Complications after implantation: is the devil as scary as he is painted?

Dental implantation is the restoration of lost teeth, based on the introduction of implants into the jaw bone to fix crowns or dentures on them. Implantation is a surgical intervention in which soft tissues, nerve endings, and blood vessels are damaged and unpleasant symptoms appear. Complications occur in 1-2% of patients and appear in the early or late period. You can avoid the consequences by enlisting the support of a conscientious implantologist.

Risks of dental implantation

Just what is happening with the market for implantation offers will cheer up anyone. A huge number of unsubstantiated statements knocks the patient off his feet and the discomfort increases with repeated consultations in other clinics. The surprising thing is that in Russia the price of an implantation service is a measure of the level of quality of the service. There are stories of “no name” implants being placed in VIP clinics with prices starting from 90 thousand rubles for the implant alone. Or stories about replacing the implant specified in the contract with another one.

The patient is not an expert in this field; he trusts his health to the doctor. After reading too much on the Internet, an element of uncertainty and randomness remains in the human mind. Careful reading of the contracts of some clinics sometimes discourages any desire to undergo dental implantation in Moscow.

Patients who are not limited in funds go to Germany or Israel for implantation. This is nice and fashionable, however, the main condition of such foreign treatment packages is not to look back. The aftertaste after such treatment excites the memory of even the strongest and most financially prepared patients. Time, flights, hotels, language barriers, eternal binding to only one clinic and doctor due to refusals to receive detailed statements about previous treatment, a tenfold increase in cost with the same technologies as in Russia. People forget these emotional overloads. For the same reason, you will not find any reviews about dental treatment performed abroad.

Yes, these are not the best times in domestic healthcare and it is better not to get sick here. But in dentistry the situation is the opposite. In Moscow, due to competition, you can find new methods of dental implantation, technological surgery, everything that is possible. However, we must be honest, there are currently no more than twenty specialists in the entire capital. Faculties switched to allocating quotas and places for priority paid training. Every year the enrollment of students “on a paid basis” increases. The results of this interesting solution are already clearly visible in Moscow clinics.

As a result, when searching for “your” doctor, a person faces the following problems:

• Every dentist uses the “best” implant systems.
• Only a few clinics operate with objective data.
• Cost does not determine quality.
• Signing a contract does not always mean using materials that are paid for by the patient.
• The content of the documentation requires “deciphering” by a lawyer.
• It is impossible to verify the honesty of the services.

If a patient ends up in a dishonest clinic, there is a high risk of encountering complications during the intervention process, as well as after it. Some appear after 2-3 years. It is important to find a clinic, as well as an implantologist, that you can completely trust. The safety of the procedure depends on the doctor’s skills and the patient’s willingness to follow the recommendations.

Related articles:

• Our advantages
• Technologies of the Center
• Implant care

How to dull the pain?

It happens that pain in a tooth strikes suddenly, and there is no way to see a dentist. In such cases, it is not uncommon for residents of remote settlements, sailors, geologists, people working on rotation in hard-to-reach regions, etc. Let's consider some methods for reducing pain. Note that the pain will disappear only for a while, so it is still worth contacting a specialist as soon as possible to eliminate the causes.

The first thing you can do in the field is to create a solution of soda, salt and iodine. Frequent rinsing with such a liquid will not only soothe the pain, but also have a disinfecting effect and stop inflammation. Decoctions of chamomile or sage also help against inflammatory processes.

The ancestors also used a head of garlic to soothe pain. By applying it to the sore gum, the pain could be dulled. Interesting fact: if you apply a cut clove of garlic to the vein on your wrist from the side of the tooth, the pain will also disappear over time.

Complications during implant installation

Installing an implant involves introducing a titanium root into the bone. The classic protocol for the procedure is as follows:

1. The doctor makes an incision and carefully peels away the gum to access the bone.
2. Creates a hole of the required diameter in the bone tissue and screws in the implant.
3. Places a titanium plug on it until the tissue heals completely.
4. Places stitches. The tissues grow together in 1-2 weeks.

