Dental implantation: contraindications and possible complications. Age restrictions for implant installation

Implantation allows you to correct any defects in the dentition, so patients are increasingly turning to dentists to install implants and micro-implants made from new high-quality materials. But implantation differs from other methods of dental prosthetics by a large list of contraindications and possible complications, so before choosing this method of restoring the dentition, you should familiarize yourself with its inherent features.

Preliminary diagnosis, indications and contraindications

Dental implantation is performed for various indications. Implants are used if one or more teeth are missing, in which case they are installed as full dentures or as a support for other structures. In case of complete absence of teeth, implantation is carried out as an independent method of prosthetics or as an auxiliary method, when only 4–6 implants are implanted into the jaw, and other prostheses are installed on them.

Implantation is a full-fledged operation, which is contraindicated in the presence of certain diseases and disorders, as they increase the risk of unpleasant complications. Therefore, before using implant prosthetics, the dentist examines the patient to assess the condition of his oral cavity and general health. For this, the following diagnostic methods are used:

Examination of teeth and gums for the presence of caries, tartar, and inflammatory processes.
Bite check.
X-ray of the jaw.
Blood tests for infection, clotting and sugar levels.

If the dentist suspects the presence of any pathologies of internal organs that may become an obstacle to the procedure, he may send the patient for a consultation with specialists of another profile, for example, a cardiologist, oncologist or immunologist.

Absolute contraindications to the installation of dental implants

Absolute contraindications to implantation are those factors in which surgery is strictly prohibited. These include:

Diseases of the blood, hematopoietic organs, clotting disorders.
Diseases of the nervous system.
Oncological neoplasms in any organ.
Connective tissue diseases.
Immune and autoimmune disorders, presence of HIV status.
Tuberculosis.
Severe diseases of the oral cavity.
Tendency to bruxism.
Diabetes.
Kidney failure.
Congenital pathologies of the bone tissue of the jaw.
Childhood and adolescence (up to 18 years).

Prosthetic methods related to implantology are contraindicated in the presence of such anatomical features as a small distance from the installation site of the prosthesis to the maxillary or nasal sinus.

Implantation is a serious surgical procedure that is accompanied by severe pain, so implants are not placed without anesthesia. If a patient develops an allergic reaction to anesthetics, he will have to look for other ways to solve dental problems. Individual contraindications are also taken into account: You cannot install dental implants made from a material that causes allergies in a particular patient.

Relative contraindications to the installation of dental implants

The presence of relative contraindications to the installation of dental implants does not exclude the possibility of prosthetics. The patient can perform this procedure after appropriate treatment, provided his health condition is normalized. This group of contraindications includes:

Local diseases of the oral cavity.
Inflammation of the ENT organs.
Bite defects.
Diseases of the mandibular joint.
Pathologies of bone tissue.
Venereal infections.
The rehabilitation period after another operation.
Rehabilitation after radiation therapy.
Taking antidepressants.
Age over 60 years (more thorough examination required).

Dental implantation performed during pregnancy can cause harm to the unborn child, since it is a kind of stress for the mother and is accompanied by the use of various medications. Therefore, a woman should postpone prosthetics until the postpartum period, and if breastfeeding, until the end of lactation.

If a patient suffers from alcohol or drug addiction or constantly ignores hygiene rules, he must give up his addictions and return to a normal lifestyle. Then, if there are no other problems, the doctor can install a prosthesis for him. If a person does not seek to change his lifestyle and continues to cause harm to health, these contraindications to the installation of dental implants become absolute, and the dentist decides to finally refuse the operation.

Making a decision about the possibility of implantation

After a complete examination, the dentist informs the patient about the absence or presence of contraindications for dental implantation. If they belong to the absolute group, the doctor will inform you about other modern methods of dentition correction. The search for alternative methods continues even if a person is not psychologically ready to endure all the unpleasant procedures during prosthetics.

If there are contraindications for dental implantation, but they are relative, further actions will be as follows:

If there is an untreated disease, the person undergoes therapy from a doctor of appropriate specialization.
If it is necessary to temporarily postpone the intervention, for example, until childbirth, the end of lactation or until adulthood, the patient waits for a certain time and during this period carefully takes care of the oral cavity.

Different dentists have different views on the same prohibitions on implantation. For example, some dentists prohibit inserting dentures into patients under 18 years of age, while others advise waiting until the age of 22. In some dentistry, implantation is even performed on pregnant women, but only in the second trimester and when they are in good health.

The decision to install an implant is influenced not only by the presence of any disease, but also by its severity.

Possible complications

If important contraindications for installing dental implants were ignored, the doctor made mistakes during manipulations, or the person did not follow the rules of nutrition and oral care during the healing period, the following complications may occur:

Complication	Possible reasons
Prolonged and heavy bleeding (longer than 3 days)	Injury or medical error during surgery
Severe, prolonged pain	Errors during implantation, development of infection
Numbness of soft tissues	Nerve damage
Severe soft tissue swelling	Development of infection
High fever that lasts longer than 3 days	Development of infection in the jaw around the installed implant or its rejection by the body
Violation of the integrity of the seams	Trauma or infection in the tissue around the implant
Pereimplantitis – signs of inflammation around the implant	Tissue infection during dental implantation or due to poor hygiene
Implant mobility	Features of the structure of bone tissue or errors during implantation

Healing related problems

There are some health problems that prevent tissue from healing after implant placement. For example, if a person is in a state of deep, long-term stress, the body may not be able to cope with the next load, and the tissue healing process will be delayed. Sometimes regeneration is complicated by internal diseases and exhaustion of the body due to malnutrition, a serious illness, or a complex operation.

