Simultaneous treatment of malocclusion with braces and installation of dental implants. Surgical correction of bite

Dental implantation

Implantation is the best way to recreate missing elements of the dentition. After a series of procedures, the bite looks aesthetically flawless, and the functions of the masticatory apparatus are completely restored. Unfortunately, implant placement is not suitable for everyone. Let's take a closer look: How is implantation carried out? Who shouldn't do it?

Ban on implantation: who is contraindicated
operation?

There are a number of pathological conditions in the body that make dental implantation impossible. Doctors at the My Orthodontist clinic carefully study the medical history of each patient. What conditions should be excluded?

Violation of hemocoagulation (blood clotting process). Implantation is always accompanied by slight bleeding - this is normal. If you ignore the pathology of blood clotting, serious complications will arise.
Diabetes mellitus (today it is not an absolute contraindication, but surgery can only be performed on patients with compensated type II diabetes. Implantation is not indicated for type I diabetes).
Autoimmune and inflammatory pathologies of connective tissue. These conditions will interfere with the healing of periodontal tissue.
Any malignant neoplasms.
HIV and sexually transmitted diseases.
Open form of tuberculosis.
Immune disorders (they will interfere with tissue healing and bone regeneration).
Osteoporosis.
Mental and nervous diseases, drug addiction. Implantation requires the patient to behave with restraint and follow all medical recommendations. People with neuroses, mental and behavioral disorders may not be able to cope with this task.
Hypertonicity of the facial muscles (muscles of mastication).

There are relative contraindications that make immediate implantation difficult. They can be eliminated surgically, treated therapeutically, or resolved naturally. Such “temporary” bans include:

carious teeth, tartar;
inflammation of the gums, temporomandibular joint;
bite pathologies and jaw defects;
infections and inflammations of the oral mucosa;
partial resorption of gum bone tissue (for correction, bone grafting and sinus lifting are performed);
smoking, alcoholism;
pregnancy.

There are a number of general contraindications related to health conditions. Implantation should not be performed when the patient is exhausted, weakened by long-term illnesses, or has anemia. If you are intolerant to local anesthetics, the procedures will also not be possible. Dental implantation can lead to a worsening of the condition of “heart patients”, rheumatic patients, people in a state of CFS and chronic stress. Taking immunosuppressants and certain other medications may interfere with postoperative tissue healing.

Preparing for implantation - patient instructions

Implant placement is a complex procedure, but it can be made as easy as possible by following simple recommendations.

Don't worry. Before the procedure, you can take a herbal sedative: valerian extract, tincture or decoction of motherwort.
Do not go to the procedure on an empty stomach, be sure to eat.
Check again to see if your teeth and mouth are healthy. Tell your doctor about any suspicions - infection at the time of surgery is unacceptable.
Don't smoke, don't drink alcohol even the day before.
Strictly follow your doctor's instructions throughout all stages of implantation.

It is better to make an appointment with an implantologist at the beginning of the day: the human psyche copes with stress more easily in the first half of the day.

Stages of dental implantation

After studying your medical history and eliminating contraindications, you can proceed with the operation. If implantation does not require preliminary surgical procedures, the procedure will consist of three consecutive stages.

First stage. Under local anesthesia, an indentation is made in the jaw where the implant is inserted. The intraosseous element is covered with mucous membrane on all sides. It takes up to six months for it to fully grow into the bone tissue of the jaw. Ingrowth is monitored using x-rays.

Second phase. A gum former is placed under local anesthesia to give the tissue a natural anatomical shape. After a few days, if there are no complications and the patient does not notice discomfort in the oral cavity, the former is replaced with a titanium abutment - a cylindrical screw that serves as a transition element between the implant and the artificial tooth. Prosthetics are prescribed after one to two weeks.

Third stage. The orthopedic dentist takes an impression of the jaws, which serves as a model for creating a prosthesis. A dental technician makes a crown. You will be tried on the manufactured design several times; The prosthodontist will adjust the crown until it perfectly matches the adjacent natural teeth.

