Immediate implantation into the socket immediately after removal of a damaged tooth

The one-stage technique mainly includes one-stage implantation protocols with immediate loading, but in some situations, simultaneously with tooth extraction, a classic implant can also be installed using a two-stage technology. According to many clinical studies, it is one-stage implants installed in the socket of an extracted tooth that protect bone tissue from atrophy and can reduce treatment time with a guaranteed high long-term result of up to 96%1.

Indications

• teeth to be removed are rotten, mobile, destroyed by carious processes,
• single restorations,
• multiple restorations,
• tooth injury,
• simultaneous tooth extraction and implant installation.

Contraindications

• emergency tooth extraction when it is not possible to prepare for implantation,
• complex tooth extraction,
• general contraindications to implantation and surgery.

Dental drainage: what it is, what it looks like

What is tooth drainage? Translated from English, “drain” means “to drain.” This is a medical instrument or device, the main purpose of which is the continuous removal of liquid contents from inflamed tissues and cavities. Usually it is inserted into open wounds and left for a short time, thus, with its help, a procedure is carried out that promotes the outflow of pus, serous exudate, blood and ichor.

This device was first invented by a French surgeon. It was originally created from materials such as glass and rubber. Today, lighter, softer and smoother materials are used for manufacturing: rubber, silicone and latex - they do not get wet, are well fixed and hold, and do not cause significant discomfort.

If you want to know what dental drainage looks like, look at the photo below. This device looks like a small thin tube, and in some cases it even looks like a thin wire, tape or just a strip of material. The device has different sizes and diameters.

Butterfly prosthesis

The design was named because of its external resemblance to a butterfly. Used when 1-2 units are missing. Consists of a crown and a base. This is a denture without turning; it is attached to adjacent teeth with clasps.

Materials:

• Classic polymers: acrylic, nylon
• Innovative polymers: Acry Free, Dental D

The prosthesis does not participate in the distribution of chewing load and does not prevent bone loss. It is quite fragile and cannot be repaired. They use it as a temporary measure, although they can last one to two years.

Indications for installing the system in the gums

Let’s take a closer look at who gets drainage and why. Many patients consult a doctor with an acute inflammatory process and severe swelling of the tissues of the oral cavity (and sometimes even the face), caused by advanced diseases and accompanied by the appearance of a lump or abscess on the gum.

In this case, it is simply necessary to resort to surgical measures, namely, to cut the inflamed gum, as well as the abscess, and release its contents. To prevent the wound from quickly overgrown again, and to prevent pathogenic contents from remaining and accumulating inside it again, specialists place a drainage on the tooth.

So, the main indication for installing the device: a purulent-inflammatory process in the mouth caused by pathologies such as advanced pulpitis and periodontitis, gumboil, fistula, abscess, cyst and granuloma. A wide opening of the purulent cavity and drainage of pathological foci are also carried out in such serious diseases as odontogenic osteomyelitis and phlegmon [1], when the bone structures of the jaw and soft tissues of the face are affected.

On a note! The procedure is contraindicated in patients with bleeding disorders and allergies to painkillers used during the operation and the incision on the gum.

Removable prosthetics

To avoid depulpation, removable dentures are used.

There are 2 large groups of partial removable dentures: plate

and
clasp ones
. The main difference is the presence of a metal arc in the latter. The arch more or less evenly distributes the chewing load without overloading the supporting teeth.

Lamellar

Their task is to replenish the dentition and relieve the remaining teeth at the expense of the base. The base rests on the jaw and palate, taking on part of the load, but such dentures cannot fully take on the chewing load.

Fixation methods: clasps, clasps, attachments. For the upper jaw, the prosthesis is equipped with a palatal plate, which ensures tight suction.

The following products are made from polymer materials:

• Acrylic

The rigid base distributes the load, but is not very comfortable to wear. It takes a long time to get used to such structures. Acrylic wears out quite quickly, becomes cracked and shrinks slightly. Such a product must be changed at least once every 5 years. The main disadvantage is the presence of substances that can cause allergies.

• Nylon

The material is flexible, it is not so difficult to get used to it and the feeling in the mouth is more comfortable. But when chewing it sags and distributes the load worse than acrylic. Hypoallergenic, biocompatible, nylon lasts longer than acrylic.

• AcryFree
  is a new polymer that combines the advantages of the previous ones. It is tough like acrylic, but hypoallergenic like nylon.

Clasp

Artificial teeth are attached to a metal arch. It strengthens the entire dentition, acting as a splint. The fastenings are the same as for plate structures: clasps, telescopic crowns, attachments. They are made from alloys of cobalt and chromium, precious metals, and titanium.