After implantation, the dentist warns the patient about possible discomfort. Moderate pain, swelling of the gums and a slight increase in temperature in the first two days after the procedure are the norm, not a complication. But it is impossible to ignore alarming symptoms that persist longer than the specified time. Inaction not only risks the possible loss of the implant, but also threatens the patient’s life.

Ignoring contraindications for the use of dental implants can be life-threatening. If the doctor decides that implantation is impossible, another prosthesis can be placed. In order not to provoke complications after installing an implant, you must strictly follow the rules of behavior during the period of its engraftment.

Bone grafting, bone tissue augmentation, guided bone regeneration, sinus lift for dental implantation

One-stage ( single-phase) basal dental implantation

One-stage express dental implantation using the immediate loading protocol ( without gum incision) - (video)

How to behave in the postoperative period ( what you can and cannot do after dental implantation)?

Possible complications, consequences and side effects of dental implantation

Where ( in which clinics or dental clinics) is it possible to get dental implantation in the Russian Federation?

What is dental implantation?

Dental implantation is one of the modern and reliable methods of restoring lost teeth. Its essence lies in the fact that part of the dental implant is implanted into the jawbone instead of the damaged root ( remote) of the tooth and is firmly fixed there. The outer part of the implant is covered with a special crown or prosthesis, which ensures high strength of the entire structure, as well as a good cosmetic result.

The advantages of this technique include quality and reliability.
At the same time, it is worth noting that complete installation of an implant can take from several months to six months, which is due to the slow fusion of the implanted part with the jaw bone tissue. Average lifespan of a dental implant ( using quality materials and correct installation techniques, as well as proper oral care) can reach 25 – 30 or more years.

What is the difference between dentures and dental implants?

Implantation and prosthetics are two completely different procedures for restoring or replacing damaged teeth. Prosthetics are used in cases where the tooth is only partially damaged, and its root is still firmly fixed in the gum. In this case, the doctor first prepares the damaged tooth ( removes damaged parts, removes nerve if necessary). Then he sharpens the remaining part of the tooth, and places a metal or metal-ceramic prosthesis on it ( a crown or so-called “bridge”, which allows you to replace several teeth at once). With proper care, the service life of such a prosthesis can reach several decades.

The main difference between prosthetics and dental implantation is that in the second case, not only the upper part of the tooth is replaced, but also its root. Instead of the root in the gum ( into the jaw bone) a metal frame is implanted ( directly implant), on which the so-called superstructure is subsequently “put on” - a crown, a bridge, and so on. Further ( if necessary) the superstructure can be replaced, while removing the implant itself from the bone is extremely difficult ( this can only be done surgically).

Indications for dental implantation

As follows from the above, indications for dental implantation can be various diseases and pathological conditions in which the entire tooth is missing or cannot be preserved ( including its root).

Implantation of one or more teeth is indicated:

With edentia. This term refers to the complete absence of teeth in the oral cavity. Typically, this condition can be observed in older people who have not sought qualified dental care for a long time, as a result of which all their teeth have fallen out.

If one or more teeth are missing in the mouth. If one tooth needs to be replaced, one implant is installed instead. If the patient is missing several adjacent teeth, a special plate can be implanted into the jaw, on which there will be 2 – 3 or more “teeth”. This will speed up the treatment process, since there will be no need to install each implant separately.
For loose teeth and tooth loss. There can be many reasons for increased tooth mobility, from diseases of the teeth themselves to pathologies of the jaw bone. As a rule, once a tooth becomes loose it will never return to its previous, normal position, as a result of which the option of replacing it with an implant should be considered.
If it is impossible to wear removable dentures. When wearing removable dentures, some people may experience constant discomfort in the oral cavity, and therefore may be advised to undergo implantation.
If it is impossible to install permanent dentures. Even when wearing a high-quality crown, part of the tooth underneath can be destroyed. If this happens, the crown will no longer be able to stay in place, and it will be impossible to install a new one due to the lack of supporting dental tissue. In this case, the only treatment option will also be implantation of an artificial tooth.
For malocclusion. Some congenital or acquired anomalies of the upper or lower jaw may cause malocclusion that cannot be corrected in any other way. In this case, the manufacture and installation of specially prepared implants can help solve the problem.

Is dental implantation indicated for periodontal disease and periodontitis?

Dental implantation is one of the main methods of treating periodontitis, while for periodontal disease it can be used only in advanced cases, when other treatment methods are ineffective.

Periodontitis is an inflammatory disease of the tissues that surround the tooth and provide its fixation in the jaw bone. With this pathology, there is destruction of the alveolar process of the jaw ( in which the tooth is directly fixed), as well as the formation of abscesses around the tooth itself. As a result, it becomes loose and falls out. Dental implantation is indicated only after periodontitis has been treated and the causes of its occurrence have been eliminated.

