Implantation of upper and lower teeth is the most modern method of dental prosthetics, during which lost teeth are replaced with artificial ones. The operation is carried out quickly and safely. Implants serve as a support for crowns and various prostheses, both removable and non-removable.
Indications for the installation of implants are:
- A single defect in the dentition.
- Loss of 2-4 teeth in a row.
- Lack of chewing teeth.
- Complete adentia.
Dental implantation in the upper jaw is more difficult than in the lower one, since they have high aesthetic requirements. In addition, the bone in the upper jaw is softer and therefore the surgeon has to use longer implants. They can be installed by several ways:
- in areas near the maxillary sinus;
- into the augmented bone tissue;
- into the jaw with increased height by reducing the volume of the sinuses (sinus lift).
Implantation of teeth in the lower jaw is preceded by an assessment of the location of the lower part trigeminal nerve... Computed tomography is used to implant prostheses bypassing the nerve.
Implantation in the lower jaw involves determining the location of the trigeminal nerve.
There are 2 main methods of performing the operation. The anterior placement method is used when all teeth are missing. In the future, it is possible to install and conditionally removable. In other cases, an increase in the height of the lower jaw is performed using the bone tissue restoration technique.
Dental implantation cost
Implantation of the upper and lower jaw is not cheap. The price for the installation of one prosthesis, excluding the cost of material, starts from 333 $ ... The final cost is based on the specific method of implantation of the implant.
| Name of the facility | Address | Price for 1 implant installation (excluding material cost), $ |
| German Implant Center | emb. Taras Shevchenko, 1/2 | from 750 |
| Dental clinic "Reutdent" | reutov, Kalinin street, house 26 | from 3578 |
| "NovaDent" | tula, st. Demonstrations, 1g | from 333 to 966 |
| Dentistry "Implantmaster" | Small Sukharevsky per. 9, page 1. | 425 |
| Dental clinic "Denta-Style" | Petrovsko-Razumovskaya alley, 10 | 483 |
| Dental center "DENTALJAZ" | st. 1812, 9 | from 425 |
How is implantation performed
Expert opinion. Dentist Govorukhin R.L.: “At the moment there are 2 methods of jaw implantation: one-stage and two-stage. is carried out as quickly as possible and is considered the most effective. After the tooth is removed from its root, dimensions are taken with a laser, then an implant is made and implanted. The whole procedure lasts no more than 1 day. "
At first, the implant is installed, and then it is given time to take root. This may take 2 or more months. Finally, an abutment is installed and dental prosthetics is performed.
Method advantages
Implantation of lower and upper teeth has an impressive list of advantages in comparison with other methods of prosthetics. Among the main advantages of this operation are:
- Elimination of the risk of injury to healthy teeth.
- Non-allergic.
- Reliable fixation of prostheses.
- By appearance the teeth on the implants are identical to the real ones.
Modern implants make it possible to fix the prosthesis without a plastic gingival mask. This is especially important for allergy sufferers. In addition, an important advantage of implantation is that this method can be used to restore any number of lost teeth, even in their absolute absence.
Complications
Complications after implantation in the upper jaw are more common than in the restoration of the lower ones, but in general, complications after this operation are very rare. Currently, the technology of implantation of implants is well established, and problems usually arise due to insufficient qualifications of the dentist. The most common causes of complications after dental implantation are non-identification of contraindications and non-compliance by a specialist with the technology of the operation.
When exposed to any of these factors, the following may develop complications:
Pain always appears when leaving anesthesia. Normally, it lasts 2-3 days, analgesics are used to alleviate the condition. If the pain syndrome persists for longer, this may be a signal that a nerve has been affected or inflammation has begun. Puffiness is a normal body reaction after tissue damage. It persists for a week after the operation, if longer, inflammation may have begun. In order to relieve swelling, it is recommended to apply ice to the operated area
In the first days after the operation, slight bleeding is often observed, which is associated with the intake of drugs that reduce blood clotting. If the symptom persists for 10 days or longer, it often indicates vascular injury. Subsequently, hematomas develop, which are accompanied by purulent processes and suture divergence.
Fever is another normal reaction of the body to surgery, but if it persists for more than 3 days, it is most likely neglected inflammatory process... Numbness persists up to 5 hours after surgery and is side effect anesthesia. If it does not go away after this period of time, the nerve may be injured.