Bleeding may occur during surgery. The reason may be the inept actions of the implantologist (which is very rare), hypertension or bleeding disorders in a patient who did not warn the doctor about the disease. Moderate bleeding from the intervention area for 2-3 hours is normal. Heavy bleeding for more than 3 hours immediately after the intervention indicates a complication. Minor exudation is possible for up to 7 days.

In our Center, implant installation is safe and completely painless

Painful sensations can be considered a complication during installation. But anesthesia is carried out first, the patient should not feel anything. Increased pain is possible, but the discomfort goes away after an additional dose of anesthetic is administered. The patient should not endure the pain; if it intensifies, the doctor must be informed immediately. We offer implantation in medicated sleep under sedation , when the patient is in a relaxed, comfortable state of half-sleep and does not feel any pain.

Levin Dmitry Valerievich

Chief physician, Ph.D.

What is the cause of complications after implantation?

The main reason for all postoperative complications when installing an implant is its rejection by the body. The cause of this process can be both medical errors and the individual characteristics of the patient’s body.

To understand why the body may reject an implant, we need to look at how the human immune system works. The task of the immune system is to identify foreign elements (both organic and inorganic origin) that have entered the body and destroy them. When immune cells detect damage to a person’s integumentary tissue, they immediately begin the process of fighting infectious agents that enter the blood through the wound. Inflammation (redness, swelling, increased temperature) of wounds during healing is a consequence of the work of the immune system.

If, during healing, large (compared to bacteria) foreign inorganic objects are present in the wound (splinters, pieces of metal, wood, and even grains of sand), then the body, with the help of immune cells, will reject these objects, “pushing” them out of the wound. Unfortunately, dental implants embedded in the bone are also foreign objects to the body.

In order to reduce the risk of the body's immune response to the implant, bioinert materials are used for its manufacture. These are materials that are implanted into the body as quickly as possible, without causing protective reactions and inflammation and without changing metabolic processes in the tissues surrounding the implant. However, such materials can cause rejection for several reasons, such as:

• individual patient reaction to the implant material;
• an allergic reaction to the implant material or medications used for pain relief and disinfection of the implantation site;
• inflammation around the implant associated with an infectious process.

In addition to natural causes of implant rejection, there is also a risk of a doctor’s error or oversight during surgery:

• incorrectly chosen implant design;
• not removed inflamed tissue around the implantation site;
• low quality instruments and implants;
• violation of rules regarding the sterility of instruments and equipment during implantation;
• inattention to the patient (ignoring complaints, information about diseases, allergies).

But patients can also make a number of mistakes and actions that can lead to implant rejection:

• ignore the doctor’s advice on caring for the oral cavity and the implant, particularly in the postoperative period;
• do not observe the rules of dental and oral hygiene;
• violate or interrupt the course of medications prescribed by a doctor;
• receive jaw injuries that trigger the process of implant rejection.

What are the dangers of implanting upper teeth?

When implanting teeth in the upper jaw, the bottom of the maxillary sinus is sometimes damaged. The complication occurs due to incorrect determination of the height of the alveolar process or excessive pressure on the instrument. This complication is extremely rare, as a preliminary computed tomography (CT) scan is performed to determine the height of the jaw bone and select the correct implant. If the bone size is not enough to install an implant of the required size, bone tissue augmentation is performed - sinus lift.

Risks when installing lower dental implants

When installing implants on the lower jaw, there is a risk of damage to the mandibular nerve.

Distortion of the vertical dimension of the mandible on an orthopantomogram (OPTG) increases the risk of incorrect determination of implant size. As a result, the walls of the mandibular canal are injured, an intracanal hematoma and nerve entrapment are formed. There is a decrease in the sensitivity of the innervation zone for 2-3 weeks until the blood masses resolve. Therefore, it is important to calculate implant sizes not using OPTG, but using three-dimensional CT.

In patients with osteoporosis, the wall of the alveolar process may be defective or completely absent. Then the nerve is compressed due to hemorrhage into the medullary space and tissue swelling. Partial loss of sensation appears the next day and lasts about a week. If paresthesia continues, the implant must be removed and therapy performed.

Complications in the postoperative period

The consequences of dental implantation are observed in almost all patients. This is the result of inevitable tissue damage and the introduction of a foreign body into them. Based on the brightness of the reactions, one can judge the implantation of the implants or the development of complications.