Unlike periodontitis, with periodontal disease there is no development of an inflammatory process. This pathology is characterized by the slow destruction of the bone tissue of the jaw and damage to its alveolar processes, resulting in exposure of the tooth root. An important feature is the fact that for a long time the tooth remains firmly fixed, does not loosen or fall out, and therefore it is not advisable to carry out implantation in the early stages of the disease ( drug and surgical treatment aimed at restoring bone tissue around the tooth is indicated). At the same time, it is worth noting that with prolonged progression of the disease and without the necessary treatment, the tooth root may become exposed ( protrude above the gum surface) by more than 50%. In this case, the tooth may become loose and the risk of tooth loss increases. If this happens, the only possible treatment option will be dental implantation.

Are dental implants performed for children?

Dental implantation for children under 18 years of age is not recommended. The fact is that as a child grows, the jaw bones and teeth themselves grow and change. An implant installed in early childhood would after some time be too small for the patient, as a result of which it would need to be reinstalled. Performing such a procedure would be impractical and extremely traumatic. That is why, in such cases, various options for dental prosthetics are first used, and after the child stops growing, the issue of installing permanent implants is decided.

Alternatives to Dental Implants

Dental implantation is a fairly reliable, but expensive and relatively labor-intensive method. If the patient is not ready for such a procedure, the damaged tooth can be “fixed” in other ways.

An alternative to dental implantation may be:

Classic prosthetics. In this case, a special crown is placed on the prepared upper part of the tooth, protecting the tooth from further destruction. It is worth noting that dentures can be removable ( the patient can remove them independently whenever he wishes) or permanent ones, which are firmly fixed to the remaining tooth and can only be removed by a specialist in a dental clinic.
Tooth reimplantation. This technique is similar to classical implantation. First, the doctor carefully removes the damaged tooth, which is then treated in a special way ( that is, restored, restored) – pathological foci of caries and other damage are removed from it, various deformations and canals are filled, enamel is restored ( outer surface of the tooth) and so on. After the restoration process is completed, the patient’s tooth returns to its original place and is fixed to the jawbone, after which it can serve for many more years ( with proper care).

Limitations and contraindications for dental implantation

The procedure for installing an implant is quite complex, time-consuming and associated with certain risks, as a result of which, before starting it, the doctor must make sure that the patient does not have any contraindications.

Dental implantation is contraindicated:

For infectious diseases of the oral cavity. If the patient has stomatitis ( inflammation of the oral mucosa), gingivitis ( gum inflammation) or another similar infectious process, you should first begin to treat it, and only after the source of infection has been completely eliminated should you begin dental implantation. The fact is that during the implantation procedure the implant will be implanted into the jawbone. If there is a focus of infection in the oral cavity, pathogenic microorganisms can enter the blood or bone tissue, causing the development of serious complications.

For severe diseases of the cardiovascular or respiratory system. During implantation, it may be necessary to put the patient under anesthesia ( medicated sleep), which can be dangerous if there is heart failure or respiratory failure.
For diseases of the immune system. In some pathologies, the functioning of the immune system, which normally performs a protective function, is disrupted ( protecting the body from the introduction of foreign bacteria, viruses, fungi and other dangerous particles). Since the implant is a foreign substance that comes into direct contact with the patient’s blood, if the function of the immune system is impaired, the patient may develop allergic reactions that can pose a danger to his health or even life.
For mental disorders. Performing a dental implant requires a certain amount of cooperation and understanding from the patient. If the patient is inadequate and is not responsible for his actions, he cannot undergo this procedure.
For diseases of the blood coagulation system. Under normal conditions, this system is responsible for stopping bleeding from wounds, injuries, cuts, and so on. If its functions are impaired, the patient may experience prolonged, heavy bleeding even after minor cuts. Dental implant surgery involves damage to the oral mucosa, gums and jawbone, resulting in an increased risk of bleeding during this procedure. That is why, before starting to perform it, the doctor must make sure that the patient’s blood coagulation system is functioning properly.
For rheumatic connective tissue diseases. With systemic lupus erythematosus, scleroderma and other similar diseases, the development of connective tissue, which is extremely important at the stage of implantation into the jaw bone, is disrupted. That is why, before dental implantation, it is necessary to achieve stable remission of the patient’s existing pathology.
In the acute phase of tuberculosis. Tuberculosis is an infectious disease that most often affects lung tissue. The acute phase of the pathology is characterized by the fact that a sick person releases the infectious agent into the environment along with exhaled air ( when coughing or simply breathing). Since during dental implantation, doctors will need to work in close proximity to the patient's respiratory tract, their risk of contracting tuberculosis increases. That is why tuberculosis should be treated first, and only after achieving stable remission ( subsidence of acute manifestations of the disease and negative laboratory tests) you can plan dental implantation.
For diseases of the temporomandibular joint. Diseases that make it impossible to open the mouth wide enough can create difficulties during dental implantation surgery.
With pronounced anomalies in the structure of the jaw. During the procedure, a metal implant of a certain length and specific dimensions will need to be implanted into the jawbone. If the patient’s anomalies do not allow this to be done ( for example, with bones that are too thin, deformed or weak), dental implantation is contraindicated for him.

Dental implantation for anemia

The possibility of implantation depends on the severity of anemia ( anemia), as well as on the speed of its development.

Anemia is characterized by a decrease in the concentration of red blood cells ( red blood cells) and hemoglobin ( ensuring the transport of oxygen to tissues and organs). With the development of anemia, the transport function of the blood is disrupted, that is, the body's cells may begin to lack oxygen. Since a certain amount of blood loss is possible during tooth implantation ( usually no more than a few milliliters, but if unforeseen complications develop, more heavy bleeding is possible), no doctor will take a patient with severe anemia for surgery.