Implant exposure and rejection are serious complications of the operation. The causes of rejection are hemorrhages, inflammation of adjacent teeth, poor-quality crown and non-observance of personal hygiene by the patient. Rejection occurs in rare cases, it is provoked by a deficiency of bone tissue, trauma during surgery, allergy to titanium, smoking and exacerbation of chronic diseases.
To date, there are various implantation technologies in the absence of teeth, which are used depending on the clinical picture and financial capabilities of the patient. What are the features of these methods? How to choose the optimal technology? How much does it cost to complete a full dental implantation in Moscow at NovaDent dental clinics?
Complete implantation for edentulous patients is the optimal method of dental restoration
You can restore chewing function with complete edentulousness using:
- removable acrylic or clasp prostheses, fixed on the gums and on the upper palate by vacuum method or with a special correcting cream;
- conditionally removable or fixed prostheses based on dental implants.
Removable dentures are relatively inexpensive, but they create a lot of inconveniences, ranging from the mobility of the prosthesis during chewing to increased sensitivity and heightened feeling of nausea.
Prosthetics of all teeth on implants completely solves these problems. Moreover, implantation improves the patient's quality of life, since:
- prevents further bone tissue atrophy;
- improves chewing function, protecting against diseases of the stomach and duodenum;
- returns the aesthetics of a smile;
- provides reliable fixation of prostheses;
- returns a feeling of naturalness and makes you forget about these problems for decades.
In the absence of contraindications such as diabetes mellitus, tuberculosis, oncology and hemophilia, implantation is the best way to restore teeth with complete adentia of the upper and lower jaw.
Prices for implantation in the absence of teeth
Included in cost:
- Diagnostics (initial consultation);
- 3D modeling of implantation;
- Implant surgery (tooth extraction, installation of 4 or 6 tapered implants);
- Anesthesia;
- Taking casts and making a temporary fixed prosthesis made of metal-plastic;
X-ray examination - paid separately.
Attention: in NovaDent clinic you can pay for dental implantation on credit and complex treatment in installments.
Technologies and stages
Implantation with adentia does not imply the installation of a separate implant for each defect in the dentition, as it is expensive and not always possible. Depending on the situation, from 4 to 10 implants are installed on one jaw, on which a conditionally removable or non-removable bridge is then fixed.
In our dental center, implantation in the absence of teeth is carried out in several stages:
- Diagnostics - includes examination, patient interview, computed tomography of the jaw and referral for blood tests (coagulation factors, allergic tests for plastics and metal). The purpose of the medical examination is to determine the condition of the bone tissue, the anatomical features of the jaw system, and contraindications for implantation.
- Planning - carried out using 3D modeling, which allows you to select the optimal parameters of the implants, to determine the angle of inclination and their positioning in the jawbone.
- Operation - implants are screwed into the bone in one visit to the dentist. If possible, titanium rods are implanted in a gentle manner through punctures in the gums.
- Prosthetics - on the day of surgery or after the removal of the sutures on the gums (after 7 days), temporary bridges made of durable plastic are fixed on the abutments. After 1-3 years, the temporary prosthesis is replaced with a durable metal-ceramic, ceramic or zirconium construction.
The implantation of implants and the fixation of new prostheses lasts from 2 to 7 days, after which the patient enjoys a healthy smile and can chew food normally.
Recently, implantology has been moving away from classical approaches in favor of innovative prosthetics technologies on fewer supports. The most popular techniques are All-on-4 and All-on-6.
Prosthetics on 4 implants using All-on-4 technology
All-on-4 technology (all on four) is the most economical method of implantation of implants, developed and patented by the Swiss company Nobel Biocare. The technique consists in the fact that 4 tapered implants are implanted into the jaw with simultaneous loading. The titanium rods are installed as follows:
- 2 implants - in the anterior part of the jaw parallel to the patient's natural teeth;
- 2 implants - in the area of \u200b\u200b5-6 premolars at an angle of 30-45 °.
Due to this arrangement of artificial roots, complete jaw implantation provides high primary stabilization of the prosthesis and does not require bone augmentation surgery. These factors allow you to immediately switch to prosthetics.
