Dental implantation: contraindications and possible complications. Age restrictions in the installation of implants

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

Preliminary diagnosis, indications and contraindications

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

Implantation is a complete operation, which is contraindicated in the presence of certain diseases and disorders, as they increase the risk of unpleasant complications. Therefore, before prosthetics with implants, the dentist conducts an examination of the patient to assess the state 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, 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 the internal organs that may become an obstacle to the procedure, he can send the patient for a consultation with other specialists, for example, a cardiologist, oncologist or immunologist.

Absolute contraindications to the installation of dental implants

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

Diseases of the blood, hematopoietic organs, violation of the coagulation process.
Diseases of the nervous system.
Oncological neoplasms in any organ.
Connective tissue diseases.
Immune and autoimmune disorders, the presence of HIV status.
Tuberculosis.
Severe diseases of the oral cavity.
Tendency to bruxism.
Diabetes.
Renal failure.
Congenital pathologies of the bone tissue of the jaw.
Children 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 place of installation of the prosthesis to the maxillary or nasal sinus.

Implantation is a serious surgical intervention, which is accompanied by severe pain, therefore, 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: Do not place dental implants made of 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, subject to the normalization of the state of health. This group of contraindications includes:

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

Dental implants performed during pregnancy can harm the unborn child, as 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 when breastfeeding - until the end of lactation.

If the patient suffers from alcohol, drug addiction or constantly ignores the rules of hygiene, he must give up his addictions and return to a normal lifestyle. Then, in the absence of 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 to perform the operation.

Deciding on 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 informs about other modern methods of correcting the dentition. 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 with a doctor of the appropriate specialty.
If it is necessary to temporarily postpone the intervention, for example, until childbirth, the end of lactation or until adulthood, the patient waits a certain time and during this period carefully cares for the oral cavity.

Different dentists have different attitudes towards the same bans on implantation. For example, some dentists prohibit the insertion of prostheses to patients under 18 years of age, others advise to wait until the age of 22. In some dentistry, implantation is carried out even for pregnant women, but only in the second trimester and with good health.

The decision on the possibility of installing an implant is influenced not only by the presence of any disease, but also by the degree of its severity.

Possible Complications

If important contraindications for the installation of dental implants were ignored, the doctor made mistakes during the 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	Implantation errors, infection development
Soft tissue numbness	Nerve damage
Severe soft tissue swelling	Development of infection
High fever that lasts longer than 3 days	The 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 tissues around the implant
Peri-implantitis - 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

Problems related to healing

There are some health problems that prevent tissue from healing after an implant is placed. For example, if a person is in a state of deep prolonged stress, the body may not be able to cope with the next load, and the process of tissue healing 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 the alarming symptoms that persist longer than the specified time. Failure to act is not only fraught with possible loss of the implant, but also threatens the life of the patient.

Ignoring contraindications for the use of dental implants can be life-threatening. If the doctor has decided that implantation is impossible, another prosthesis can be placed. In order not to provoke complications after the installation of the implant, it is necessary to strictly follow the rules of conduct during the period of its engraftment.

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

Single stage ( single-phase) basal implantation of teeth

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

How to behave in the postoperative period ( do's and don'ts after dental implants)?

Possible complications, consequences and side effects of dental implants

Where ( in which clinics or dental clinics) Can dental implants be done in the Russian Federation?

What is dental implantation?

Dental implants 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 introduced into the jawbone instead of the damaged root ( remote) of the tooth and 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 the complete installation of the implant can take from several months to six months, due to the slow fusion of the implanted part with the jaw bone tissue. Average lifetime of a dental implant ( with the use of quality materials and the correct installation technique, as well as with 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 is 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, if necessary, removes the nerve). Then he sharpens the remaining part of the tooth, and imposes 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 implantation of teeth is that in the second case, not only the upper part of the tooth is replaced, but also its root. Instead of a root in the gum ( into the jaw bone) a metal frame is implanted ( directly implant), on which the so-called suprastructure is subsequently “put on” - a crown, a bridge, and so on. Further ( if necessary) the suprastructure can be replaced, while it is extremely difficult to remove the implant from the bone ( This can only be done through operational).

Indications for dental implants

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 saved ( including its root).

