Preparation for the procedure.
First stage:
– Diagnosis of the condition of the teeth, gums and bone tissue: X-rays, computer tomography of the jaw to assess the state of teeth, bones and the choice of implant placement;
– treatment of teeth, removal of plaque (it is important that the cavity of the mouth is as harmful as possible bacteria);
– exclusion of contraindications: the condition of the whole organism is assessed. Blood and urine tests, tests of thyroid hormones must be given before implantation. Your doctor needs to know everything about your body, because the main condition for successful implantation is the satisfactory overall state of your health, proper oral hygiene and the presence of sufficient volume of bone tissue (if bone tissue is not sufficient for implant placement, there are different ways to enhance the bone );
– computer simulation of treatment: in our clinic, implantation is performed with the previous computerized planning of the next operation (using your imaging, virtually all surgical manipulations are modeled in the program). This allows us to develop a full plan of treatment, to choose a place in the bone for the implantation, to evaluate the risks and to predict the outcome of the treatment;
– for the accurate fixation of the implant, based on the computer planning, a surgical template is made: to avoid mistakes during the operation and to install the implants in the intended position. Patterns are especially irreplaceable in complex clinical cases and small amounts of bone tissue.
The second stage: the preparation of bone tissue
Increasing the bone in volume due to its reduction, caused by prolonged absence of teeth. The process of atrophy of dense bone tissue starts immediately, as soon as the patient removes the tooth – the bone ceases to receive the usual load, natural metabolic processes stop there.
Making bone tissue before implants is an additional operation that is performed only if the volume of the bone is less than the length and width of the installed structures and the bone is simply not enough to secure implant fixation.
The bone grafting can be done in the following ways:
– sinus-lifting: an operation for increasing the height of the bone of the upper jaw. Provides slight displacement upward of the lower part of the nasal sinus. This cavity is filled with artificial bone (which for several months will be replaced by its own), implants can also be installed at the same time;
– osteoplasty: an increase in bone volume with the help of artificial or natural bone tissue in an area where its own tissue is too small.
– autotransplantation: a type of osteoplasty, in which the patient’s own bone is used, borrowed from other departments;
– regeneration of bone tissue is directed: the technique allows restoring bone tissue using special protective membranes.
Stage Three: Implant implantation in the bone
This is a procedure worked out in nuances!
Many patients are most afraid of this stage. However, it is not necessary to worry – necessarily used anesthesia or medication sleep, if for him there is evidence. Depending on the chosen implantation technique, the installation of implants can be done by different protocols:
– the classical protocol: clear cut, exfoliate – thus creating access to the bone. In a dense bone tissue, with a boron, a hole is created in which the implant is placed. From the top it is closed with a special stub, glued back to place and stitched. In this form, the implant remains for 1-6 months for complete adaptation in the bone tissue. A temporary removable prosthesis is fixed from above;
– Minimum invoice protocol: Used for rapid implantation techniques. Provides the installation of implants without cutting gums and creating a bed in the bone – by puncture both tissues. The construction is screwed up, so the fabrics are absolutely not injured. In addition, the bone is not lost during the installation, and is compressed around the implant at the time of its fixation – this gives the structure excellent initial stability;
– fixation of the implant in the well of the removed tooth: the titanium root is established immediately after the tooth extraction. Depending on the indications, the implant can be immediately loaded, or give it time to attach.
Fourth stage: gum formation
This stage is relevant only for the classical method of implantation, in which implants after the installation are adapted for several months, are covered with gums. In 1-2 months after the implantation of the implants, gums are opened and a special part of the implant-gum former is fixed on the implant. It is necessary for adjusting the ash path as close as possible to the contour of the own tooth. In some cases, additional plastic surgery with gums may be required, which involves surgical correction of the position of the gums.
Fifth stage: prosthetics
Prosthetics is the final and nicest stage for each patient. Once the implants have fully adapted in the bone, or right after they are installed (if you have chosen an emergency denture procedure), you can proceed to install dentures.
For this, in the classical implantation, the gums are reopened, the gum former is removed, the abutment is fixed in its place, which is the part that will connect the implant and the crown. In express techniques, this stage is skipped because one-stage implants are used, in which the bulk is immediately connected to the top. After this, the casts are removed, on the basis of which are created individual prosthetics.
On implants it is possible to fix absolutely any designs – permanent single dental crowns, bridges or removable prostheses. Depending on the type of selected construction, the prosthesis is fixed with the help of a special glue or mounting system. It allows to freely remove and put on artificial teeth.