How is dental implantation done, what types of implants are there, how are they installed, and what are the differences between the methods of implanting them? Dental clinics use various methods. The choice depends on the clinical picture, the scale of the problem, the patient’s financial capabilities and other factors. There is a list of absolute and relative contraindications when such intervention is prohibited.
The procedure is associated with a high risk of injury, soft tissue infection, and rejection of the implanted material. To avoid negative consequences, you need to carefully consider treatment tactics and adhere to all doctor’s recommendations.
What is implant installation?
This is the process of implanting metal screws and plates (usually titanium) into bone tissue. They come in various forms, the choice depends on the type of intervention. Most often, pins are implanted into the gum bones, and then artificial crowns and bridges are installed on it. High-strength hypoallergenic materials are used in production.
Implanted screws come in conical and cylindrical shapes. They include a stem, a neck and a support head for the abutment. The cost and quality of treatment depends on the origin. Models made in Germany are considered the most popular in the modern dental market.
How does enlargement occur through the areola?
Mammoplasty through the areola is performed under general anesthesia and lasts about an hour. First of all, the surgeon makes a 3.5-4 cm incision to install the implant, along the pigmented edge of the areola, which differs from the skin in structure. Thanks to this, the scar is completely invisible in the postoperative period. Then Philip Nikolaevich creates a subcutaneous tunnel under the base of the mammary gland or under the pectoralis major muscle, without affecting the breast tissue. In this place there will be a so-called “pocket” for placing the implant. The implant is inserted into the pocket. After surgery, dissolvable sutures are placed in the skin and the patient is placed in a compression bra.
Basic methods of implant installation
There are several methods that are most in demand. The choice of one technique or another depends on the type of structure, the length of time teeth are missing in a row, the financial capabilities of the patient, the location of the problem and other factors.
Patchwork method
This is the most common intervention option. Main stages (after all preparatory activities):
- anesthesia (administration of a drug for anesthesia);
- treating gums with antiseptics;
- incision of gum tissue to form a flap;
- creating a hole (bed) for the exact dimensions of the structure being mounted;
- screwing the screw into the bone and installing a plug;
- suturing.
The main disadvantage is the long healing time. This is very traumatic, recovery lasts up to 2 weeks. The risk of complications increases, such as bleeding, pain, ingress of harmful microorganisms and, as a result, an inflammatory process and rejection.
Minimally invasive surgery (transgingival implantation)
This method is used primarily for express implantation using one-component models. The pins are installed very quickly and with minimal trauma.
The doctor does not make massive incisions. In this case, the screw is screwed into the bone through the gum. No flaps are formed, no bed is created. The main advantages of the procedure:
- speed of manipulation;
- relief of symptoms during the recovery period;
- reducing the duration of rehabilitation.
Many people pay attention to the fact that after 2-3 days the discomfort completely disappears. The risk of infection is reduced, the pins are not rejected.
Using laser
This is not an independent technique, but an additional method of intervention that helps reduce the likelihood of injury. The laser system is most often used with the patchwork method, when it is necessary to peel off soft tissues. The beam is an alternative to a scalpel. Very thin incisions are formed, and the gums are minimally injured.
During the manipulations, disinfection occurs, capillaries are cauterized, which means there is no bleeding. Healing occurs several times faster.
Doctors carry out antibacterial treatment in this way. The tone increases, which means the period of restoration of cellular structures is reduced.
Lateral method
This method is associated with many risks and increased trauma. This is usually how extensive disk and plate structures are installed, which are integral with the support. During the operation, large flaps are formed, including from the side. The dentist uses a special tool to cut down the bone area intended for the screw.
When installing a dental implant, the bed must be identical in size to it. A doctor’s work is practically a piece of jewelry; it is important to prevent even the slightest deviations. To avoid loosening, a prosthesis is placed immediately.
This option is now practically not used. This is associated with a high risk of rejection, injury, and inflammation.