Why do neighboring teeth hurt after installing a crown?

After restoration of one or more defects in the oral cavity, a person may experience some discomfort for several days. Unpleasant sensations often occur in people who have put off prosthetics or restoration of damaged teeth for a long time. Their tongue is accustomed to feeling voids in certain places; neighboring dental units have shifted slightly to redistribute the load. Usually a few days are enough to get used to the installed artificial structures and stop feeling them.

If, after installing a crown, the neighboring teeth are very painful, you need to urgently tell the dentist who is seeing you about it. Aching pain can be caused by:

• the impact of an artificial structure on soft tissues and nerve endings - pain can spread throughout the jaw, radiate to the ear or head,
• “acclimation” of living teeth to a new position,
• damage to dentin or pulp during grinding before installing a bridge.

An inflammatory process should not be ruled out. It is not always associated with the prosthetics performed - neighboring teeth can get sick on their own. Even an experienced dentist will be able to determine the cause of the discomfort only after examining the oral cavity and studying a photograph of the areas of the jaw that are disturbing the patient.

Consequences during the period of osseointegration

When implants take 2-4 months to heal, complications sometimes arise in the form of:

• peri-implantitis - inflammation of soft tissues in the surrounding area, which leads to the destruction of bone tissue, accompanied by pain and suppuration;
• implant rejection - consequences of peri-implantitis, inflammation and necrosis of bone tissue extends beyond the area where the titanium root is installed.

Cause of complications:

• violation of the rules of oral hygiene by the patient, smoking;
• body condition - weakness of bone tissue, severe chronic diseases;
• Violation of implant installation technique is very rare in practice.

Postoperative period of dental implantation

Dental implantation is a real operation itself. Like any intervention, it temporarily undermines the body’s defenses and causes discomfort. After implantation, unpleasant sensations may appear - swelling, pain and fever.

To recover faster and avoid complications, you need to follow the instructions of your treating implantologist. During the main postoperative period after dental implantation, you need to adjust your lifestyle and diet. At the first suspicion of a developing complication, seek qualified help at the Mextodent dental clinic.

The body's first reactions to implantation

Installation of a titanium rod - the basis of the implant - into the jaw bone tissue is the most important stage of dental implantation. The success of the entire procedure depends on how the body accepts the foreign body.

This stage is the most traumatic and potentially dangerous. The body reacts to surgery in different ways. In the postoperative period after dental implantation, pain may be present. The unpleasant sensation persists for two to three days.

Within normal limits and a moderate increase in temperature - just above 37. This condition is accompanied by weakness and general weakness. The injured area itself may bleed a little at first. A slight swelling of the gums should not cause concern.

If discomfort develops into unbearable pain that does not go away even after taking painkillers, or swelling does not subside in the first days, consult a doctor immediately. Causes of concern should be incessant bleeding, severe inflammation of the gums, and the appearance of bad breath mixed with notes of rot.

In professional dental clinics, the postoperative period after dental implantation is carried out by an experienced implantologist. If all is well, after about a week and a half the patient's stitches are removed.

Do I need to take medication after implantation?

If the risk of complications is high, low-grade fever persists and swelling does not decrease, the dentist decides to prescribe certain groups of drugs. In order for dental implantation to be successful and the recovery period not to be prolonged, the patient is recommended to take anti-inflammatory and healing medications. For pain, use anesthetic.

Taking medications on your own is strictly prohibited - only the doctor determines the dosage and frequency of administration.

General recommendations

Cold will help relieve swelling and stop bleeding - apply ice wrapped in a clean cloth to your cheek for a few minutes.

During the main postoperative period after dental implantation, you should not overexert yourself or overcool. A sharp increase in ambient temperature is also prohibited - you cannot visit saunas and baths.

You should not drink alcohol - it greatly irritates the injured oral mucosa. If you smoke, you should also give up cigarettes for a while and take care of your mucous membranes.

In the first few days, you should not eat hard foods. In any case, try to chew on the healthy side of the jaw. Hot and too spicy will also add pain. The best option is broths, cereals and pureed vegetables, which not only do not injure the oral cavity, but also saturate the body with vitamins and strengthen immune processes.