Implantation of one or more teeth is indicated:

With edentulous. This term refers to the complete absence of teeth in the oral cavity. Usually 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.

In the absence of one or more teeth in the mouth. If one tooth needs to be replaced, one implant is placed instead. If the patient is missing several adjacent teeth at once, 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 is no need to install each implant separately.
With looseness and loss of teeth. There can be many reasons for increased tooth mobility, from diseases of the teeth themselves to pathologies of the jawbone. As a rule, once a loosened tooth will never return to its previous, normal position, as a result, the option of replacing it with an implant should be considered.
When it is impossible to wear removable dentures. When wearing removable dentures, some people may experience constant discomfort in the oral cavity, and therefore they can be recommended to perform implantation.
When it is impossible to install permanent prostheses. Even when wearing a high-quality crown, part of the tooth under it can be destroyed. If this happens, the crown can no longer be held in place and a new one cannot be placed due to the lack of supporting dental tissue. In this case, the only treatment option will also be the implantation of an artificial tooth.
For malocclusion. With some congenital or acquired anomalies of the upper or lower jaw, there may be malocclusion that cannot be corrected otherwise. In this case, the manufacture and installation of specially prepared implants can help solve the problem.

Is dental implantation indicated for periodontitis and periodontitis?

Dental implantation is one of the main methods of treating periodontitis, while in case of periodontitis 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 ensure its fixation in the jawbone. With this pathology, destruction of the alveolar process of the jaw is noted ( in which the tooth is directly fixed), as well as the formation of abscesses around the tooth itself. As a result, it loosens and falls out. Tooth implantation is indicated only after the treatment of periodontitis and the elimination of the causes of its occurrence.

Unlike periodontitis, periodontal disease does not develop an inflammatory process. This pathology is characterized by the slow destruction of the jaw bone tissue and damage to its alveolar processes, resulting in the exposure of the tooth root. An important feature is the fact that for a long time the tooth remains firmly fixed, does not stagger and does not fall out, and therefore it is not advisable to carry out implantation in the early stages of the disease ( medical and surgical treatment is indicated, aimed at restoring bone tissue around the tooth). At the same time, it should be noted that with prolonged progression of the disease and without the necessary treatment, the root of the tooth may be exposed ( protrude above the gum line) by more than 50%. In this case, the appearance of unsteadiness of the tooth is possible, and the risk of its falling out also increases. If this happens, the only possible treatment will be dental implantation.

Are Dental Implants Performed for Children?

Dental implants are not recommended for children under 18 years of age. The fact is that in the process of growing up a child, the jaw bones and the teeth themselves grow and change. An implant placed in early childhood would have been too small for the patient after some time and would have had to be reinstalled. To perform such a procedure would be impractical and extremely traumatic. That is why in such cases, various options for prosthetics are first used, and after the child’s growth stops, the issue of installing permanent implants is decided.

Dental implant alternatives

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

An alternative to dental implants can be:

Classic prosthetics. In this case, a special crown is put on the prepared upper part of the tooth, which protects the tooth from further destruction. It should be noted that dentures can be removable ( the patient can take them off by himself whenever he wants) or permanent, which are firmly fixed to the rest of the 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 processed in a special way ( i.e. restored) - pathological foci of caries and other damage are removed from it, various deformations and channels are sealed, 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 last for many more years ( with proper care).

Limitations and contraindications to dental implantation

The procedure for installing an implant is quite complicated, time-consuming and involves 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:

With infectious diseases of the oral cavity. If the patient has stomatitis ( inflammation of the oral mucosa), gingivitis ( inflammation of the gums) or another similar infectious process, you should first deal with its treatment, and only after the complete elimination of the focus of infection, proceed with the implantation of the tooth. The fact is that during the implantation procedure, the implant will be implanted into the jawbone. If at the same time there is a focus of infection in the oral cavity, pathogenic microorganisms can enter the blood or bone tissue, causing the development of formidable complications.