At the NovaDent center, 4-on-all jaw implantation is performed with dental implants: Nobel, Astra Tech, Osstem, Dentium, Mis, Ankylos.
Prosthetics on 6 implants using All-on-6 technology
All-on-6 technology (all on six) is another development of Nobel Biocare, which consists in the installation of 6 implantable supports in the jaw with instant loading. The rods are implanted in the same way as in the case of All-on-4.
.At first glance, there seems to be no difference between the upper and lower teeth. However, it is not. The fundamental difference lies in bone density, which plays an important role in the implantation procedure in the absence of upper teeth. The fact is that in the process of chewing food, the upper jaw experiences much less stress compared to the lower. Therefore, the bone here is not so dense and atrophies much faster after tooth extraction. For this reason, bone repair is often performed in the upper jaw prior to implantation so that the implant can be securely placed.
Another feature of upper teeth implantation is the close location of the maxillary sinuses. If the width and length of the jaw bone is insufficient in the area of \u200b\u200bthe canines and lateral incisors, sinus lifting of the upper jaw (a type of bone grafting) is mandatory. If this is not done, the implant will pass through the bone during the insertion process and damage the sinus. When carrying out sinus lifting and implantation of the upper teeth, at the same time, first, the bottom of the maxillary sinus is lifted and filled with osteoplastic material, and then the implant is inserted into the bone tissue. Recently, in order to carry out implantation without a sinus lift, specialists began to use long zygomatic implants.
Interesting fact!
Despite the fact that implantation has become popular relatively recently, numerous finds of archaeological scientists testify to the active attempts of ancient people to master this dental direction, using so-called implants made from various materials: ivory, wood, precious stones, animal teeth and even dead people!
Implantation of anterior upper teeth
One of the most important tasks of implantation of anterior teeth in the upper jaw is not only a high-quality restoration of the functionality of the dentition, but also the improvement of the patient's smile aesthetics. Therefore, such an operation has the following features:
- The need to create an aesthetic gingival contour. When implanting the upper anterior teeth, it is necessary to create a beautiful gingival contour. Otherwise, "calculating" the presence of a prosthesis will not be difficult even for a non-specialist. So that the gum does not lose volume and an aesthetic contour is formed, it is necessary to carry out a one-stage implantation with immediate loading of the implant with a temporary crown. The prosthesis will create the necessary support for the soft tissues and prevent them from atrophy.
- Accurate implant placement is important. When implanting the upper anterior teeth, the most accurate placement of the artificial root is required. If the implant is inserted at the wrong angle (see the photo below), it will complicate the installation of the crown, and in the future can lead to complications. Computed tomography helps to plan the future operation correctly, allowing you to understand the anatomy of the maxillary bone in detail.
- The special structure of the implants.In addition, small-diameter implants with a special thread design are used for the implantation of the anterior upper teeth, so as to less traumatize the surrounding tissues.
- High demands on the esthetics of prostheses.Instead of metal abutments (a crown is attached to them), which can show through the gum, white zirconium constructions are used. The material of the dental crown must also have high aesthetic characteristics. Therefore, all-ceramic or zirconia prostheses are recommended.
Implantation of chewing teeth in the upper jaw
When implanting chewing teeth in the upper jaw, as a rule, a two-stage technique is used, in which the crown is fixed only after the complete engraftment of the implant. This classic method is considered the most reliable and predictable. The operation is often accompanied by bone grafting or sinus lift. As for the type of implants, for the implantation of upper teeth, the opinions of experts agree that the best option is prosthetics on classic root-shaped constructions.
Implantation of the upper jaw in the absence of teeth
In the case of implantation of the upper jaw in the complete absence of teeth supported by implants, depending on their number, separate dental crowns, bridges or complete conditionally removable structures can be installed. The latter option is more democratic in cost and is divided into several subspecies, which are discussed below.
Complications after dental implantation in the upper jaw
Those planning implantation in the absence of teeth in the upper jaw should be aware that the following implantation complications are possible:
- swelling after implantation of a tooth in the upper jaw;
- numbness of the upper lip;
- nosebleeds;
- rejection of bone material;
- increased mobility of the implant;
- rejection.