One-step method
Implantation is possible not only in case of long-term absence of a tooth. For example, the structure can be fixed immediately after a unit is pulled out or falls out. Thus, the pin is screwed into the fresh hole formed after extraction. At the same time, it is allowed to replace as many removed incisors, canines and molars as desired. However, the main condition remains the mandatory preparatory stage. That is, such operations are not performed urgently; treatment must be planned in advance.
Which screw will be installed depends on the readings. Both one-piece and two-piece elements are used.
Implant structure
Silicone endoprostheses consist of a shell and a filler.
Filler
Typically, the implant is filled with high-viscosity silicone gel. It has good elasticity and holds its shape well. However, if it ruptures and leaks, it is dangerous, and gradually, when wearing an endoprosthesis, flows into its lower part, which reduces the aesthetic effect. The filler is not always silicone of varying degrees of cohesiveness (viscosity). There are implants filled with saline solution, with different projections and sizes.
Cohesive gel is also used. It is soft and provides a natural effect: the silicone implant looks like a real breast and at the same time has a “memory” effect, that is, it returns to its original shape when subjected to deformation.
Shell
Most products today have a textured shell that allows natural ingrowth of the surrounding soft tissue. This ensures good fixation of the endoprosthesis in place and reduces the likelihood of capsular contracture.
Vertical and inclined installation
Most structures are installed this way. If several pins are installed simultaneously, the doctor must observe the principle of parallelism. In some cases, the material is screwed into the bone tissue at an angle of 45 degrees. This is indicated when the base thickness is insufficient or its density is low due to atrophy and inflammation.
Inclined placement allows for large areas of solids to be brought into contact with the implant surface. In addition, this way you can bypass atrophied areas, anatomical structures, and prevent possible plastic surgeries. However, not all models are suitable for carrying out such manipulations.
Examination before surgery
Before the operation, the patient should not have colds or other diseases. It is necessary to undergo examination:
- do an ultrasound of the mammary glands and blood vessels of the lower extremities;
- take blood and urine tests;
- undergo an ECG;
- consult an anesthesiologist.
- Print list of examinations
You should take a bath the night before. A light dinner is allowed. The operation is carried out strictly on an empty stomach; eating and drinking on the day of mammoplasty is PROHIBITED!
Installation options depending on bone type
Often screws are implanted not only in a vertical position, but also in the central spongy tissue. It is this area that is most susceptible to atrophic processes and resorption after extraction. It is not always possible to use this area during therapy; some dentists resort to extensions.
Manufacturers have developed models designed for attachment to other types of bone structures:
- Basal and compression. They are located in the deepest layers that are not prone to atrophy. A well-known, time-tested brand is Oneway Biomed.
- Zygomatic Elongated, mounted at an angle exclusively on the upper jaw. Such structures are characterized by reliable fixation without deformation.
Selection of implant sizes
Bust measurements
To measure breasts, surgeons use different techniques and fairly simple instruments: surgical calipers and a plumb line.
One end of the plumb line is installed in the area of the jugular notch so that the free end passes in the middle of the navel. The first line (A) is drawn with a dotted line.
The second line is drawn parallel to the first, along the edge of the mammary gland (B). Line B runs perpendicular to line B along the upper edge of the breast. It usually corresponds to the third rib and can be felt. Auxiliary line D is perpendicular to B and runs along the outer edge of the gland, corresponding to the anterior anatomical axillary line. Line G runs along the fold of skin under the breast.
After this, the length of perpendicular segments passing through the nipple from line B to line D and from line B to line D is measured with a caliper.
3-D modeling of the mammary glands
3-D modeling will help you imagine what your breasts will look like with a particular breast implant.
To do this, a 3D simulator films the body in different projections, creating a three-dimensional image of your body. Then the size and shape of the breast with the implant is modeled, taking into account the volume of soft tissue (see photo). You can create several images with different types of implants, and then view them from all sides on a 3D model. After this, the final choice is made.