In severe diseases of the cardiovascular or respiratory system. During implantation, it may be necessary to put the patient under anesthesia ( medical sleep), which can be dangerous in the presence of heart failure or respiratory failure.
With diseases of the immune system. In some pathologies, the work of the immune system is disrupted, which normally performs a protective function ( 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 immune system is impaired, the patient may develop allergic reactions that may pose a danger to his health or even life.
With 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 carry out this procedure.
With diseases of the blood coagulation system. Under normal conditions, this system is responsible for stopping bleeding from injuries, injuries, cuts, and so on. If its functions are violated, the patient may experience prolonged, profuse bleeding even after small cuts. The operation to implant a tooth is associated with damage to the oral mucosa, gums and jawbone, as a result of which the risk of bleeding during this procedure is increased. That is why, before starting its implementation, the doctor must make sure that the patient's blood coagulation system is functioning properly.
In rheumatic diseases of the connective tissue. With systemic lupus erythematosus, scleroderma and other similar diseases, the processes of development of connective tissue are disrupted, which are extremely important at the stage of implantation of the implant into the jawbone. That is why before dental implantation it is necessary to achieve a stable remission of the patient's pathology.
In the acute phase of tuberculosis. Tuberculosis is an infectious disease that most often affects the lung tissue. The acute phase of the pathology is characterized by the fact that a sick person releases the pathogen into the environment along with exhaled air ( during coughing or simple breathing). Since doctors will need to work in close proximity to the patient's respiratory tract during dental implantation, they are at increased risk of contracting tuberculosis. That is why tuberculosis should be treated first, and only after a stable remission has been achieved ( subsidence of acute manifestations of the disease and negative laboratory tests) dental implants can be planned.
In diseases of the temporomandibular joint. Diseases that make it impossible to open the mouth wide enough can create difficulties during dental implant surgery.
With pronounced anomalies in the structure of the jaw. During the procedure, a metal implant of a certain length and certain dimensions will need to be implanted into the jawbone. If the patient's anomalies do not allow this ( for example, with bones that are too thin, deformed or fragile), dental implantation is contraindicated for him.

Dental implants for anemia

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

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

It should be noted that not only the severity of anemia is important, but also the speed of its development. So, for example, the normal level of hemoglobin in men is 130 g / liter, and in women - 120 g / l. If anemia develops slowly ( for example, if you are deficient in iron, vitamin B12, or other substances), the body has time 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 low hemoglobin level ( but not less than 90 g/l). If anemia has developed as a result of bleeding, the body does not adapt well to rapidly changing conditions, as a result of which it will be possible to perform dental implantation only after the cause of anemia has been eliminated and normal hemoglobin levels have been restored.

Are dental implants done during menstruation?

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

Dental implants during menstruation can be complicated by:

development of anemia. During menstrual bleeding, a woman normally loses about 50-150 ml of blood ( sometimes up to 200 ml, depending 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. This is why dental implants as well as any other surgical interventions) during menstruation is undesirable.
Stress. During menstruation, the female body experiences stress, which is manifested by increased excitation of the nervous system, hormonal changes, and so on. Implant surgery can increase stress, which can lead to increased nervous excitement, nervousness, a nervous breakdown, and other psychological disorders.
Blood coagulation disorders. As mentioned earlier, the coagulation system ensures that bleeding stops. During menstruation, increased activation of blood coagulation factors is noted, which is protective ( prevents excessive bleeding). If at the same time to perform dental implantation ( during which damage to the tissues of the gums, jaw and oral mucosa also occurs), this can further increase the activity of the blood coagulation system, thereby increasing the risk of developing related 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 disrupting the delivery of blood and oxygen to certain tissues and organs ( including to the heart, lungs, brain and so on).

Can dental implants be performed while pregnant or 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:

The toxic effect of drugs. The implantation procedure is extremely painful, and therefore can only be performed using anesthesia ( anesthesia, anesthesia). Anesthesia is associated with the introduction into the bloodstream of a woman of a number of drugs that can penetrate the placenta ( organ that provides nourishment to the fetus) into the fetal circulation and disrupt its development. This can lead to intrauterine anomalies or even intrauterine death of the fetus. 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 overly pronounced reaction of the immune system, manifested by general malaise, skin itching, a pronounced decrease in blood pressure, an increase in body temperature, and so on. Allergies can occur both during anesthesia and in response to the introduction of a foreign substance ( implant) into the jawbone. The development of a severe allergic reaction can lead to impaired blood supply to the fetus, thereby causing damage to its organs ( first of all, the brain) or even intrauterine death.
Damage to the fetus by x-rays. In the process of preparing for implantation, it is necessary to perform an X-ray examination, that is, to take a picture of the jaw and teeth ( sometimes not just one but several). Exposure to radiation can adversely affect the process of laying and development of the organs of the embryo or fetus, which will lead to the occurrence of intrauterine developmental anomalies in it.
The development of infectious complications. During pregnancy, there is a weakening of female immunity, which is necessary for the normal development of the fetus. In such conditions, the introduction of even a small number of pathogens into an open wound can lead to the development of a severe infection, which will require additional treatment ( in particular the appointment of antibiotics, which are contraindicated in pregnancy, as they can damage the fetus).