It is worth noting that not only the severity of anemia is important, but also the speed of its development. For example, the normal hemoglobin level in men is considered to be 130 g/liter, and in women – 120 g/l. If anemia develops slowly ( for example, with a deficiency of iron, vitamin B12 or other substances), the body manages to adapt to gradually changing conditions and does not experience a pronounced lack of oxygen. In such cases, surgery can be performed even with a slightly reduced hemoglobin level ( but not less than 90 g/l). If anemia develops as a result of bleeding, the body does not adapt well to rapidly changing conditions, as a result of which dental implantation can be performed only after eliminating the cause of anemia and restoring normal hemoglobin levels.

Are dental implants done during menstruation?

It is not recommended to install an implant or other surgical interventions during menstrual bleeding, as this can negatively affect the general condition and health of the woman, as well as lead to the development of complications.

Dental implantation during menstruation can be complicated:

Development of anemia. During menstrual bleeding, a woman normally loses about 50–150 ml of blood ( sometimes up to 200 ml, which depends on the individual characteristics of the body). At the same time, with the development of any pathologies or complications, bleeding may be more pronounced, as a result of which blood loss can reach 500 ml or more. In this case, severe anemia may develop, requiring urgent treatment. That's why dental implants ( as well as any other surgical interventions) is not recommended during menstruation.
Stress. During menstruation, the female body experiences stress, which is manifested by increased stimulation of the nervous system, hormonal changes, and so on. The operation to install an implant can increase stress, which can lead to increased nervous excitement, nervousness, nervous breakdown and other psychological disorders.
Disorders of the blood coagulation system. As mentioned earlier, the coagulation system ensures that bleeding is stopped. During menstruation, there is an increased activation of blood clotting factors, which is protective in nature ( prevents excessive blood loss). If you perform dental implantation ( during which damage to the tissues of the gums, jaw and oral mucosa also occurs), this may further increase the activity of the blood coagulation system, thereby increasing the risk of developing associated complications. The most dangerous complication in this case may be the formation of blood clots ( blood clots) directly in the vascular bed. Such blood clots can clog blood vessels, thereby interfering with the delivery of blood and oxygen to certain tissues and organs ( including to the heart, lungs, brain and so on).

Is it possible to have dental implants performed during pregnancy or while breastfeeding?

During pregnancy, dental implantation is prohibited, as this can lead to the development of complications that pose a danger to the health and life of the mother and fetus.

Dental implantation during pregnancy can be complicated by:

Toxic effects of medications. The implantation procedure is extremely painful, and therefore can only be performed using anesthesia ( anesthesia, pain relief). Anesthesia involves the introduction into a woman’s bloodstream of a number of drugs that can penetrate the placenta ( organ that provides nutrition to the fetus) into the fetal bloodstream and disrupt its development. This can lead to intrauterine anomalies or even intrauterine fetal death. It is also worth noting that painkillers prescribed to the patient after implantation may also have a toxic effect.
Allergic reactions. An allergy is an excessively expressed reaction of the immune system, manifested by general malaise, itchy skin, a pronounced decrease in blood pressure, an increase in body temperature, and so on. Allergies can occur both during pain relief and in response to the introduction of a foreign substance ( implant) into the jawbone. The development of a severe allergic reaction can lead to disruption of the blood supply to the fetus, thereby causing damage to its organs ( primarily the brain) or even intrauterine death.
Damage to the fetus from X-rays. In the process of preparing for implantation, it is necessary to perform an x-ray examination, that is, take a picture of the jaw and teeth ( sometimes not one, but several at once). Exposure to radiation can negatively affect the process of formation and development of embryonic or fetal organs, which will lead to the occurrence of intrauterine developmental anomalies.
Development of infectious complications. During pregnancy, there is a weakening of women's immunity, which is necessary for the normal development of the fetus. Under such conditions, the entry of even a small number of pathogenic microorganisms into an open wound can lead to the development of a severe infection, which will require additional treatment ( in particular, the prescription of antibiotics, which are contraindicated during pregnancy, as they can harm the fetus).

Dental implantation during breastfeeding is also not recommended, since medications introduced into the mother’s body can be excreted in breast milk and enter the baby’s body, provoking the development of allergic and other dangerous reactions.

Features of dental implantation for diabetes mellitus type 1 or 2

If the patient is diagnosed with an initial form of diabetes mellitus, which has not yet led to the development of complications, and the patient himself takes the treatment prescribed to him, dental implantation is not contraindicated for him. At the same time, with long-term progressive forms of the disease, as well as with the development of complications from internal organs and systems, it will be extremely difficult or even impossible to perform the procedure for implantation.

Diabetes mellitus is a disease in which some cells in the human body cannot properly metabolize glucose ( sugar, which is a source of energy for them). This leads to disruption of the functions of many organs and systems, which is accompanied by the development of severe complications.

Today, type 1 diabetes mellitus is distinguished ( insulin dependent) and 2 types ( non-insulin dependent). In the first case, the cause of the disease is a violation of the production of the hormone insulin, which is normally produced by the pancreas. With its deficiency, glucose cannot penetrate the cells, which leads to an increase in the concentration of sugar in the blood. External administration of insulin helps solve this problem, which was the reason for the name of this form of the disease.

