantation of implants in the upper jaw is considered 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 maximum effect.

Front teeth

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

When choosing implants, you need to be careful, so doctors approach this process with special 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 additional surgery, which, in turn, significantly speeds up the process of survival of the foreign body.

Chewing teeth

When chewing, more stress is placed on molars and premolars than on the front teeth, so when implanting them, doctors usually perform a two-stage operation. This allows the artificial root to be implanted into the bone tissue without further loss, that is, rejection by the body. In the majority clinical cases the implant is successfully implanted.

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

Even complete adentia is not a death 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 separate ones supported by implants. Also, in case of complete absence of teeth, conditionally removable structures can be used. This is one of the cheapest and at the same time effective methods restoration of teeth.

If we compare implantation of the upper and lower jaws, then in the first case, various types of complications arise much more often. But even despite this difference, such complications occur after implantation extremely rarely. It's all about accurately performing the implantation procedure according to technology. Therefore, complications predominantly arise not due to the procedure itself, but due to the inexperience or insufficient qualifications of the doctor who performed the implantation.

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

Dental implantation - main stages

Under the influence of certain factors, dental implantation, including 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;
severe bleeding in the implantation area;
increased body temperature;
divergence of applied sutures;
implant rejection;
numbness of gum tissue.

Immediately after recovering from anesthesia, the patient faces severe pain, which persists for several days after surgery. To facilitate pain syndrome, 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 complete 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. Cost of upper teeth implantation.

If the patient’s budget does not allow for 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 allow you to save a lot, but you cannot exclude the possibility of developing an allergic reaction to cheap materials.

How long will implants last?

The main advantage of implants is their durability, which is why the cost of the procedure is quite high. As a rule, each manufacturer gives a certain guarantee for its products, but if you choose the average service life, then for budget products it becomes 10-15 years, and for more expensive ones - from 20 years and above. 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 after the operation the patient properly monitors the condition of his teeth, observing the rules of oral hygiene, then he will not be afraid of any complications after the operation. Besides proper hygiene oral cavity will significantly increase the service life of the implant established by the manufacturer.

Video - Installation of implants on the upper jaw

Teeth are a necessary element both for high-quality processing and for external beauty.

In case a person lost most or all teeth, they can be restored using complete implantation.

Complete implantation of all teeth: types and techniques

In case of missing teeth, the procedure is carried out three ways

removable;
non-removable;
conditionally removable.

Removable method

The removable method is more suitable for those people who already had removable dentures, but they couldn't get used to them.

Important! Getting used to removable implants - long-term and psychological difficult process. Therefore, the patient needs to tune in to necessary adaptation.

If you need to have surgery on the lower jaw, then carry it out on 2-4 implants. More often used 4 implants with spherical attachments. This is how it happens:

good fixation implant;
available hygiene oral cavity;
relative inexpensive procedures.

When using removable method on the upper jaw, use 4-6 implants.

A practical method of fixation is considered use of beams. However, the price with this method is higher than with fixation with attachments.

Fixed method

The next type of full implantation is fixed method. As a result of its use, implants resemble your own teeth, so a person quickly adapts to a new design.

When implanting the lower jaw with a non-removable method use 6 implants, if the process takes place in a classical way. Also used 4 implants. This technique is called "all on four". Developed her company "Nobel Biocare". The idea is that two implants installed at an angle of 45º.

Photo 1. Using the All-on-4 or “all on four” method, a fixed prosthesis is installed on a completely toothless jaw and fixed with only 4 implants.

If artificial teeth are inserted in the upper jaw, then more often use 6-8 implants.

Conditionally removable method

When choosing a conditionally removable mode, the patient receives the following advantages:

high-quality fixation, even with severely atrophied bone;
the implant is placed immediately on an ongoing basis;
comfortable wearing.

Attention! When complete dental implantation is performed using screw fixation, then this method is called conditionally removable. Artificial tooth a person cannot remove it himself. This is done by a dentist.

How many implants are implanted into each jaw at once?

The number of implants inserted depends on what technique the doctor uses. So, in the absence of all teeth, they use 12-14 implants.

Attention! The use of full implantation is not suitable for those who does not have the required amount of bone tissue, as well as those who have close nerves.

This procedure is expensive, so not all people can afford it.

Photo 2. When using the bridge technique, the bridge is attached not to living teeth, but to artificial roots implanted into the bone - implants.

When using the bridge technique, 6-8 implants per lower jaw And 7-10 on the top. Using a bridge is a method that is not so expensive, but adaptation to implants is easy and quick.

Limitations for replacing teeth with implants

Implantation gives good results. After the procedure, a person receives teeth, similar to real ones. But you should not think that this method is suitable for everyone and has no restrictions.

Insufficient amount of good bone tissue

Implantation of all teeth at once is possible only if there is sufficient amount of bone tissue.

If it is smaller than the implant, then it won't be able to fix. Therefore, before starting the procedure, it is necessary to perform an operation bone tissue growth.

You can do this in several ways:

sinus lift;
autotransplantation;
planting artificial bone material;
alveolar ridge cleft to increase the width of the bone block.

Lack of individual anatomical features of the jaws

Due to the specificity of the jaw structure, in some cases implantation impossible.