It is also not recommended to carry out implantation of teeth during breastfeeding, since the medicines introduced into the mother's body can be excreted in breast milk and enter the child's body, provoking the development of allergic and other dangerous reactions.

Features of dental implantation in type 1 or type 2 diabetes

If the patient has an initial form of diabetes mellitus, which has not yet led to the development of complications, and the patient himself takes the prescribed treatment, 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 the internal organs and systems, it will be extremely difficult or even impossible to perform the procedure for implanting an implant.

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

Currently, type 1 diabetes mellitus is 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 enter the cells, which leads to an increase in the concentration of sugar in the blood. The introduction of insulin from the outside helps to solve this problem, which was the reason for the name of this form of the disease.

In type 2 diabetes, the cause of the disease is damage to body cells that cannot interact with insulin, as a result of which glucose cannot enter them. It also leads to an increase in 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 supply of glucose, the walls of small blood vessels are damaged, as a result of which the vessels are destroyed. Over time, this leads to insufficient blood supply to the affected organs. Against the background of impaired oxygen delivery, the processes of cell division are disrupted ( regeneration), as well as an increased 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.

Do dental implants 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 after that, dental implantation should be planned.

Dental implantation is contraindicated:

In the presence of tumors in the oral cavity, 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 progressively developing. In this case, there is a rapid violation of the functions of many internal organs and systems, which often leads to the death of the patient.
during radiotherapy. Radiotherapy can be used in the treatment of certain tumor diseases. Its essence lies in the impact on the tumor tissue with 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 in the human body, as a result of which the processes of wound healing, including the process of bone tissue fouling of the implant, will slow down.
With chemotherapy. Chemotherapy is the use of drugs to treat tumors. During chemotherapy, the processes of cell division in various organs are also disrupted, as a result of which it is impossible to implant the implant at this time.

Dental implants for hepatitis

In itself, the presence of hepatitis 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. With an exacerbation of the disease, the patient has an increase in body temperature, general weakness, indigestion, nausea, vomiting, and so on. To perform implantation of a tooth in such conditions is prohibited, as this can lead to the depletion of the compensatory capabilities of the body 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 major problems.

Things are much worse in chronic, long-term progressive hepatitis. In this case, against the background of a chronic inflammatory process, most of the liver cells can be affected, which will lead to the development of complications ( especially cirrhosis of the liver). This will be accompanied by dysfunction of many other organs and systems, in particular the blood coagulation system. The fact is that many clotting factors are formed precisely 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 in the event of bleeding, it will be extremely difficult for doctors to stop it, as a result of which the patient may lose a lot of blood.

Are dental implants performed for HIV infection?

HIV is a human immunodeficiency virus that can enter the body through sexual contact, as well as through blood transfusion, with repeated use of syringes by different people ( what is common among people who abuse drugs) and so on. When this virus enters the human body, it infects the cells of its 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 whole years or even decades. In the initial stages of the disease, as well as with proper treatment, there are enough cells of the immune system in the patient's body to resist infections. It is not forbidden to perform dental implantation in such patients, however, they must inform the doctor about their 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 ( maybe he will prescribe stronger antibiotics for a longer time).

If HIV has infected most of the cells of the patient's immune system, the body's resistance to infections is extremely low. In this case, during the operation, even simple, usually harmless bacteria ( that live permanently in the human mouth) can enter the wound and cause a severe systemic infection, which can lead to the death of the patient. Implantation of teeth in such patients is strictly contraindicated.