Oral hygiene during the implantation process should also be special. Hard brushes that can injure the wound are a categorical no. Plaque from teeth adjacent to the operated area can be removed with a cotton swab. The procedure must be carried out with extreme caution.

At the same time, maintaining oral hygiene in the main postoperative period after dental implantation is more important than ever. After all, the presence of bacteria and microbes can lead to inflammation and suppuration of the wound. For daily oral care, choose antiseptic rinses.

In the first days after surgery, you should not actively rinse your mouth. Simply put the solution in your mouth, hold it and spit it out.

There is no need to warm a swollen cheek under any pretext. If anything bothers you, contact an implant dentist. He will give professional advice and prescribe medications that will improve your condition.

Problems during the second surgical stage

The second stage of dental implantation involves:

• opening the implant (to do this, the doctor cuts the gum above it);
• removing the plug;
• installation of a gum former.

Due to disorders of bone regeneration, the intraosseous element is twisted, and when implanting teeth in the upper jaw, it is pushed into the maxillary sinus. This complication is prevented at the stage of formation of bone tissue around the implant - during the period of osseointegration, CT is periodically performed to monitor the formation of bone structures.

There are opposite situations when the top of the implant is overgrown with bone tissue. This process is not considered a complication and does not have a special impact on the implantation process. The doctor cuts the periosteum and removes excess with a saw to properly install the healing abutment.

For prosthetics

The final stage of dental implantation involves the installation of dentures. To do this, the doctor:

• removes the gum former;
• installs the abutment (plays the role of an adapter from the intraosseous element to the crown);
• attaches a crown or orthopedic structure created from previously taken impressions of the patient’s jaw.

The orthopedic design must suit the patient taking into account the position of the implants. Errors can result in incomplete adhesion of the prosthetic attachments and abutments, leading to loosening of the implants. Inconsistencies between them lead to incorrect distribution of the load during operation, which also leads to damage to the structure and is fraught with rejection.

The coordinated work of the orthopedist and implantologist during preparation is extremely important.

Main causes of discomfort

Firstly, when making single crowns, the doctor faces a dilemma: either the crown should only touch the edge of the gum, practically without having any effect on it, or go under the gum by 0.3-0.5 mm or even to a much greater depth in the presence of pathological periodontal pocket. In the first case, there is a risk that the neck of the tooth will soon be exposed, and then the crown will look short and become unsafe for the tooth; with the second option, the patient may feel discomfort associated with the pressure of the edge of the crown on the gum.

Secondly, when making a bridge prosthesis, a different kind of problem often arises - strongly inclined supporting teeth, which is most often observed after a long period has passed from the moment of tooth extraction and the start of prosthetics. Partially or completely this issue is due to significant preparation of the teeth, up to the need to make stump inlays taking into account their parallelism, but when this is not enough, the prosthesis is fixed, slightly moving apart or tightening the supporting teeth, and the patient’s discomfort from the procedure goes away on its own after a few hours.

With full dentures, discomfort is most likely, which is associated with the large volume of the prosthesis itself, as well as the unusual sensations in the mouth that it causes: pressure on the mucous membrane, tongue and palate, impaired diction, salivation (salivation), etc. In addition, removable dentures often requires repeated visits for correction - clarifying the profile of the surface adjacent to the mucous membrane, the boundaries of the prosthesis and the degree of pressure on the teeth of the retaining clasps, and until the specialist achieves the optimal shape of the new prosthesis, the patient cannot avoid certain discomfort.

Usually, the phenomenon of discomfort after dental prosthetics is a temporary condition, since you need to get used to, adapt to, adapt to everything new, and thanks to the experience, professionalism, and skill of the specialists working in our clinic, this period becomes much shorter and less noticeable for the patient.

During operation

Late complications occur 6 months or more after implantation. Causes:

• violation by the patient of the rules of oral care;
• exacerbation of chronic diseases;
• errors by the implantologist in selecting the implantation protocol, violation of prosthetic technique;
• installation of low-quality implants;
• hormonal changes in women in the first six months after installation of implants (menopause, pregnancy).