High price

The cost of restoring the dentition by implantation is considered in an expensive way. This applies to cases with an increase in the amount of bone tissue.

Currently developed budget methods. It all depends on the complexity of the operation and the cost of its components.

When it is impossible to completely replace all teeth with implants

There are few indications for complete tooth replacement, but there are enough contraindications. They are divided into two large categories: absolute and relative.

Absolute contraindications

The presence of absolute restrictions indicates that the installation of implants is impossible due to technical circumstances or because of possible serious consequences.

These contraindications are:

Relative contraindications

The second group of contraindications are relative restrictions. If they are present, the procedure is carried out only with strict adherence following conditions:

Correct Preparation.
Choice suitable implantation method according to the parameters.

Contraindications include:

wrong bite;
alcohol or drugs addiction;
disease temporomandibular joint;
pregnancy;
already installed implants;
viral diseases;
recovery period after chemotherapy.

Important! A contraindication to the installation of artificial teeth using implants is considered age up to 22 years. This is explained by the fact that up to this age the child continues to develop and form. bone structure body.

Prosthetics on implants

Since implantation is not suitable for all patients, there is alternative replacement and installation of artificial teeth - prosthetics on implants.

This method is that first the jaw introduce artificial roots made from durable, non-allergenic materials, and then attach fixed or removable dentures.

Removable and non-removable methods differ from each other:

Removable prosthetics are attached to an artificial root due to the mini-lock. To fix the structure, press on it. In this case, the patient can carry out manipulations independently opening and closing the lock without the help of a dentist. As for fixed prostheses, a person cannot perform such actions. Only a doctor can do this.
With the non-removable method it is necessary wait for the implant to fully engraft, and then install the prosthesis itself. In case of complete absence of teeth, this process lasts for several years. With the removable method Implant healing occurs faster, since the number inserted is less.
A reliable option when replacing teeth it is considered removable prosthetics. This is explained by the fact that with a non-removable method there is a possibility of uneven distribution of the chewing load. In addition, if a defect appears in one structural element, then the entire prosthesis will have to be removed
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Complete dental prosthetics supported by implants are used in the absence of large quantity teeth and complete edentia, that is, if there is not a single tooth left in the row. Since they were all removed in different time, the condition of the jaw tissues varies markedly in each individual segment of the jaw. That is why several different methods can be used to restore completely missing teeth.

Stages of full complex dental implantation

The technology of the technique depends on the selected one or more implantation methods. Only 2, 4 or 6-8 evenly distributed implants can be installed on the entire dentition, which allow you to secure a permanent or removable denture. In this case, both classic implants can be used for areas of bone tissue with sufficient volume, as well as single-piece implants for immediate loading, if there is a deficiency of the jaw bone and rapid restoration of teeth is necessary.

1: preparation for treatment

Any dental implantation requires preparation and thorough examination both the patient’s entire body and jaw tissues separately. At the very first stage, a comprehensive examination is carried out - contraindications are identified, chronic diseases, the volume and condition of the jaw bone is assessed, because it is in it that the implants will be implanted.

2: installation of implants

For complex dental implantation, when restoration of the entire dentition or most of it is required, various implants can be used: mini-structures to support a removable denture, classic or one-piece implants to fix a complete permanent or removable denture. They are implanted into the bone tissue depending on the technique used: in 2 stages, or by puncturing the tissue with immediate installation of prostheses.

An important feature of complex implantation is that to restore the entire dentition, one implant is never installed for one tooth. In order to fix the prosthesis on the smile area, 2 implants are enough; for the entire dentition - from 4 to 6-8 structures.

3: complete denture prosthetics

When restoring an entire row of teeth, both removable and permanent structures can be used. At the same time, removable dentures on implants are noticeably different from conventional ones: they are more compact in size, less massive, securely fixed, and do not cause discomfort or inconvenience. At the same time, it is not necessary to remove them constantly (due to this they are usually called conditionally removable) - it is enough to remove them from the mouth only for periodic hygiene care from the inside.

Advantages and disadvantages of the method

restoration of a large number of teeth as much as possible effective way,
lower cost of treatment due to the use of a minimum number of implants and reduction of treatment stages,
possibility of fixing both permanent and removable dentures,
no bone augmentation is required - in most cases - surgery can be avoided by using the immediate loading technique.

Video about the principles of All on 4 implantation (All on 4)

The technique has no disadvantages, since it is an ideal option for restoring a large number of teeth - taking into account the state of the jaw system, the required number of implants is selected from 4 to 12 implants, which will support your new teeth for life.

Duration of treatment and service life of implants

The duration of restoration of a complete dentition depends on the implantation method. If artificial roots are fixed using the classical protocol, the treatment period will take about 4-6 months; if using the implantation method with instant loading, then the prostheses can be fixed within a week after implantation of the structures. In any case, implants will traditionally last until the end of life, prostheses - somewhat less, but they are easily updated without damaging the artificial roots.

Cost of complex implantation

The cost of the technique is fixed, it includes all the necessary manipulations: installation of certain implants, anesthesia, computer modeling of the entire treatment process, taking impressions, manufacturing and installation of dentures.