The result of a series of procedures will be a completely restored dentition. High-quality implanted teeth cannot be visually distinguished from real teeth.

Are there any complications?

The risk of complications or unsuccessful results during implantation is possible - usually this outcome is associated with errors by implantologists. Sign up for the procedure only in a trusted clinic with a good name, study patient reviews, and do not be afraid to inquire about the licenses of the medical institution and the qualifications of doctors.

Implantation is considered a low-traumatic intervention. The intraosseous element takes root in 97-98% of cases. A successfully placed implant completely fuses with the surrounding jaw tissue. Specialists at the My Orthodont clinic, observing the treated patients, note the durability of the “new” teeth and the normal condition of the surrounding tissues.

How long should I see a doctor after implantation?

The success of the operation depends on the coordinated work of the team of specialists and the patient’s behavior. Before the operation, the doctor will advise you on oral hygiene and tell you what pastes, brushes, and flosses you need to purchase. Regular care of implanted teeth is easy.

Upon completion of the main procedures, an inspection schedule is drawn up. You will visit your doctor once every six months (in some cases, every 3 months). During a preventive examination, a specialist will evaluate the quality of oral hygiene and the condition of the jaw tissue.

Dental implantation is a progressive method of restoring the chewing apparatus and a beautiful smile. This is a complex multi-step process, but the result is worth it!

Malocclusion consists of improper closure of the teeth in the upper and lower jaws. As a result, deformations and displacements of the dentition occur. Prosthetics in conditions of malocclusion pose a significant problem.

Why is this dangerous and risky?

With an incorrect bite, the force when chewing changes, and the load on the teeth and jaws is unevenly distributed. Therefore, prosthetics in such conditions may not only not bring the desired effect, but even cause harm.

If the jaws are not closed correctly, the force of pressure on some teeth is greater, while others are less; accordingly, the load is distributed unevenly, which can cause the implant to be knocked down or broken. To prevent this from happening, the materials from which the artificial crown will be made must have sufficient strength. It is advisable not to perform implantation with ceramics, because... she is the most fragile.

In addition to the uneven load, there is also the problem of teeth wearing out ahead of time; orthopedic structures, if the patient has them, also suffer. If you notice tooth wear, it is important to contact a specialist in time to cover your teeth with an artificial crown. Such a crown must have sufficient strength.

If there is a malocclusion, the teeth may tilt in different directions. Such a defect will complicate the prosthetic procedure, because It can be difficult to place an implant in a gap between teeth. Then special preparation is applied using a surgical or orthodontic method, during which excess teeth will either be removed or the dentition will be straightened.

Prosthetic procedure for malocclusion

If the defect is not very pronounced, then the procedure is carried out as standard. A plaster cast of the jaw is taken for the patient, then an artificial prosthesis is modeled.

If there is significant curvature of the teeth, then the patient is advised to wear orthodontic structures for several years in order to straighten the dentition, and successful prosthetics become possible.

Where there is improper closure of the teeth, the future shape of the crown is carefully planned. The design should not cause difficulty in jaw movement and should not have an adverse effect on neighboring teeth. The preparation method for each case is purely individual, depending on the clinical picture of each patient.

Experts distinguish two degrees of occlusion:

Jaw displacement. With a slight displacement, implantation is possible. Sometimes in such a situation the problem can be corrected through the use of dentures. When severe jaw misalignment is observed, implantation will most likely be denied.
Incorrect position of teeth. When the roots of adjacent units do not interfere with the installation of the implant, attention is paid to aesthetics. If you cannot achieve the ideal look right away, alignment is required using a braces system. Another option is to remove interfering units.

To more accurately determine the clinical situation, a preliminary x-ray examination of the oral cavity is performed and impressions of the jaws are taken.

Minor deformations include:

lack of space in the dentition to install a full crown on an implant;
tilting or incorrect rotation of some teeth;
large gaps between teeth.