In type 2 diabetes, the disease is caused by damage to the body's cells that cannot interact with insulin, as a result of which glucose cannot enter them. This also leads to increased blood sugar levels, although insulin production is not impaired. In this case, various drugs are used for treatment that help reduce sugar levels, thereby preventing the development of complications.

As mentioned earlier, diabetes affects many organs, including blood vessels. Due to insufficient glucose supply, the walls of small blood vessels are damaged, resulting in the destruction of the vessels. Over time, this leads to insufficient blood supply to the affected organs. Against the background of impaired oxygen delivery, cell division processes are disrupted ( regeneration), and also increases the risk of developing infections ( due to insufficient supply of immune system cells to the affected tissue). If such complications have developed, it will be impossible for the patient to implant the tooth. The fact is that after the implant is installed, it must grow into the bone tissue of the jaw. However, due to a violation of the blood supply, this process will proceed extremely slowly and "sluggishly", as a result of which the implant will not take root as it should. Moreover, due to impaired blood supply to the oral mucosa, the risk of wound infection during the procedure increases, which is fraught with the development of a dangerous purulent infection.

Are dental implants performed for oncology?

Oncological ( tumor) diseases in themselves are not a contraindication to dental implantation. At the same time, it is worth noting that the presence of a malignant tumor requires its immediate treatment, since otherwise the risk of complications and death of the patient increases. That is why, when a cancerous tumor is detected, first of all, it should be cured, and only after that, dental implantation should be planned.

Dental implantation is contraindicated:

If there are tumors in the mouth, face, head, neck. During the operation, damage to the tumor is possible, which can lead to its metastasis ( progression of the disease, accompanied by the spread of tumor cells to other tissues and organs).
in the presence of metastases. The presence of metastases in distant tissues and organs indicates that the tumor is developing progressively. In this case, there is a rapid disruption of the functions of many internal organs and systems, which often leads to the death of the patient.
During radiotherapy. Radiotherapy can be used to treat some tumor diseases. Its essence lies in exposing tumor tissue to certain doses of radiation, which leads to the death of tumor cells. At the same time, it is worth noting that irradiation can disrupt the division of normal cells of the human body, as a result of which the wound healing process will slow down, including the process of overgrowth of the implant with bone tissue.
With chemotherapy. Chemotherapy is the use of drugs to treat tumors. Chemotherapy also disrupts the processes of cell division in various organs, as a result of which implantation cannot be performed at this time.

Dental implantation for hepatitis

The presence of hepatitis in itself is not a contraindication to dental implantation. At the same time, the development of complications associated with this disease can create certain difficulties that make it impossible to perform the procedure.

Hepatitis is an inflammatory liver disease that develops as a result of infection with specific viruses, against the background of alcohol abuse, intoxication of the body, and so on. When the disease worsens, the patient experiences an increase in body temperature, general weakness, indigestion, nausea, vomiting, and so on. It is prohibited to perform dental implantation in such conditions, as this can lead to depletion of the body’s compensatory capabilities and the development of complications. At the same time, after adequate treatment and achievement of remission ( subsidence of acute manifestations of the disease) implantation can be carried out without any serious problems.

The situation is much worse with chronic, long-term progressive hepatitis. In this case, against the background of a chronic inflammatory process, most of the liver cells may be affected, which will lead to the development of complications ( in particular to liver cirrhosis). This will be accompanied by disruption of the functions of many other organs and systems, in particular the blood coagulation system. The fact is that many coagulation factors are formed by liver cells. When they are destroyed, the concentration of these factors in the blood will decrease, as a result of which the patient will have a tendency to bleed even after minor tissue damage. It will be impossible to perform dental implantation in such conditions, since if bleeding occurs, it will be extremely difficult for doctors to stop it, as a result of which the patient may lose a lot of blood.

Is dental implantation performed for HIV infection?

HIV is a human immunodeficiency virus that can enter the body through sexual contact, as well as through blood transfusions and repeated use of syringes by different people ( which is common among people who abuse drugs) and so on. When this virus enters a person’s body, it infects the cells of his immune system, as a result of which over time the body becomes less resistant to the development of various infections. Ultimately ( without the necessary treatment) the patient dies due to the development of many infectious complications from various organs.

It is worth noting that the process of damage to the human immune system proceeds very slowly, taking years or even decades. In the initial stages of the disease, as well as with proper treatment, there are enough immune system cells in the patient’s body to resist infections. Such patients are not prohibited from undergoing dental implantation, but they must inform the doctor about their existing pathology. In this case, the doctor will work extremely carefully so as not to become infected with HIV himself, and will also pay special attention to the prevention of infectious complications during surgery and in the postoperative period ( he may prescribe stronger antibiotics for a longer time).

If HIV has infected most of the cells of the patient’s immune system, his body’s resistance to infections is extremely low. In this case, during surgery, even simple, usually harmless bacteria ( which constantly live in the human oral cavity) can enter the wound and cause the development of severe systemic infection, which can cause the death of the patient. Dental implantation is strictly contraindicated for such patients.

Dental implantation in old age

Old age is not a contraindication to dental implantation. If the patient does not have the previously listed contraindications ( diseases of the cardiovascular, respiratory and other systems, diabetes, malignant tumors and so on), one or more teeth may be implanted. Features of the procedure in older people include a slowdown in regeneration processes ( recovery) bone tissue. As a result, after the implant is placed, it may take longer for it to be firmly fixed in the bone and begin to function normally.