Dental implants in the elderly

Old age is not a contraindication to dental implantation. If the patient does not have the above contraindications ( diseases of the cardiovascular, respiratory and other systems, diabetes, malignant tumors, and so on), he can be implanted with one or more teeth. The peculiarities of the procedure in the elderly 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.

Preparing for dental implants

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 deals with dental implants?

For dental implants, make an appointment with a dentist. It should be noted that today in dentistry there are many narrower specialties, each of which deals with the solution of certain issues. In addition, it is the stamatologist, if necessary, who can refer the patient to other specialized specialists if their consultation is necessary for the dental implantation procedure.

To perform a dental implant, the patient may need a consultation:

Dentist-orthopedist. This specialist is directly involved in determining the indications and contraindications for implantation, helps the patient choose the most appropriate method of implantation, and is also directly involved in the implant installation process and in the patient's postoperative treatment.
Dentist-surgeon. This specialist is engaged in the extraction of teeth, as well as the treatment of other diseases of the dentition, requiring surgical intervention. His consultation may be needed both 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, in which surgical treatment is indicated).
Dentist-therapist. Consultation or treatment with this specialist may be required if the patient has caries ( a source of infection in the oral cavity), periodontitis ( inflammatory lesions of 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 prostheses.

Examination of the patient before implantation of teeth

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 the dentist includes:

Interview with the patient. During the conversation, the doctor clarifies what kind of 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, on the basis of which he determines whether he needs implantation or whether other methods of treatment should be resorted to.
Informing the patient about possible treatments. After the examination, the doctor must tell the patient about all the possible treatment options for the disease he has, as well as their features, possible complications, and so on.
Identification of possible contraindications. At the first consultation, the doctor should ask the patient if he has any diseases in which implantation is contraindicated.
Informing the patient about the implant procedure. The doctor must tell the patient everything about the chosen treatment method, including the technical features of the procedure, the method of anesthesia, the duration of treatment, the duration of postoperative recovery, possible consequences, complications, the cost of the procedure, and so on. If during the consultation the patient has any additional questions, the doctor must also answer them.

If, after an examination of the oral cavity and a conversation, the patient agrees to the operation, the doctor prescribes additional laboratory and instrumental examinations to be done before the operation.

What tests should be done before dental implantation?

Before performing the procedure, a series of tests should be passed, on the basis of which the doctor will determine whether the implant can be installed in this patient.

Before dental implants, you may need:

General blood analysis. This analysis contains data on the concentration of hemoglobin and erythrocytes in the blood ( their decrease may be a sign of anemia, in which implantation is contraindicated). Also, based on a general blood test, it is possible to detect the presence of an infection in the body ( this may be indicated by an increase in the concentration of leukocytes more than 9.0 x 109 / l), which is also a contraindication to the operation.
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 can also be a reason for canceling or postponing the procedure of dental implantation. 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 urinalysis 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. The diagnostic value before dental implantation is the determination of markers of hepatitis B and C viruses, 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 pricks himself 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 the operation. Secondly, during the operation, he will be extremely careful not to get 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 study, however, 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 made, 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 awaits the patient at the dentist's appointment?
Dental implantation. Rules of conduct after dental implantation. Complications and consequences of dental implantation. Where are dental implants done?

The choice of prostheses for restoring teeth 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 fast, sometimes painful and always financially expensive. Implantation is considered today the optimal method of prosthetics for many reasons:

the procedure is very fast, sometimes in one session;
you can restore the entire dentition at once;
prostheses 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 endure and spend money once, but then forget about problems with your teeth for the rest of your life.

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

What is dental implantation

When implanting into bone tissue, a pin made of titanium or another 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 fixed bridges - 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 adentia, when the teeth are missing along with the roots and there is simply nothing to attach the prostheses to. This is a rather laborious and expensive method, which 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 it is strictly forbidden to carry out implantation due to factors that cannot be eliminated. These include:

blood pathologies, its poor coagulation - since this type of prosthetics has a serious effect 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 them to establish contact and explain the rules of conduct in the operating room, the essence of the operation, risks, etc.;
malignant formations. With such a pathology, any surgical intervention can be an impetus for 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 during sleep, when a person does not control himself and risks not only breaking prostheses with 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 installing 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;
jaw bone defects;
smoking, drinking alcohol or drugs;
pregnancy or breastfeeding.