Comfort check
However, 3-D modeling does not answer the question of how comfortable you will be with breasts of the selected size. For this purpose, manufacturers have developed sizers - implant simulators. They are worn before surgery to select the appropriate model in terms of shape, profile and volume. It is recommended to wear under a tight sports bra that tightens the breasts well. Sizers cover the breasts, but are not underneath the breasts or the muscle and do not give a full view without a tightening.
Experienced surgeons recommend a simple way to check: buy a bra of the desired size, pour rice into a nylon stocking (300 ml for each “extra” size) and distribute the cereal evenly in the bra cup. You can walk around with such a bust for several days, play sports, do household chores, in general, do everything that you are used to in everyday life. This method will tell you how comfortable you will be with the new breast.
Alternative Methods
All options considered involve the implantation of screws into the bones. Nowadays all implantation materials are screwed in this way. An artificial metal root completely replaces the natural one. The implant has a similar appearance and is placed in almost the same area. Additional segments may be affected at greater depth.
Intramucosal technology for installing dental implants
The pin is not screwed into the bone structures, but directly into the gums and a little deeper. This way the installed structure will not fall out. Outwardly, it resembles buttons, and not an imitation of the root part of the unit.
The technique is gradually becoming a thing of the past due to its fragility. There is a high probability of complications (injury, inflammatory processes).
Endodontic-endosseous method
This option is also outdated. A device in the form of a small awl is inserted into the root canal, then it is moved slightly beyond its limits and fixed in hard tissues. It was used mainly in the presence of a mobile or broken incisor, canine, or molar. Such fixation is difficult to implement and becomes loose over time. The technology is not suitable for long-term restoration and is indicated for patients with narrow-shaped canals.
Mini implantation
How dental implants are inserted: tooth installation technology involves shallow immersion into bone structures. Over time, the pins become loose, the fastenings wear out, which means the prosthesis becomes mobile and causes severe discomfort.
This method is welcomed only as a short-term method while the patient is undergoing long-term therapy. For example, this happens when restrictions are discovered on the use of more “long-lasting” techniques. The treatment period is up to 5 days. The prosthetics are removable; screws can be inserted even in cases of complete edentia.
Preparing for surgery
Before the operation, you need to have a face-to-face consultation with the surgeon. He will assess the condition of the breast and individual health characteristics, and select the ideal implants and surgical technique. For example, if you have a small areola, placing a large implant through the periareolar approach will be difficult. In this case, Philip Nikolaevich can offer endoscopic augmentation through the armpit. If the sagging of the glands is severe (ptosis from the 3rd degree), the doctor will recommend a lift (mastopexy).
The doctor will also tell you about contraindications and possible risks after the operation, how it will proceed, and how quickly you can return to your normal lifestyle.
Stages of implantation, technology for installing dental implants
A whole team of experienced doctors goes through several successive steps. Each of them has its own characteristics.
Survey
Before performing surgical procedures, it is imperative to conduct a high-quality diagnosis. The patient is sent for laboratory tests, x-rays, and CT scans of the jaw. Thanks to a thorough examination, the structural features of the maxillofacial apparatus, the location of nerve endings are revealed, and the thickness of the bones is determined.
In addition, a visual examination of the oral cavity is mandatory. The specialist fills out a card indicating the presence of chronic pathologies.
Implantation plan
Depending on the results of diagnostic procedures, a therapeutic regimen is developed. The dentist selects the optimal method of intervention, advises the most suitable designs, and calculates the number of units used. A 3D model of the jaw is created using a computer. Online you can “try on” different types of implants, as well as depict their angle of inclination. A prosthesis is added to the image. In this way, the doctor is able to assess the resistance of the pins to chewing load.
Surgical stage
This is the direct implantation of a screw into hard and soft tissues. Anesthesia is indicated before surgery. Anesthesia in such cases can be either local or general. Sedation (medicated sleep) is often used.
All doctors’ manipulations take about 40 minutes on average (if only one unit is missing). When entire rows need to be restored, it will take several hours.