Preparation before dental implantation

In order for the implantation procedure to occur as quickly, efficiently and safely as possible, the patient must be properly prepared for it. Preparation includes a full examination of the patient, as well as compliance with certain rules, which the attending physician will tell him about.

Which doctor performs dental implants?

To perform dental implantation it is necessary make an appointment with a dentist. It is worth noting that today in dentistry there are many narrower specialties, each of which deals with solving certain issues. In addition, it is the dentist who, if necessary, can refer the patient to other specialized specialists if their consultation is necessary for the dental implantation procedure.

To undergo dental implantation, the patient may need consultation:

Dentist-orthopedist. This specialist is directly involved in determining indications and contraindications for implantation, helps the patient choose the most suitable implantation method, and also takes a direct part in the process of implant installation and postoperative treatment of the patient.
Dentist-surgeon. This specialist specializes in tooth extraction, as well as treatment of other diseases of the dental system that require surgical intervention. His consultation may be necessary before implantation ( to remove the remains of damaged teeth, instead of which implants will be installed), and after the end of the procedure ( in case of development of purulent complications for which surgical treatment is indicated).
Dentist-therapist. Consultation or treatment with this specialist may be required if the patient has caries ( being a source of infection in the oral cavity), periodontitis ( inflammatory damage to the tissues that fix the tooth) and other pathologies in which implantation is contraindicated.
dental technician. This specialist is directly involved in the manufacture of dental implants and dentures.

Examination of the patient before dental implantation

During the first consultation, the doctor determines the indications and contraindications for implantation, and also informs the patient about the features of the upcoming procedure.

The initial examination of the patient by a dentist includes:

Conversation with the patient. During the conversation, the doctor clarifies exactly what problems bother the patient, how long he has been suffering from dental diseases, whether he has visited dentists before, and so on.
Examination of the oral cavity. During the first consultation, the doctor carefully examines the patient’s mouth and teeth, based on which he determines whether he needs implantation or whether he should resort to other treatment methods.
Informing the patient about possible treatment methods. After the examination, the doctor must tell the patient about all possible treatment options for his disease, as well as their characteristics, possible complications, and so on.
Identification of possible contraindications. At the first consultation, the doctor should ask the patient if he has any diseases for which implantation is contraindicated.
Informing the patient about the implantation procedure. The doctor must tell the patient everything about the chosen treatment method, including the technical features of the procedure, the method of pain relief, the duration of treatment, the duration of postoperative recovery, possible consequences, complications, cost of the procedure, and so on. If during the consultation the patient has any additional questions, the doctor should also answer them.

If, after examining the oral cavity and conversation, the patient agrees to undergo the operation, the doctor prescribes additional laboratory and instrumental examinations that must be done before the operation.

What tests need to be done before dental implantation?

Before performing the procedure, you should undergo a series of tests, based on which the doctor will determine whether the patient can have an implant installed.

Before dental implantation you may need:

General blood analysis. This analysis contains data on the concentration of hemoglobin and red blood cells in the blood ( their decrease may be a sign of anemia, in which implantation is contraindicated). Also, based on a general blood test, the presence of infection in the body can be detected ( this may be indicated by an increase in leukocyte concentration of more than 9.0 x 109/l), which is also a contraindication for surgery.
Blood chemistry. A biochemical blood test may contain data on the functioning of the liver, kidneys, heart and other internal organs. Violation of their functions may also be a reason for canceling or postponing the dental implantation procedure. Moreover, during a biochemical analysis, the concentration of glucose in the blood is determined, which makes it possible to identify patients with diabetes.
General urine analysis. A general urine test can detect infections of the genitourinary system, as well as functional kidney diseases.
Analysis for viral hepatitis. As mentioned earlier, hepatitis can be caused by infection with certain viruses. Before dental implantation, the determination of markers of hepatitis B and C viruses is of diagnostic value, since they can lead to a chronic course of the disease and liver damage. Also, the doctor performing the operation can become infected with these viruses if during the procedure he comes into contact with the patient’s blood ( for example, if his glove breaks or he gets stuck with a needle).
HIV analysis. This analysis is carried out for several reasons. First, if the doctor knows that the patient has HIV, he will take additional measures to prevent the development of infectious complications during and after surgery. Secondly, during the operation he will be extremely careful not to become infected himself. Thirdly, the analysis is performed before any surgical intervention in order to ensure the safety of the doctor. The fact is that after the operation, an HIV-infected patient can sue the doctor, saying that it was during the implantation that he was infected with this virus. Laboratory confirmation of the presence of HIV in a patient before surgery will prevent this scenario.
Pregnancy test. This is not a mandatory test, but before planning implantation, it is better for a woman to make sure that she is not pregnant. The fact is that in some cases the total duration of tooth implantation can be several months ( after the first stage, a certain break is taken, and then the second stage of the operation is performed
Dentist (dentist, orthodontist) – what kind of doctors are they and what do they treat? When should you see a dentist? What can a patient expect at a dentist appointment?
Dental implantation. Rules of conduct after dental implantation. Complications and consequences of dental implantation. Where are dental implants performed?

Choosing dentures for dental restoration is a very responsible process. They are not installed for one day; in case of any complications, replacing them will not be so easy and quick, sometimes painful and always financially expensive. Implantation is considered today the optimal method of prosthetics for many reasons:

the procedure goes very quickly, sometimes in one session;
you can restore the entire dentition at once;
dentures look natural and aesthetically pleasing, while fully performing the functions of natural teeth;
no long-term adaptation after implantation;
implants do not require any special care.