Important information: if the patient is too lazy to take care of his oral cavity, forgets to brush his teeth and does not like to use flosses and rinses for his mouth and teeth, implantation is also contraindicated for him. In this case, it is better to stay on removable nylon prostheses, for example.

General contraindications not listed above include:

intolerance to anesthetic drugs or contraindications to their use;
general somatic pathologies that may worsen during the installation of prostheses or after it;
the patient is taking immunosuppressants, antidepressants, anticoagulants;
stressful state of the patient;
pathological depletion 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;
too small distance from the jaw to the maxillary sinuses.

You can not start the procedure for installing implants if any diseases are noted in the acute stage, especially colds or infections of the upper respiratory tract.

Attention: in case of cancer, implantation is not possible. But if a person has been operated on and is declared healthy after a course of chemotherapy, the installation of implants is possible under one condition - at least one year must pass from the moment of irradiation.

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

Dental implants are essentially a surgical procedure. Therefore, it also has not only indications, but also contraindications. Everyone who plans to install artificial teeth should not chase fashion and prestige, but adequately assess the real situation and choose the option that will be safer and more reliable. It is necessary to take into account the recommendations of the dentist in this case.

- a great modern way to restore teeth. There can be many reasons for such a restoration - from the loss of a tooth due to a bruise to age-related losses. Dental implants look very natural and do not bring 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 placement 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 for 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:

Diseases of the blood vessels. For example, poor blood clotting nullifies the success of any operation. It is possible to open bleeding.
Some of the diseases of the central nervous system that prevent adequate patient perception of surgical intervention.
The presence of malignant tumors. The intervention of the surgeon can hurt the formation and affect its growth.
Diseases associated with tissue growth. The inserted implant requires active growth of tissues around it, otherwise, the whole operation does not make any 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, the elimination of these problems contributes to the abolition of the ban on implantation. These include:

Presence of teeth.
Inflammatory processes of the gums.
Inflammatory processes of the tissues that surround the teeth.
Diseases of the joints.
Incorrect bite setting.
The presence of bad habits: alcohol abuse, smoking, drug addiction.
Atrophy or bone defects.
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 ongoing medical procedures 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 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 for 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 drugs.

From the above, it can be seen that there are many contraindications to prosthetics, but not all of them are absolutely prohibiting the operation. Timely treatment of certain diseases, elimination of oral problems such as caries and other conditions under which surgical intervention becomes possible.

It should be noted that reaching a certain age is not a contraindication to the installation of a prosthesis. In this case, you should simply consult with your doctor about choosing the most optimal prosthesis option.

How to find out about the presence of contraindications for the installation of dentures?

Before carrying out an operation to install a dental prosthesis, 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 general practitioner or genetics. 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 the identification of contraindications eliminates the risk of complications after implantation.

In fairness, it should be noted that implant manufacturers have done everything possible to implant "foreign" teeth as naturally as possible. For example, with simultaneous implantation, the implantation of an artificial root can be carried out directly into the socket of the extracted tooth.

Absolute contraindications for implantation are:

pathologies of the immune and endocrine systems, blood, connective tissue;
oncological, venereal, 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 implant placement. This method of prosthetics is shown 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 implantation of teeth 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, such as basal, which allow the operation to be performed even when the bone tissue is already partially atrophied and its ability to heal is reduced (symptoms characteristic of the elderly).

General and local contraindications to the installation of implants

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

Local contraindications for implantation include:

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

Temporary contraindications

The condition of the patient (patient) in which he temporarily stays can limit the possibility of installing an implant:

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

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

Examinations and analyzes before implantation

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

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

During the examination, the presence of oncological and chronic diseases in the patient is revealed.

In parallel, an examination of the oral cavity is carried out:

orthopantomogram - a picture of the entire jaw;
Computed tomography 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 surgical intervention, then other manifestations:

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

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

Read more about complications after implantation.

Weigh the risks?

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

With the introduction of the implant, there is a possibility of getting into nerve fibers, violations of soft tissues, which will naturally cause a more pronounced reaction of the body. However, such situations are extremely rare and usually do not have severe consequences.

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

The dental clinic will offer you special systems marked with a serial number. Thus, you can protect yourself from acquiring low-quality implant material, and with it, reduce possible risks to a minimum.