The above problems can arise due to poor oral care or due to the low qualifications of the implantologist. Therefore, in order to prevent complications after implantation of the upper teeth, it is necessary to provide the installed implants with proper postoperative care and choose a clinic with a good reputation, experienced specialists and modern equipment.
The lower jaw, as you know, is the only movable area on the face, thanks to which we are able to communicate, talk, eat and perform any active actions associated with opening the mouth. It is very strong, the bone is unusually dense, strong and durable. But the work of the mandibular joint cannot be called fully complete if teeth are completely or partially absent. After all, their loss directly affects the health, functionality of the alimentary tract and articulation of the speech apparatus, attractiveness and even external changes in the appearance of a person's face.
In order to prevent negative consequences and continue living your usual life, you need to think in time about the quality restoration of the lost units. And one of the best ways will be the implantation of the lower teeth, the features of which we propose to talk about in the material presented below.
Implantation of lower and upper teeth: fundamental differences
As practice shows, implantation of the teeth of the lower jaw is much more successful than the lower one, the implants from below grow together faster with the bone tissue, they have a more stable position initially. And everything is explained quite simply:
- the mandibular bone is denser and more voluminous than the maxillary: this is due to anatomical features and predetermination - the teeth from below take on all the main load of chewing food, while from above they serve more for aesthetics of a smile. It is not so easy to lose the lower teeth, they are rarely traumatized, their root system is firmly held in the bone tissue, the same principle then works during implantation - in some cases, a minimum number of implants is enough to fix the prosthesis, if we are talking about complete adentia of the jaw. And at the same time, much less restrictions on nutrition and diet are imposed during the rehabilitation period than after the recovery of the upper ones,
On a note! The longer a person delays in restoring lost teeth, the more the bone sags and dissolves from above, while from below it is able to maintain its good quality and volume longer. Accordingly, in the future, during implantation, the patient has more chances to do without bone augmentation procedures, but it all depends on the chosen treatment protocol, of which there are a lot of them today.
- there are no nasal (maxillary) sinuses below: there is always a risk of injuring these cavities. However, do not forget that the lower one also has its own characteristics - a rather massive ternary nerve passes here, which, with insufficient preparation for treatment or the unprofessionalism of the doctor, can also be affected, which will lead to complications after implantation of the lower teeth. In particular, we are talking about paresis of the ternary nerve, the patient may experience prolonged numbness and severe edema after implantation of a tooth in the lower jaw.
Classic technology or two stages of treatment
Implantation of the lower anterior teeth, especially when they are absent in a minimum amount (from 1 to 4), is best carried out according to the standard classical two-stage canons of treatment: here it is assumed that there is the necessary volume of bone tissue in the area of \u200b\u200bartificial roots, or its augmentation in case of lack. Please note that bone blocks are transplanted from below, but from above in most cases it is used, which is never carried out on the lower jaw during implantation. After all, this operation involves the displacement of the sinuses or maxillary sinuses.
Important! If, with a two-stage restoration of the anterior tooth in the lower jaw, you are shown a bone augmentation operation, then keep in mind that after that you will have to wait up to 6 months before you can start directly with the procedure for installing implants. The same feature applies to the case when there are decayed teeth in the mouth: if there are indications for their removal, the classical implantation should be postponed until the holes heal. However, if you take care of the question in advance, you can put the implant right into the hole - there really is such an opportunity today.
Despite the fact that the restoration of the lower teeth does not require the achievement of the highest aesthetics, as in the upper frontal zone of the smile, professional doctors also strive for a high-quality result - with the classical approach, beauty will be at the highest level, from the teeth to the mucous membrane. It will surround the crown very tightly and look very natural.
But it is worth emphasizing that the most unpleasant feature of the classical approach is that you cannot immediately use new teeth in the work, namely, chew them, therefore the method is called "two-stage". After the implants are installed, they cannot be loaded with a prosthesis until the surrounding tissues are completely engrafted. On average, this period is 3 months, but in the lower jaw, osseointegration is faster, especially if such high-quality brands as or were chosen as artificial analogs of the root.
