The implant placement after tooth extraction: when to put
When a tooth is lost, the gum and bone begins to deform, as there is no required load. If between tooth extraction and implantation takes a long time, in order to eliminate the defect of the dentition have to build up the bone and shape the gums. It costs more, takes longer and increases the risks. The installation of the implant after tooth extraction when the wound is still not healed, most preferred. The advantage of implants is that you do not have to prepare adjacent teeth, that is to grind them up and remove the roots. Also, sometimes it’s the only way to restore normal chewing function, for example, when you want to restore the extreme of the teeth or the patient is unwilling or unable to wear dentures. Artificial crown on the implant looks more natural than a bridge prosthesis.
What are the contraindications for implantation
Dental implantation is a surgical intervention and therefore has absolute and relative contraindications.
Absolute contraindications preclude the carrying out implant surgery and are forced to resort to other ways to restore chewing function. A ban on implantation impose the following condition:
- diseases associated with changes in bone structure. If the bone has become porous, it cannot hold an implant. On the skeletal system is affected by diabetes, osteoporosis, diseases of the endocrine system and other;
- reducing the protective functions of the body. During the operation, violated the integrity of tissues, and healing takes time. If the body is not able to resist disease-causing microorganisms present in the oral cavity, it may start the inflammatory process;
- the presence of cancer. Under the influence of a foreign body in the body the tumor begins to grow faster and to metastasize;
- mental pathology. During the surgery, the patient may not adequately respond to the actions of a doctor;
- if you are allergic to anesthesia. Implantation of artificial root is done under local anesthetic, and if you set a few pins, you can apply General anesthesia. If the allergies to anesthesia the body can respond to anaphylactic shock;
- diseases of the blood, or problems with blood clotting. With such pathology, the patient can lose a lot of blood even with a small incision;
- diseases in which impaired formation of connective tissue. In this case, the pin can not gain a foothold in the hole and reeling;
- if there is a tone of the masticatory muscles, bruxism;
- the inflammatory process in the bone, the presence of granulomas or cysts.
Tuberculosis, AIDS, sexually transmitted diseases, not amenable to treatment, also make it impossible to install the implant.
Relative contraindications of dental implantation is carried out only after the removal of factor that may contribute to complications in the form of inflammation or foreign body rejection. In order to eliminate them may require not only the assistance of a dentist, and other specialists (General practitioner, endocrinologist, cardiologist).
Relative contraindications to dental implant placement are:
- any inflammatory process in the oral cavity (gingivitis, periodontitis, stomatitis, inflammation of the joint);
- the presence of carious lesions of teeth;
- signs of lack of hygiene (presence of hard and soft dental deposits, dental caries, inflammation of the mucosa);
- addictions (alcoholism, Smoking, drug abuse) lead to a longer recovery of mucosal tissue.
Delay the implantation is recommended if:
- escalated any somatic disease;
- apply the medicines that can affect blood clotting;
- the patient is in a state of depression;
- the body is exhausted;
- a woman bears a child or is breastfeeding.
How is dental implantation
Implanted in the gums of the artificial root can occur in one of the following scenarios:
- classical implantation. Between implant and tooth extraction is from two to four months. This reduces the risk of possible complications, but can begin the process of atrophy of bone. After recovery of the tissue in the place of the removed root, the gums are cut or pierced to install the titanium post. When puncturing the tissue heal on their own, when the incision sutured;
- single-stage implantation. Is the root of the artificial tooth immediately after removal, and mucous tissue is sutured. With this method, the gingiva does not change its contour and the dentist can ensure that the metal structure of the implant will remain unnoticed to others. If the patient set pin in place of incisors or premolars, then it’s a visit to make and attach a temporary crown to preserve the aesthetics of the smile.
Install the implant immediately after the extraction of a diseased tooth for the patient much easier, because it reduces the number of clinic visits, is fully preserved masticatory function. But it is not always possible to put the implant once a tooth pulled. Only a specialist assess the condition of the oral cavity and the hole, say possible implantation immediately after removal or should I wait the full recovery of the tissue.
When it is impossible to put the implant immediately after tooth extraction
To defer one-stage implantation have if:
- inflammatory process has begun;
- appeared fistula;
- there are diseases of the oral mucosa;
- there isn’t enough bone or a pathological change in its structure;
- to remove the tooth gently not happened and is traumatized hole, or is it too big that it could hold the implant.
Prior to the implantation, the patient must undergo a medical examination, therefore, the implantation of artificial root right is possible only in a planned tooth extraction. In the presence of relative contraindications, the patient is prescribed anti-inflammatory therapy is carried out sanitation of the oral cavity, if required, increase bone tissue, and are complete healing wells.
As a rule, one-stage implantation is performed much less frequently than the classic. This is due to the fact that the removal of the tooth is often damaged bone and difficult to create the implant is identical to the tooth, so there can be problems with healing due to the insufficient fit of the pin to the bone. In addition, when simultaneous implantation increases the risk of complications.
When you put an implant immediately after tooth extraction
In order for dentist to install the titanium pin immediately after a routine tooth extraction should be complied with the following conditions:
- a sufficient amount of bone for implanting the desired implant;
- the bone and gums need to be able to hold the implant length from 13 to 16 mm;
- the hole is not too big for the pin;
- healthy adjacent tooth, which can hold an artificial root to until he will not grow into the tissue;
- overall health is satisfactory (no diseases in the acute phase, depression);
- was previously carried out sanitation of the oral cavity and other measures to eliminate relative contraindications.
How is single-stage implantation
First, the physician must determine whether there are absolute or relative contraindications for implantation. Upon detection of absolute contraindications is sought other therapy, when the relative therapy to eliminate the factors that increase the risk of complications (treatment of caries, is hygienic teeth cleaning, shall be appointed anti-inflammatory therapy), or given a referral to other professionals.
The patient before implantation must pass a General analysis of blood to detect inflammation in the body and an x-ray of the tooth that needs to be removed. Is required and a panoramic image made with computer tomography, for visualization of the dentition.
If the removal of the patient’s tooth went well and not require the restoration of bone tissue, the hole in pin is inserted, and the gums are sutured. Removed a tooth and is implanted under General anesthesia. The operation lasts about 20 minutes. If necessary, the doctor may put a temporary crown.
The most likely complications in dental implantation is the appearance of pain, swelling of tissues around the implant, a small amount of bleeding from the wound. Such problems generally disappear within 2-3 days. If the patient is at the stage of healing not «protects» the gum, you can stitches. Failure to comply with physician orders and neglect hygiene, and may the wound to get infected, leading to inflammation. The most dangerous complication is peri-implantitis, caused by infection with the hole.
During the 4-6 months osseointegration occurs. After the artificial root has taken root and it did not cause rejection by the immune system is made permanent crown. It can be made of cermet, ceramics or metal.