Technological research has made it possible to produce clasp dentures without the use of metal.

Quadrotti prostheses are made of durable polymer. It is light, but so strong that the base of it is smaller than that of ordinary clasps and the palatal bridge is very narrow. If 1-2 teeth

, in a prosthesis without turning, they do without an arch.

Drainage of the hole after the root removal procedure

Separately, it is worth mentioning situations when drainage is installed and the socket of an extracted tooth is drained. The procedure is indicated in the following cases:

• immediately after removal of a neglected and irreparable unit that has caused the appearance of an abscess in the oral cavity: if the manipulation is not performed, the likelihood of developing postoperative complications increases,
• drainage in the gums after tooth extraction is a mandatory treatment measure for those patients who have developed purulent complications during the rehabilitation period: alveolitis, gumboil, abscess,
• drainage is often installed after the removal of a wisdom tooth, and this is done to directly administer medications into the wound, which ensures rapid tissue healing and, of course, minimizes complications.

What can be put in place of an extracted tooth?

There are many options for replacing an extracted tooth. An experienced orthopedic surgeon will offer removable and fixed structures, solutions for restoring individual teeth or a number of missing units, and reconstruction of a completely edentulous jaw. For each case, protocols, methods, and treatment techniques are provided.

How to insert a tooth in place of a removed one - options:

• prosthetics on dental implants;
• bridge prosthesis;
• removable prosthetics;
• clasp prosthesis.

What can be put in place of an extracted tooth depends on:

• number of units removed;
• condition of bone tissue;
• dental diagnoses;
• patient's age.

Based on the preliminary diagnosis, the doctor makes a decision on the timing and features of treatment.

Features of the procedure

Let's take a closer look at how drainage is placed on a tooth. The procedure includes several important steps.

Stage No. 1

First, the specialist conducts a thorough visual and x-ray examination of the inflamed area to get an accurate idea of ​​the location of the abscess, its size and depth.

Stage No. 2

The doctor administers local anesthesia so that the patient does not experience pain during the procedure. Next, at this stage, surgical intervention is performed.

If the tooth next to which the abscess has appeared can still serve, then the specialist cuts the inflamed gum with a scalpel. In cases where saving the tooth is not practical, the dentist removes its root, after which he places a tube to drain the fluid directly into the open socket (in this case, no tissue incision is made).

Stage No. 3

The opened purulent cavity is thoroughly cleaned, treated with antiseptic solutions, after which drainage is fixed in it. One end of the device is inside the wound, and the other is outside.

Next, the doctor prescribes medications, antiseptic rinses and antibiotics for home use, which, together with the installed device, will work to quickly eliminate the inflammatory process and normalize the patient’s condition.

When is it necessary to remove a tooth along with the root?

All decent dentists try to preserve “their” patient’s tooth in every possible way. Even if we are talking only about the remaining root, today there are also several restoration options. One of the most popular is prosthetics using a stump tab.

However, in some cases complete extraction of the tooth is indicated, i.e. removal of both the coronal part and the root.

Indications for root removal:

• granulomas or cysts that do not respond to drug treatment;
• destruction or severe deformation of the root;
• inability to treat root canals (usually also due to deformation or non-standard shape);
• maxillary osteomyelitis;
• periodontitis or periodontal disease in a late advanced stage. In this case, the roots of the teeth have increased mobility and also act as a kind of “foundation” for tartar;
• cracks in the root or perforated bottom (such phenomena are contraindications for prosthetics using a stump inlay);
• “forgotten” fragments of dental instruments that cannot be removed;

Feelings after installation

Experts say that if the device is installed correctly, it should not cause any discomfort. Yes, its presence in the mouth can be felt by directly touching it with your finger or tongue. But the drainage in the tooth should not cause pronounced discomfort, rub the mucous membrane and get in the way. It is normal and correct if liquid is constantly released through it.

If you have a tooth removed and drainage installed, the sensations will, of course, be more pronounced. After all, you have undergone a full-fledged surgical operation, after which swelling, pain, a slight increase in body temperature, and difficulty opening your mouth are possible. However, all these symptoms are, to a large extent, just normal consequences of extraction (removal). But in some cases they can indicate serious complications. How to separate normality from pathology? The answer to this question is in the feature article on the site.

Prosthetics on implants

This method is good because it can be used when one or more teeth are missing. In case of complete edentia, it is also used, but there is no talk about preparation. A metal pin is inserted into the place of the lost tooth, and dentures are put on it, without grinding the adjacent teeth.