Rehabilitation
Regardless of the chosen technique for installing a dental implant, the patient goes home immediately after the operation. Prosthetics are rarely performed on the same day as surgical procedures. It is important for gingival and bone tissues to recover after serious mechanical impact.
Medical recommendations:
- to prevent damage to the integrity of the suture material, do not rinse the oral cavity for several days; baths are encouraged;
- careful hygiene (it is important to take care of the health of the remaining incisors, canines and molars);
- follow advice on proper nutrition and a healthy lifestyle;
- do not neglect scheduled visits to the doctor even in the absence of adverse reactions.
Installation of prostheses
Prosthetics are of the following types:
- Immediate. The structure is installed 4-5 days after successful implantation. The technique is more often used for large volumes of work on the entire jaw.
- Deferred. It is necessary to wait for complete healing. Usually it lasts up to six months. This method is indicated in the absence of 1-2 teeth.
- Early. An intermediate option between the two discussed above. This means that the process will not be completed in a couple of days, but at the same time the patient will not have to wait 6-8 months. If the device model is modern and progressive, 90 days or even less is enough. Rapid integration with bone tissue is achieved due to special surface characteristics.
What characteristics determine the size of the implant?
An incorrectly chosen endoprosthesis will not only look unnatural, but further health problems are possible.
Over time, the following may appear: back pain, rapid fatigue, and numbness areas will appear in certain areas of the skin of the chest and around it. What to do, how to choose the right implant? Trust your plastic surgeon. The doctor takes into account both the patient’s wishes regarding breast shape and the expected result. It is important to come to an understanding here before the operation begins.
Many patients believe that breast size is affected by the volume of implants. However, this is not quite true. Three parameters of the implant are responsible for the size:
- projection - height from the base;
- base width;
- volume.
With projection everything is usually clear, but other parameters are less clear. The ratio of projection to base width gives a profile that is classified into four categories:
- low (mini) - this profile is installed extremely rarely for women, sometimes for minor breast correction with ptosis. More often, such an endoprosthesis is chosen by men of asthenic physique to make their chest look athletic;
- medium (demi) - often chosen for breast correction so that after surgery the result looks natural, sometimes this size is chosen as a transitional size in order to later move to a higher profile;
- high (full) - a popular option, suitable for women who dream of natural and high breasts; this profile is suitable for patients with a narrow chest with ptosis of the glands;
- extra-high (corse) - very large breasts, attracting attention with their unnatural size; This profile is usually chosen by artists.
The greater the height and narrower the base, the higher the profile of the breast implant; this must be taken into account when choosing an endoprosthesis. The profile determines how far the breast will visually protrude forward after mammoplasty. Small-sized implants with a high profile are placed in patients with a narrow chest. Sometimes such endoprostheses are indicated for severe ptosis, or breast ptosis, which often occurs after breastfeeding a child.
Contraindications to inserting dental implants
Implantation is not permitted in all cases. There is a list of conditions when medical manipulation is absolutely contraindicated:
- Problems with blood clotting. In this case, any surgical intervention is prohibited.
- Epilepsy. During the procedure, the risk of an epileptic seizure increases sharply.
- Exacerbation of mental illness.
- Fall of immunity. The implanted pin may be rejected.
- Connective tissue diseases. The regeneration process will take a long time.
- Syphilis, tuberculosis. The bones are affected and the screw is rejected.
- Deep periodontal disease, periodontitis.
- Severe forms of rheumatism.
- Malignant tumors. Relapse is possible.
- Allergic reactions to the materials used and medicinal formulations.
- Cardiovascular pathologies in advanced cases. Seizures are possible that can cost the patient his life.
Relative contraindications, when surgery to install a dental implant instead of a tooth is undesirable, but under certain conditions is sometimes allowed:
- Diabetes. Metabolism is disrupted, and wounds take a very long time to heal. Treatment is carried out at the compensation stage in compliance with special rules.
- Pregnancy. Accompanied by an increased risk of miscarriage.