An innovative approach in dentistry or how to start chewing right away
Implantation with complete adentia (when there is a mouth without teeth in the anamnesis), in the absence of a large number of chewing and anterior teeth on the lower jaw, should provide a person with maximum comfort with a minimum investment of time and money. Agree that the new teeth on the lower jaw, like the lost ones, should be as functional as possible, suitable for nutrition, for grinding food, their main purpose is to make active chewing movements. They should also be ready for stress not a year after going to the doctor, but right away, otherwise how can you even talk about a full-fledged lifestyle.
Fortunately, patients today have such an opportunity - this is a prosthesis, which, by the way, in 90% of all cases, make it possible to do without augmentation of bone tissue at all, even with its poor quality, inflammation or insufficient volume. There is not one method, there are several of them - as they say, for every taste, color, situation and wallet. In general, they differ in the number of supports or implants installed under the prosthesis - the number, brand and method are determined by a specialist based on an assessment of the quality of bone tissue. This is done using computed tomography of the jaw, with 3D modeling of the treatment process - the smaller the bone, the worse its quality, the more implants are required for a successful result.
1. Trefoil or three-implant prosthetics technique
The technology is presented by Nobel and involves the use of original Trefoil implants, specially designed for this complex. This is a separate technique that has been developed and positioned specifically for the restoration of teeth in the lower jaw. The protocol takes into account the structural features of the mandibular joint, allows the patient to save money and acquire the entire row at once. It uses only three implants and a prosthesis that restores up to 12 units. Artificial roots are installed only in the frontal section, because, as studies have shown, it is least of all atrophied in this area.
2. Solving the problem with four implants
Two of them are installed in the area of \u200b\u200bthe chewing lower teeth at an angle, two in the frontal zone parallel to each other. The angular position of the lateral roots allows you to use a large area of \u200b\u200bbone tissue, use only the densest layers that are not prone to inflammation, avoid bone grafting, and increase the strength of implant attachment in the bone.
Here patients have several options to choose from: the Nobel all-on-4 concept, or the Straumann Pro Arch. These are the only protocols that have really proven themselves for the restoration of all teeth with just such a number of implants. By the way, manufacturers do not limit their choice and often offer doctors to add 1-2 more implants, for example, in the frontal zone, if there is a need for this and the system will function better.
Also, under the auspices of "prosthetics for four" you may be offered other models, for example, Osstem or Alpha Bio. They will help you to save money, but be careful, because the manufacturer does not have such an impressive research base compared to the original concept developers. Remember, the miser pays twice!
3. Solution on six implants
This is another protocol - separate. In fact, based on the previous one using four implants. The name itself is a registered trademark - the development of the all-on-6 protocol belongs to the doctors of this particular dentist.
The technique is quite versatile, because it allows you to restore teeth not only on the lower jaw, but also on the upper one. As the name implies, the number of implants is increased, so this solution is suitable for situations where bone atrophy is more pronounced.
4. Solution for bright bone atrophy
Here we are talking about increasing the number of implants, because the smaller the bone, the better the support for the implants should be. This applies to any jaw. Therefore, we are talking at least 8, maximum 14 implants. Such a protocol is called a Prosthesis, as in any other case, it is placed immediately. But it is held in place with the help of cement fixing - this way it is more reliable. There are many implants, so the prosthesis is attached with high quality, it does not need to be relocated (in other situations, screw fixation is used).
ALL-ON-4® implantation on Nobel implants 6 months after treatment
“Before deciding on a complex lower implantation, I collected information for a long time. I consulted in three clinics, found out the cost, asked about possible methods treatment in my case. The minimum price was 250 thousand rubles for immediate installation of the prosthesis and the maximum price for a two-stage installation was 560 thousand rubles. As a result, I chose dentistry, where contact and understanding with the doctor immediately arose, where he did not fight off my numerous, meticulous and annoying questions, but gave detailed answers. Well, they treated me with four implants, which turned out to be quite profitable for the price. By the way, they gave another payment by installments. But in fact, I got a result that justified all the expenses, now I seem to be 7 years younger and I can chew even what was not always possible in my youth, because I always had bad teeth. "
Elena Konstantinovna, a fragment from the review on the portal Dentistry.rf
5. Solution for those with periodontitis
The basal protocol should also be considered for patients with pronounced problems, in addition to, of course, adentia: acute lack of jawbone, periodontitis and periodontal disease, osteomyelitis. The method is also indicated for smokers and elderly patients. All this is due to the fact that the implants have a smooth surface, therefore, even in contact with the gums, plaque does not accumulate on them. In addition, the coating is antibacterial, which helps to stop the inflammatory process.