In addition, dental implants are strong and durable - this is exactly the case when you should be patient and spend money once, but then forget about dental problems for the rest of your life.

And yet, even this seemingly ideal method of prosthetics has its drawbacks. There are numerous contraindications to dental implantation – and they all have a serious reason; ignoring them can lead to the most dangerous and sad consequences.

What is dental implantation?

When implanted into bone tissue, a pin made of titanium or other durable and hypoallergenic alloy is implanted in place of the missing tooth. Then a crown is placed on this pin. Sometimes implants serve as a support for bridge-like fixed prostheses - in this case, 4-5 holes are drilled in the jaw and the same number of implants are implanted.

This type of prosthetics is recommended for complete or partial edentia, when teeth are missing along with the roots and there is simply nothing to attach the dentures to. This is a rather labor-intensive and expensive method that not everyone can afford; in addition, the list of contraindications is quite extensive.

When dental implants cannot be installed - contraindications

All contraindications to dental implantation can be divided into the following categories:

absolute and conditional;
temporary and chronic;
local and general.

Absolute contraindications are those in which implantation is strictly prohibited due to factors that cannot be eliminated. These include:

blood pathologies, poor coagulability - since prosthetics of this type have a serious impact on soft and hard tissues, the risk of bleeding after installation is quite high;
nervous and mental disorders of the patient, which do not allow him to establish contact and explain the rules of behavior in the operating room, the essence of the operation, risks, etc.;
malignant formations. With such a pathology, any surgical intervention can trigger the progression of cancer and even lead to death;
pathologically reduced immunity (AIDS or HIV infection) - in this case, the immune system simply cannot cope with the restoration of tissues injured during the installation of implants;
tuberculosis and any of its complications;
bruxism - pathological grinding of teeth mainly in sleep, when a person does not control himself and risks not only breaking dentures under strong compression, but primarily injuring the tissue and oral cavity;
diabetes;
lupus erythematosus, scleroderma, rheumatism and rheumatoid arthritis.

Relative contraindications are those that can be eliminated, after which there will be no obstacles to the installation of new teeth. This:

diseases of the oral mucosa - gingivitis and stomatitis;
the presence of caries, pulpitis and other dental pathologies requiring dental treatment;
periodontitis or periostitis;
malocclusion;
defects of the bone tissue of the jaw;
smoking, drinking alcohol or using drugs;
pregnancy or breastfeeding.

Important information: if a patient is lazy to take care of his oral cavity, forgets to brush his teeth and does not like to use floss and rinses for his mouth and teeth, implantation is also contraindicated for him. In this case, it is better to choose removable nylon dentures, for example.

General contraindications not listed above include:

intolerance to anesthetic drugs or contraindications to their use;
general somatic pathologies that may worsen during or after the installation of prostheses;
the patient is taking immunosuppressants, antidepressants, anticoagulants;
patient's stressful condition;
pathological exhaustion of the body - cachexia.

As for local contraindications, there are two main ones:

insufficient volume of bone tissue in the area of the jaw in which dental implantation will be performed;
the distance from the jaw to the maxillary sinuses is too small.

You cannot begin the procedure for installing implants if you have any diseases in the acute stage, especially colds or infections of the upper respiratory tract.

Attention: implantation cannot be performed if you have cancer. But if a person has been operated on and after a course of chemotherapy is declared healthy, installation of implants is possible under one condition - at least one year must have passed from the moment of irradiation.

It should be noted that even if there are contraindications, this is not a death sentence. Almost all of them are easily eliminated. And if the doctor says that first you need to treat a chronic disease, perform certain measures, or just wait, and then do prosthetics, you should listen to his advice.

Dental implantation is essentially a surgical operation. Therefore, it also has not only indications, but also contraindications. Anyone planning to install artificial teeth should not chase fashion and prestige, but rather assess the real situation adequately and choose the option that is safer and more reliable. In this case, it is imperative to take into account the dentist’s recommendations.

– an excellent modern way to restore teeth. There can be many reasons for such restoration - from tooth loss due to bruise to age-related losses. Dental implants look very natural and do not cause any discomfort to their owner.

Contraindications to dental implantation can be divided into several types:

absolute;
relative;
are common;
local;
temporary.

The most important in this classification are absolute and relative contraindications. Let's look at each type.

Contraindications

By its nature, the installation of implants is a surgical procedure, in some cases associated with various difficulties.

Therefore, as with any surgical intervention, there are a number of contraindications to implantation, ignoring which can lead to various consequences, both at the stage of the procedure and after the installation of a denture.

Absolute

Absolute contraindications include those that cannot be corrected and which inevitably interfere with the operation.

Implantation is not possible in the following cases:

Blood vessel diseases. For example, poor blood clotting reduces the success of any operation to zero. Possible bleeding.
Some of the diseases of the central nervous system that prevent the patient from adequately perceiving the surgical intervention.
The presence of malignant tumors. The intervention of a surgeon can affect the formation and affect its growth.
Diseases associated with tissue growth. The inserted implant requires active growth of tissue around it, otherwise the whole operation makes no sense - the prosthesis will not take root.
Tuberculosis in any form.
Diabetes.
Some of the diseases of the oral mucosa.
Hypertonicity of the muscles responsible for chewing.