The most common complications:

• Mucositis - manifests itself as redness, cyanosis or bleeding of the gums in the area where the intraosseous element is installed.
• Peri-implantitis is characterized by inflammation along the border between the implant and bone tissue, resorption (destruction) of the latter.
• Sinusitis - may be of rhinogenic origin, then the area of ​​​​the artificial root becomes a secondary focus of infection.
• Inflammation of the maxillary sinus can develop against the background of peri-implantitis.
• Damage to the orthopedic structure - when chewing, loads regularly occur on the dentures and the implants themselves.

Similar articles:

• Guarantees of our Center
• Reasons for rejection
• Engraftment of implants

What contraindications to implantation can lead to possible complications?

Restrictions can be absolute or relative. The first ones say that implantation is impossible. Ignoring will lead to complications for the patient. Absolute contraindications include:

• chronic diseases in the stage of decompensation;
• serious bleeding disorders;
• mental disorders.

With relative restrictions, implantation is carried out after treatment and improvement of the patient’s condition. These include:

• ARVI;
• chronic infections;
• suffered a heart attack or stroke;
• period of pregnancy and breastfeeding;
• risk of bacteremia (against the background of rheumatism, endocarditis, as well as in patients with prosthetic heart valves);
• exacerbation of chronic diseases;
• drug treatment that reduces the regenerative capacity of tissues.

What is special about the tactics of our specialists?

Prevention comes first

. We are convinced that careful preparation is the key to success during such an important procedure as dental implantation. After all, ideally, artificial teeth should last the rest of your life and perform all their functions. Therefore, we pay maximum attention to examination, exclusion of contraindications, and treatment planning. So that the result is what both the doctor and the patient expect.

The doctor's experience is key.

Each of our implantologists and maxillofacial surgeons has performed several thousand operations to install implants, including in complex clinical situations - with bone deficiency, diabetes, periodontal disease, and complete edentia.

Proven systems are the key to success.

Our clinic in Moscow uses only original components and instruments from trusted manufacturers with a good reputation and a survival rate of at least 97%. We know how certain implant models behave, what features each of them has.

Accessible information for every patient.

After the procedure, the doctor gives detailed instructions, including which sensations are a sign of a normal postoperative period, and which ones indicate that a consultation is needed right now. The doctor gives all the information in a form accessible to people without medical education.

A personal assistant is available 24/7.

We have a personal treatment coordinator for each patient. He resolves all issues with the organization of consultations, examinations, and research. For all questions, you should contact your personal assistant, including if your gums hurt after surgery. If necessary, he will immediately contact the doctor and arrange an unscheduled examination. This does not affect the cost.

Discomfort after any operation is a normal reaction to injury. Don’t panic if your gums hurt for a couple of days, your cheek is swollen and you have a low fever. But if pain and swelling last too long, disrupting your overall well-being, you don’t need to endure and wait for complications. It is important not to miss any appointments with your doctor after surgery, and if you have questions, do not hesitate to ask them.

Have you decided to have a dental implant? Start with a consultation and a panoramic photo. We have it for free.

What to do to prevent the installation of implants from causing harm

To avoid complications during dental implantation, you need to cooperate with the implantologist and strictly adhere to the recommendations. It is important to familiarize yourself with some of the nuances of the procedure in order to recognize the danger.

Follow your doctor's recommendations

Expert advice is aimed at speeding up the implant healing process. But the main task is to protect a person from complications. Recommendations from experts that must be followed strictly:

1. Take prescribed medications (strictly on time, in the indicated doses, for the prescribed period).
2. Irrigate the oral cavity with antiseptic solutions (do this regularly for the required period to prevent tissue infection).
3. Monitor (by the visual condition of the gums or the patient’s own feelings) the process of implant integration, consult a doctor if alarming symptoms occur.
4. Care for the oral cavity according to the prescribed scheme (do not skip hygiene treatments, do it conscientiously).
5. Quit smoking for at least 2 weeks before and after surgery (bad habit slows down healing).

Choose quality implants

Cheap artificial roots have not undergone sufficient clinical testing, and it is impossible to predict safety and stability during use. The surface of the material may contain tiny foreign particles that interfere with osseointegration, which increases the risk of complications.