In case of minor violations, implantation can be performed. However, the patient is made aware of the possible risks. If he is ready to put up with it, the procedure is carried out.

If there is severe malocclusion, titanium roots cannot be installed until the dentition is straightened. For this purpose, preliminary orthodontic treatment is carried out. Otherwise, there is a risk of strengthening and strengthening the deformity, which may even harm the patient. Therefore, an implant surgeon may refuse to perform implantation.

What is the dental system and why do deviations occur?

The dentofacial system refers to the upper and lower jaws, as well as all their constituent elements:

temporomandibular joints;
gums;
chewing muscles;
teeth;
bone tissue;

When all the teeth are in place, the occlusion is correct, and there are no inflammatory processes in the oral cavity, then the dental system is normal and functioning well. At the same time, the teeth are able to withstand maximum chewing loads and are not injured. In the presence of defects, chewing dysfunction occurs, which creates obstacles for the installation of implants. The most common abnormal changes in the dental system are:

bite deformation - displacement of the jaws relative to each other;
incorrect arrangement of teeth, presence of gaps between them;
anomalies in the structure of the bone tissue of the jaw;
loose bone structure or atrophy.

Experts distinguish five types of deformation:

deep- when the bottom row is almost completely covered by the top;
distal- the upper jaw protrudes significantly forward compared to the lower jaw;
mesial- sagittal anomaly of occlusion, when the chin (lower jaw) protrudes forward;
open— partial or complete non-occlusion of teeth;
cross- transversal anomaly, in which one of the jaws is only partially formed or is displaced to the side from the other.

Due to malocclusion, the load on the jaw is distributed unevenly, which leads to premature destruction of units located in the zone of maximum pressure. If an implant ends up there, peri-implantitis may develop, which provokes rejection. Therefore, before implanting titanium roots, all problematic issues must be eliminated.

What could be the consequences if implants are installed and the anomaly is not corrected?

Before implantation, it is important to consult with an orthodontist in order to pre-select methods for correcting existing defects and plan the stages of treatment. Otherwise, the following complications may occur:

violation of the integrity of the temporomandibular joints (clicking, crunching, pain appear);
destruction of certain teeth exposed to the greatest chewing load;
increased abrasion of tooth enamel;
premature loosening of the artificial root and development of the inflammatory process (peri-implantitis);
psychological discomfort and internal dissatisfaction;
reduction in the service life of the implant due to uneven load on it;
chronic headaches that appear as a result of compression of nerve endings and muscle spasms;
worsening deformity.

Is it possible to correct a bite if an implant is already installed?

Correction of occlusion disorders after implantation is not carried out. The fact is that after osseointegration the artificial tooth root becomes absolutely motionless in the jaw bone. This is its main difference from natural material, which is slightly springy or “cushioned” and amenable to artificial movement.

The implant after engraftment is immobile and cannot be moved

The titanium rod is implanted at a certain angle and follows the position/inclination of natural teeth. When living units begin to shift, the implant moves along with them, which can provoke rejection. Therefore, bite correction is always carried out before implantation.

If the patient has implants in the mouth and occlusion correction is required, they are removed. This is followed by orthodontic treatment and re-implantation of titanium roots, taking into account the formed occlusion. There may be isolated exceptions - when the implant is installed before the defects in jaw closure are corrected, and then the natural teeth are displaced, attracting or pushing them away from the fixed metal root.

Price

Name of service	Cost, rub.
Bite correction
Consultation with an orthodontist	For free
Tying the arch to one bracket	400
Fitting and applying the arc	500
Observation during the treatment phase	1000
Alginate impression	1000
Placing one bracket on the NO MIX material	1800
Making a diagnostic model (2 pcs.)	2500
Diagnostic model calculation	2500
Treatment of anomalies (bite correction)	70000
Implantation
Operation

The ideal closure of the dentition ensures harmonious, coordinated work of muscles and joints. For minor violations, it is possible to correct the bite with prosthetics - then the treatment can be completed in the shortest possible time. This method includes replacing a lost tooth or.