Relative

with caries, insertion of implants is prohibited

This group includes contraindications, the presence of which currently prevents the operation.

However, eliminating these problems helps to lift the ban on implantation. These include:

Presence of teeth.
Inflammatory processes of the gums.
Inflammatory processes of the tissues that surround the teeth.
Joint diseases.
Incorrect bite setting.
Presence of bad habits: alcohol abuse, smoking, drug addiction.
Atrophy or defects of bone tissue.
Carrying a child.

Are common

General contraindications for any surgical intervention.
Ban on anesthesia.
Some somatic diseases, the course of which may be affected by the installation of implants.
A number of treatment procedures performed that may affect the healing process in the postoperative period.
Diseases of the central nervous system.
Severe and prolonged stress.
Poor oral hygiene.
Exhaustion of the body.

Local

The locals include:

Poor oral hygiene.
A small amount of bone tissue is required for operations to install dental implants.
Unsatisfactory (low) distance to the sinuses of the upper jaw and nose.

Temporary

Pregnant women are also not recommended to undergo surgery

Temporary contraindications, as the name implies, disappear over time.

These include:

Carrying a child.
periods of the disease.
Stages of the rehabilitation period.
The period after irradiation of the body.
Dependence on drugs and medications.

From the above it is clear that there are many contraindications to prosthetics, but not all are absolutely prohibitive to the operation. Timely treatment of certain diseases, elimination of oral problems such as caries, etc. are the conditions under which surgical intervention becomes possible.

It is worth noting that reaching a certain age is not a contraindication to installing a prosthesis. In this case, you should simply consult with your doctor about choosing the most optimal prosthetic option.

How can I find out if there are contraindications for installing dentures?

Before performing an operation to install a denture, the dentist must examine the patient and collect an anamnesis.

In some cases, the doctor may require additional tests, such as an examination by a physician or geneticist. Only after the dentist is convinced of the possibility of prosthetics, the operation is performed.

A detailed study of the patient’s health status and identification of contraindications allows us to eliminate the risk of complications after implantation.

To be fair, it should be noted that implant manufacturers have done everything possible to make the implantation of “foreign” teeth as natural as possible. For example, with one-stage implantation, an artificial root can be implanted directly into the socket of an extracted tooth.

Absolute contraindications to implantation are:

pathologies of the immune and endocrine systems, blood, connective tissue;
oncological, sexually transmitted, mental diseases;
diabetes;
tuberculosis.

In the presence of such diseases, implantation is not performed, as it poses a risk to the patient’s life.

Age restrictions

Age is only a relative contraindication to the installation of implants. This method of prosthetics is indicated from the age of 18; as for the upper limit, it simply does not exist.

However, practical experience shows that the most favorable period for dental implantation is from 25 to 60 years.

Age over 60 years is not a contraindication to implantation. Preparation for surgery - the list of tests and examinations will not be less than usual.

There are various techniques, for example basal, which allow surgery even when the bone tissue is already partially atrophied and its ability to heal is reduced (symptoms typical of older people).

General and local contraindications to implant installation

Deviations in the mental and physical state of the patient at the time of preparation for surgery are classified as general factors. During the period of therapeutic treatment, depression, immediately after an illness, the person’s health condition is unstable, and therefore complications may arise during and after the operation.

Local contraindications to implantation include:

unsatisfactory condition of the oral cavity (bacterial plaque, inflammation of soft tissues);
insufficient volume and strength of bone tissue at the site of implant installation.

Temporary contraindications

The possibility of installing an implant can be limited by the condition of the patient (patient), in which he is temporarily:

pregnancy;
alcoholism, drug addiction;
rehabilitation period after radiation therapy.

In this case, the doctor should postpone implantation to a later date.

Examinations and tests before implantation

Contraindications to implantation are determined only after a complete examination of the body. In addition to a general urine and blood test, a blood test requires special attention:

for HIV and hepatitis;
on the hormonal background;
to assess the level of coagulation.

The examination reveals the presence of cancer and chronic diseases in the patient.

At the same time, an examination of the oral cavity is carried out:

orthopantomogram – a picture of the entire jaw;
computed tomogram is a three-dimensional image that allows you to determine the size and volume of bone tissue.

Complications after implantation

The chemical composition and shape of some implants are chosen so precisely that the percentage of their engraftment is 95-97%. Such indicators are demonstrated by Nobel systems made on the basis of titanium dioxide.

If short-term pain and swelling can be called a normal reaction of the body to surgery, then other manifestations:

intense continuous bleeding;
an increase in temperature with a simultaneous deterioration in general condition;
seam divergence;
inflammation or prolonged numbness of soft tissues,

are the result of poor diagnosis or negligence of the patient himself. It should be taken into account that there is still a small percentage that the implant will be rejected.

Read more about complications after implantation.

Let's weigh the risks?

When considering the risks, the doctor takes into account only contraindications to implantation. He cannot predict factors beyond his control, either physically or mentally.

When inserting an implant, there is a possibility of contact with nerve fibers and disruption of soft tissue, which will naturally cause a more pronounced reaction of the body. However, such situations occur extremely rarely and usually do not have complex consequences.

Implants are products that are manufactured in a separate production facility, so their quality is guaranteed by the manufacturer. In such an important matter as implantation, you should not trust random people.

The dental clinic will offer you special systems marked with a serial number. In this way, you can protect yourself from purchasing low-quality implant material, and at the same time reduce possible risks to a minimum.