In our Center for dental implantation, implants from Nobel Biocare are used, which were developed based on the results of clinical research
over 50 years.
Nobel Biocare advantages:

• Survival rate 99,3%.
• The microstructure of the TI-Unite implant surface imitates root dentin; the artificial root takes root within 2 weeks .
• Protection against counterfeiting thanks to proprietary numbering of Nobel Biocare implants.
• Lifetime warranty.

Find out the cost

The price of implantation includes the cost of materials, preparation and operation of expensive equipment, and the services of several specialists on whom the result depends. Taking into account acceptable costs, dental implantation cannot cost 10-20 thousand rubles.

How to get rid of pain

If your dental implant hurts, you should consult an implantologist in any case.

Before visiting the dentist, pain can be relieved by:

• anti-inflammatory and painkillers (Ketanov, Nise, Nurofen);
• rinsing the mouth with antiseptic solutions (Chlorhexidine, Miramistin).

Immediately after implantation, you can prevent pain by adhering to the following recommendations:

• on the first day, apply cold to the cheek on the operated side;
• exclude solid foods;
• stop smoking;
• take prescribed medications;
• maintain oral hygiene.

If suspicious symptoms appear, such as increased body temperature, increased pain, or deterioration in health, you should immediately consult a doctor.

Prices in our Center are natural and final

The cost of the surgical stage of installing the Nobel implant is from 60,000 rubles. Includes the cost of the implant, its installation, anesthesia, bone reconstruction, installation of formers, as well as pre- and post-operative examinations.

Levin Dmitry Valerievich

Chief physician, Ph.D.

Contact experienced doctors

The level of qualification of a specialist is indicated by:

• practical experience working with implants;
• portfolio of work and client reviews;
• evidence of regular completion of advanced training courses;
• reputation and popularity of the clinic.

Our Center employs highly qualified doctors and employees of Moscow universities. They undergo internships in the USA and Germany and regularly take advanced training courses. Our implantologists know the nuances of all time-tested implantation protocols and the latest innovations. We will try to help and not disappoint you.

Question answer:

I don’t have enough bone tissue, they suggested basal implantation. What complications are possible?

Basal implantation is a branch of surgical dentistry, which involves restoring the dentition without replenishing bone tissue deficiency. Implants are installed even if there is a lack of cancellous bone. This reduces the number of necessary surgical procedures and shortens the treatment time, but the method is not confirmed by positive results of long-term data and has many disadvantages: traumatism - elongated titanium rods are used, which are installed in the deep layers of the jaw bone; difficult rehabilitation - long, accompanied by swelling and pain; used when 3 or more teeth are lost - implants are installed at an angle and can damage the roots of adjacent teeth; the service life of implants has not been confirmed; the 2-year rejection rate is about 40%; rejection occurs with exfoliation of bone tissue; low aesthetic result - it is impossible to make dentures that look like natural teeth; limits the possibilities of prosthetics using other methods.

Levin Dmitry Valerievich

Maxillofacial surgeon, chief physician of the Center

After installation, neighboring teeth hurt - reasons

In addition to the natural complications that arise after implant installation, there is a risk of developing “side effects.” For example, neighboring teeth may begin to hurt. This problem usually appears due to the patient’s fault if he did not follow the recommendations and did not monitor oral hygiene. Additional reasons include:

• Most often, aching pain in neighboring teeth is caused by tissue inflammation , which goes away after the implant has healed. If the inflammatory process is caused by the penetration of pathogenic microbes, this is eliminated by drug treatment.
• Sharp pain only bothers you when the nerve endings are damaged , which indicates the doctor’s unprofessionalism.
• Sometimes painful sensations occur due to the fact that the implant puts pressure on the root of the adjacent tooth . This means that the wrong design was selected or it was installed too close to a healthy root (the implant touches it). Even if it takes root, the discomfort and pain in the adjacent teeth will not stop. This problem can only be eliminated through surgery.
• There are situations when pain in neighboring teeth appears due to the fact that the crown is poorly polished and exceeds the appropriate size . The product will require urgent correction.
• The use of low quality or counterfeit implants can lead to implant failure. The main signs of non-engraftment: swelling, severe bleeding, discharge of pus from the wound. However, this rarely happens.