Dental prosthetics for malocclusion are carried out in the presence of the following defects:

large interdental spaces;
disharmonious tooth size;
the presence of chips and reversals.

In the latter case, if the pathology is mild, you can get by with the installation of veneers - thin plates of porcelain or composite material that replace the outer layer of enamel. A small grind is performed so that the veneer does not stick out.

Crowns have wider functionality, they can solve more problems, but a significant part of them is ground down. Recommended in cases where it comes to preserving a tooth with extensive lesions.

Larisa Kopylova
Dentist-therapist
Important! When a living tooth breaks down due to trauma or other damage, the entire row can shift and disrupt the established bite.
Disharmony in the position of the jaws is caused by:
early loss of primary incisors or permanent molars - back teeth;
bad habits - sucking a pacifier, finger sucking;
loss of teeth.

A timely installed crown or veneer will help maintain chewing functions.
Directly about bite correction with crowns
A crown is a product for micro-prosthetics; it is “placed” on a previously prepared place. Orthopedic correction using crowns can solve the problem quickly, but not in all cases. Main functions of crowns:
preventing further destruction of living teeth;
implant protection.

Crowns can save you in case of injury or too extensive caries.
The table below shows the types of crowns, their advantages and disadvantages:
Material Advantages Flaws Scope of application
Stainless steel Sturdy, inexpensive Unaesthetic appearance, with the stamped version there may be a loose fit to the tooth Temporary closure of the damaged area, children's prosthetics (baby teeth)
Metals and their alloys Minimum thickness, durability Unnatural color Permanent prosthetics
Metal ceramics Durability, aesthetic appearance It should not be used in children and adolescents or in cases of pathological abrasion of the enamel. Prosthetics of anterior teeth
Ceramics without metal Suitable for those with metal allergies Less durable, wears away the teeth in contact with them more Restoration of upper incisors
Metal-plastic Low price Fragility, possibility of allergic reactions Temporary option when removing crowns for correction with braces
Prosthetics with crowns are performed when more than half of the tooth is destroyed.
Procedure
To correct your bite with crowns, you will need to visit the dentist’s office two or three times:
The first time a specialist will conduct a diagnosis. It will determine the condition of the oral cavity and whether crown treatment can be applied in a particular clinical case. The treatment plan is agreed upon with the patient, after which impressions are taken and the teeth are polished to prepare for the installation of crowns. Temporary crowns are installed on the prepared sites.
After the creation of prosthetic structures, the patient visits a doctor to install them. This stage includes testing the dentition to correct the bite.
The third time you will have to visit the dentist only if necessary. The appearance of discomfort when chewing or pain.

Treatment of malocclusion with crowns is one of the fastest ways to correct a malocclusion.
Indications for the procedure
One of the most painful and dangerous is. With such an anomaly, the upper teeth extend too far beyond the lower ones, which can injure the mucous membrane and provoke inflammation. Often the main task of prosthetics is to raise the bite. Required in the following cases:
short lower teeth;
incorrect position of the jaws, as a result of which more than 2/3 of the lower rows overlap with the upper ones;
permanent injury to the mucous membranes of the oral cavity;
excessive abrasion of enamel;
protrusion of the lower lip;
slurred speech;
problems with the mandibular joint – crunching, pain;
difficulty chewing food.

Larisa Kopylova
Dentist-therapist
Important! The decision to perform prosthetics for malocclusion is made only by the orthodontist, together with the patient, depending on the clinical picture.
In case of complete edentia - loss of teeth - or the absence of a large number of them, the production of complete or partial removable dentures is suitable for patients with occlusion pathology. The full version is suitable for the upper jaw; it holds well due to the suction effect. In the lower jaw, due to anatomical features, they try to preserve at least one tooth for putting on a partial denture.
Crowns remain the most common type and preferred type of prosthetics for patients with malocclusion - this way you can save more living teeth. Before carrying out the procedure, it is necessary to check whether there are any contraindications.
Who is it contraindicated for?
Before installing crowns or implants, the patient must receive a clear treatment plan and understand:
whether the teeth in contact with the crown will wear out even more;
how long will the crown last, how will the load be distributed on it.