- Exacerbation of the inflammatory process. Therapy is carried out only after complete recovery.
Who is indicated for mammoplasty through the areola?
The main indications for which mammoplasty through the nipple may be recommended:
- dissatisfaction with small breast volume;
- the desire to restore the volume and elasticity of the mammary glands after pregnancy or weight loss;
- asymmetry of the shape and size of the mammary glands;
- tubular mammary glands;
- large areola diameter;
- slight sagging of the breasts (ptosis of the 1st-2nd degree);
- desire to replace previously installed implants with new ones.
Mammoplasty through the areola is suitable for young nulliparous girls who plan to breastfeed their child in the future, and for women after childbirth who want to regain their beautiful shape and do not exclude further lactation. Breast augmentation through the nipple does not affect the glandular tissue at all and does not interfere with feeding functions.
Possible complications
One of the most serious consequences of medical intervention is the rejection of material implanted into bone tissue. The screw is rejected when the patient’s immune status is elevated and allergic reactions occur. Fortunately, this phenomenon is rare.
Often the gums respond with an inflammatory process to a foreign object, pain, swelling, and redness appear. In severe cases, surgical removal of the pin cannot be avoided. After this, rinsing and disinfection are performed, and a course of antibacterial and anti-inflammatory drugs is prescribed.
If the doctor does not follow the rules of asepsis, pathogenic microorganisms may enter the wound. As a result, acute infections develop, which are accompanied by dangerous symptoms, including suppuration. Also, treatment can be complicated by otitis media, neuritis of the facial nerve, and abscess. In such situations, intragingival injections and antimicrobial therapy using a dropper are indicated.
The procedure for installing dental implants, placement and treatment methods depend on the clinical picture, the degree of damage to the dentition, the presence of contraindications, financial capabilities, the age of the patients and other factors. The older a person is, the higher the likelihood of encountering such a problem. Many people are afraid that a smile looks unattractive to their interlocutors, although the real danger from missing elements in a row is more serious complications.
What you need to know about breast surgery
Breast augmentation with implants or mammoplasty is an operation to implant an artificial element - an endoprosthesis or an implant - into the area of the mammary glands. This method not only increases volume and size, but also corrects the shape, gives elasticity and visual appeal, eliminates sagging and other defects.
However, the implantation of breast implants is carried out not only for aesthetic purposes, but also for medical reasons, for example, if the breast is not formed correctly or when it needs to be restored after amputation.
It should be borne in mind that implantation is a serious surgical operation that has a number of contraindications and can cause serious health consequences. Therefore, the key to successful plastic surgery is the right clinic and high-quality, well-chosen implants.
Modern implants so skillfully imitate the natural shape and structure that they are indistinguishable from real breasts even to the touch. Only a specialist can determine the surgeon’s intervention.
And although mammoplasty is now used everywhere, is painless and without a long rehabilitation period, it is used for certain indications:
- small breast size (micromastia);
- pronounced asymmetry of the mammary glands;
- replacement of an already installed endoprosthesis;
- loss of volume as a result of weight loss;
- sagging mammary glands after pregnancy and lactation;
- recovery after amputation;
- age-related ptosis.
*Photos before and after installation of implants for micromastia
Postoperative period
You will be discharged from the hospital on the 2nd day after the operation. After 3-4 days, depending on how you feel, you will be able to return to work. In the first week you need to come to the surgeon for examination 1-2 times, then 1 time every 2 weeks during the first month, and finally 1 time in the next 3-4 weeks. You will need to wear a special compression cuff for 2-3 weeks after surgery. For the first 10 days, it is advisable to sleep on your back.
You can take a shower no earlier than 6-7 days after plastic surgery - just before that, your external sutures will be removed. The scars will appear pinkish for the first 3-4 months and then disappear. The aesthetic result appears 3-4 weeks after surgery. The final result depends not only on the skill of the surgeon, but also on the health of the patient and how carefully she follows the doctor’s instructions.