What are the advantages:

• neighboring teeth are not affected and remain “alive”;
• the number of artificial teeth can be any;
• the method is used to restore anterior and chewing teeth;
• the implant prevents bone tissue atrophy;
• Implants come with a lifetime warranty.

For prosthetics on implants, you can use any of the following methods:

• Removable prosthetics

A removable denture is attached to part of the jaw or to the entire dentition much better than on natural teeth. Removable structures do not fall out arbitrarily, but the patient is able to remove them himself for hygiene procedures. Conditionally removable ones are secured with screws; only a dentist can remove them.

• Fixed prosthetics

The classic bridge design has proven its effectiveness. This is a reliable way to restore your teeth. When attached to implants, all the disadvantages disappear: dentures are without grinding, which means there is no need to depulpate the supporting teeth. The metal pin is stronger than the natural root, the design will last for many years. Implants prevent bone tissue from resorption. There are no restrictions in the choice of materials for crowns, and the number of artificial teeth can be more than 2

.

Unfortunately, sometimes there are contraindications to installing implants. In such cases, other prosthetic methods are used without turning adjacent teeth.

Duration of treatment

Many patients are interested in how long tooth drainage costs. On average, it is left for 3-6 days. During this time, all pathogenic fluid should completely leave the wound. If all is well, the patient usually feels relief within 24 hours after installation. With each subsequent day, positive dynamics are observed, swelling subsides and disappears, and the color of the mucous membrane normalizes.

It also happens that after this period, unpleasant symptoms of the disease persist, which means that the inflammatory process continues. Then doctors conduct a new examination, adjust treatment tactics and resort to other measures.

If there is drainage after tooth extraction, when can it be pulled out? The doctor decides. If the dynamics are positive, the tube is removed after 3-4 days. When the inflammatory process persists or complications of extraction appear (for example, alveolitis), the specialist pulls out the tube, performs a thorough curettage, that is, cleaning the hole, after which he can reinsert the device.

If you need to insert a tooth after it has been removed

The best solution to insert one tooth is a one-time implantation, but a tooth can only be inserted if too much time has not passed since its removal. To firmly fix the implant in the bone, the jaw bone tissue must be dense and have a certain height. But the longer a tooth is missing, the more the bone thins and dries out. Therefore, if you had a tooth removed several years ago, you can have it replaced either with prosthetics or classical implantation.

Rules to follow when having a device in your mouth

Anyone who has had drainage installed after a gum incision or tooth extraction needs to know how to behave during this period. Doctors give the following recommendations:

• you need to follow a certain diet: it is forbidden to eat hot and hard foods and chew on the side of the jaw where the intervention was performed. You need to give preference to soft and liquid dishes, drink more clean water,
• It is undesirable to sleep on the cheek on which the device is installed,
• Brushing your teeth should be done extremely carefully, avoiding the area where the tube is located: for hygiene, you can use a brush with soft bristles and a non-abrasive toothpaste. It is better to avoid using an irrigator for a while,
• Intensive rinsing of the mouth is prohibited: to carry out antiseptic and disinfectant procedures, simply take liquid into your mouth, hold for 2-3 minutes, spit it out,
• It is important to protect yourself from physical activity and sports.

Why can’t you “walk without a tooth”?

The absence of even one tooth entails a number of unpleasant consequences for the health of the oral cavity and the body as a whole. The insidious thing is that these consequences occur very systematically and unnoticed by the patient.

1. The chewing load on neighboring teeth increases and, as a result, their lifespan is reduced
2. Neighboring teeth, without the support that was present before, begin to move and try to close the resulting gap. As a result, the teeth become crooked and the correct bite is disrupted.
3. Aesthetic discomfort (especially important for front teeth)
4. Gastrointestinal problems due to poorer chewing of food.

What to do if the device falls out

Some patients do not even have time to find out how the tooth drainage is removed at the dentist, because the tube itself falls out of their mouth. What to do in this situation? If the system falls out in the first few days after the procedure, then you need to quickly contact your doctor to have it reinstalled. During this period, the likelihood that all the pus has come out is still too small, and the wound will heal very quickly, accordingly, pathogens will remain inside it.

If the device falls out 4-5 days after the procedure, and you notice that the swelling has subsided and pus is no longer oozing from the wound, then there is nothing to worry about. In this case, we can assume that the drainage installed for the treatment of various dental pathologies and after tooth extraction has successfully fulfilled its purpose. However, you still need to see a doctor.

Important! The main reasons for premature loss of the device: improper oral hygiene technique, active rinsing, violation of the postoperative regimen, poor-quality installation of the tube in the dental office.