Particular care should be taken with implants - rods implanted into the jaw. The main problem is that the patient, having decided on this procedure before installation, seriously complicates his treatment. Teeth can move into the bone under the influence of certain settings, but implants cannot. An exception is the installation of one or several implants at once in the correct position, agreed upon with an orthopedic dentist, in order to then use them to attract the teeth into the correct position. The decision is made only by a specialist as part of orthodontic treatment.
There are contraindications to prosthetics to eliminate malocclusion:
significant malocclusion;
exacerbation of chronic diseases and infectious diseases (for example, tuberculosis);

Dental diseases - periodontitis, periodontal disease - are not a relative contraindication, but their treatment must be carried out before or during prosthetics.
Alternative options for correcting your bite
Orthodontic treatment is aimed at correcting the bite; in its arsenal there is a number of designs that allow you to straighten the dentition. Among them:
Bracket systems. Fixed structures attached to the teeth and interconnected by arches. They allow you to achieve significant results and are used for the most severe cases, however, this type of treatment takes more time. It can be painful for the patient, especially at the beginning of wearing the structure, because the teeth are displaced in the bone tissue.
Mouth guards, aligners. Removable structures made from transparent polymers. They make teeth easy to clean, there is less discomfort, and they preserve the enamel as much as possible.
Trainers. Removable metal structures for correcting malocclusion; they do not require a dental impression, but you cannot talk to them, which makes them difficult to use in everyday life.
Surgical intervention. Used only in the most difficult cases, under general anesthesia. After surgery, the patient often wears braces to secure the results.
Special exercises. Well suited for children when the dentition is in the process of active formation.

All these methods are aimed at eliminating the cause of malocclusion, and not at masking imperfections.
A little about care
After installing crowns, the patient needs to remember that covering a tooth with a crown does not mean that it does not need care. If hygiene is insufficient, bacteria can penetrate between the tooth and the crown, causing caries. Necessary:
brush your teeth after breakfast and dinner;
eliminate frequent snacks, especially sweets;
use dental floss after meals;
Protect the crowns from strong physical influences - do not bite your nails or pens, and be careful when consuming nuts and other hard foods that can damage the installed elements.

Correcting a bite with prosthetics is a quick and relatively inexpensive method compared to the whole arsenal of other orthodontic means. Unfortunately, it is not always effective; it is used for minor abnormal positions of the teeth.
Larisa Kopylova
Dentist-therapist
Important! Prosthetics do not eliminate the root cause of pathological occlusion - incorrect position of tooth roots in bone tissue.
Conclusion
If there are severe defects in the position of the jaws, crowns and veneers will not help - it is necessary to resort to treatment with braces and only then carry out prosthetics. As a rule, in case of severe anomalies in the position of the teeth, the defects are corrected with braces, mouthguards, aligners, and only then, as a final touch, prosthetics are performed.

A unique structure is one of the distinctive features of Conmet orthodontic implants. The special cutting of the screw allows it to be securely fastened into the gum tissue without deep dissection. The head is made in the shape of a brace - this is the support for the ligature. It takes the load on itself and prevents the supporting teeth from becoming loose.

In what cases is the Conmet technique used?

with serious anomalies of the dentition (fan discrepancy, distal bite, crowding);
significant advancement of molars;
for cutting through “delayed” fangs;
if the conventional system is ineffective;
to speed up the leveling process.

This system has many advantages: effectiveness, ease of installation, minimal risk of rejection, no complications after implantation. There are no age restrictions either. In addition, the price of orthoimplants is three times lower than conventional ones.

The difference between mini-implants and standard ones is that soft implantation does not allow much stress on the titanium base. You cannot screw permanent crowns onto it. But for the best performance of braces, they are indispensable.