What are the benefits of immediate loading implantation
So, do not forget about the main advantages of one-stage implantation methods with immediate loading of the prosthesis for the restoration of teeth in the lower jaw:
- the patient receives the result in a matter of days, and sometimes even hours: the prosthesis is fixed in the first three days after the installation of titanium roots,
- you can chew food right away: you do not need to be afraid, the main thing is to follow the doctor's instructions. This is very important, because due to chewing, the bone around the body of the implant is actively growing - osseointegration of titanium screws is many times faster,
- the prosthesis that you will receive will contain a metal frame that connects the implants together. It will firmly hold them in place, provide the necessary rigidity to the entire structure, due to an adequate load on the roots, it will also contribute to the activation of metabolic processes in the bone. Show some patience, start with soft foods in the first days of rehabilitation, and within a month you will be able to eat your favorite dishes and chew meat.
Naturally, your diction will also be restored, the oval of the face will be straightened, fine wrinkles will be smoothed out. And the most important thing: no headaches against the background of missing teeth and excellent work of the digestive system. You can really start smiling, forget about having to have your teeth treated and constantly visit the dentist.
What are the alternatives if implantation is not for you?
Naturally, many patients are inclined to first assess all the possible risks that may arise during implantation of lower teeth. Many are afraid of possible complications. For example, such as loss of implants or dehiscence of sutures, peri-implantitis, rejection of artificial structures and accompanying acute pains, fever, mental and physical discomfort, additional expenses.
Important! To avoid difficulties, carefully approach the choice of a specialist, because a successful result depends on him 90%. Pay due attention to the equipment of the clinic and preparatory measures, as well as the period of rehabilitation: the doctor is required here to work out the treatment process and a thorough analysis of the clinical picture, from the patient - to take blood tests, to visit highly specialized specialists, if there are indications for that, follow the instructions of the doctors.
It is against the background of apparent difficulties that some people prefer to restore teeth in the lower jaw using removable dentures or bridges. It's cheap, fast, safe and really is a kind of alternative to implantation. However, after all, implantation is not suitable for everyone - there are certain indications based on the state of health, when at the moment (for a while or forever) it is still better to refuse such an approach.
But if, for personal reasons, you do not want implantation, remember that after installing removable prostheses on the mandibular joint there will be a large load, as a result of which the structures will quickly begin to wear out and become loose, the abutment teeth will collapse, the bone tissue under the prostheses will continue to atrophy, and constant discomfort will begin and rubbing the mucous membrane, particles and food debris will easily begin to clog under the prosthesis. Already after 2-3 years, it will be easier to get rid of such prostheses and install new ones than to correct and fix them on adhesives. And this, again, will entail new expenses and inconveniences, which, if you chose implantation, will never happen to you.
So, want to start eating well and looking good? It's time to choose a clinic for yourself, which will solve your problem with high quality and for many years.
Related Videos
They are conditional (include health problems in which the procedure is prohibited, implantation is possible after their exclusion) and absolute (implantation is contraindicated).
Diseases of the heart and blood vessels are one of the absolute contraindications to surgery
- chronic grinding of teeth;
- increased tone of the chewing muscles;
- blood clotting disorder;
- diseases of the central nervous system;
- pathology of the heart and blood vessels;
- dysfunction of the endocrine system.
Relative contraindications:
- inflammatory processes of the oral cavity;
- thinning of the bone structures of the jaw;
Why implantation in the upper jaw is complicated
The implantation procedure of the upper teeth is more complicated than the lower ones due to the softer structure of the maxillary bone. The restoration of the lost units from above is carried out with elongated models of titanium roots:
- in areas near the maxillary sinus;
- into pre-enlarged bone mass;
- after a sinus lift (an increase in the volume of the lost bone due to raising the maxillary sinus and filling the formed space with biomaterial).
How much will it cost on average in Moscow
The cost of implantation in different clinics is determined individually, taking into account:
- scope of planned work;
- materials used, medicines;