Expert opinion
Elena Vladimirovna Orlova
Specializations: Dentist-therapist, endodontist

Experience: 33+

“Under no circumstances should you install drainage on a tooth yourself. You can injure the tissues or, even worse, introduce an infection into them, after which the inflammation will flare up with renewed vigor. All procedures for its installation and removal must be carried out by professional doctors under completely sterile conditions."

Crown instead of an extracted tooth - implantation

Implantation is a modern solution for partial and complete adentia. This is what doctors recommend to patients, and there are many reasons for this:

• complete replacement of a lost tooth - not only the upper part, but also the root system;
• restoration of chewing and other functions - after prosthetics, the patient is not limited in the choice of menu, and the quality of speech does not suffer;
• aesthetics - both the crown itself and the artificial gum contour, if present, look natural;
• preservation of bone tissue - bones experience full load, which eliminates atrophy and degradation of bone structures;
• speed of prosthetics - some protocols allow you to restore a tooth immediately after removal.

Implantation options:

1. Classic two-step protocol. After removal, the doctor waits for complete healing of the gums and restoration of soft and bone tissues. Then he installs the implant and, after its complete engraftment (4-6 months), places an artificial crown or bridge on the implants without damaging neighboring units. The treatment is long and is recommended for patients who, immediately after extraction, were unable to replace their teeth with prosthetics - the socket has healed, and the tissues have partially atrophied. It is possible to speed up treatment using a two-stage protocol. Premium dental implants Nobel, Strauman take root in 2-4 months, which reduces the period of prosthetics by half.
2. One-stage implantation protocol. When a tooth is removed, the patient is immediately implanted with an implant, a gum former or a full-fledged temporary crown. Such treatment requires removal by an experienced implant surgeon, as well as preliminary examination to reduce risks.
3. One-stage implantation protocol. It completely eliminates the question of when a tooth can be replaced with a prosthetic after extraction, as it combines all three stages of treatment. The doctor performs an extraction, places a dental implant and immediately loads it with a crown. The patient simply replaces the damaged tooth with a new artificial one, which significantly speeds up the recovery process.

Self-removal of the structure: possible or not

Some patients experience severe discomfort, so they are interested in how to remove drainage from a tooth on their own. Others do not have time to make an appointment with a doctor on time, so they also want to know the answer to this question. Often, the dentists themselves provide detailed instructions so that the patient can perform the procedure at home. The procedure should be as follows:

• wash thoroughly with soap and disinfect your hands,
• treat the oral cavity with some antiseptic: Miramistin, Chlorhexidine are suitable,
• stand in front of the mirror, open your mouth, carefully grab the tip of the tube protruding from the wound with your thumb and forefinger and pull it towards you without force,
• rinse your mouth with an antiseptic,
• Do not consume food or drink for the next 2 hours.

“On the eve of the New Year holidays, I had a drainage installed after the removal of a dental cyst. The procedure is painless, as it is under anesthesia, but the doctor said that due to the holidays, I will have to pull the tube out of the wound myself in four days. I described in detail how this is done. When the hour struck, I was very worried, I thought it was difficult, but in fact I did everything quickly. However, after ten minutes the pain was so severe that I had to take pills. But within a day I even forgot that I once had this tube. After the holidays, I saw the doctor, he said that I was good, and the tissues were healing normally!”

Irina R, review from 32top.ru

The procedure is simple, but if the device has not fulfilled its main purpose, then it should not be carried out under any circumstances. And, in general, even if your condition has improved significantly, you should not resort to independent measures without consultation with a specialist. It is better to have a professional doctor perform all steps to remove the device. Why? Removing the tube yourself can cause severe pain, prolonged bleeding, damage blood vessels and injure surrounding tissue.

Insert ceramic teeth

Inserting ceramic teeth will be the right decision if you need to restore your front teeth, which are clearly visible when communicating with people around you. But for the restoration of chewing teeth, ceramic crowns are not suitable: ceramics is a fairly fragile material and a crown made from it may not withstand the heavy load that is constantly placed on the chewing teeth when chewing food.

The high aesthetics of ceramic crowns determines the expensive prices for this type of orthopedic structures. But the patient gets a beautiful and natural smile: you can also evaluate the results of dental restoration with ceramic crowns from the photos that we have posted below. Ceramic crowns can be placed on both the abutment tooth and the implant.

Preparing for dental prosthetics

Many people do not like any dental procedures, and this is due to the fear of unbearable pain. You should not be afraid of dental prosthetics, since the most unpleasant thing you will encounter is tooth grinding and depulpation. And all procedures are carried out using local, good, strong anesthetics.

An important diagnostic point is x-ray examination to determine the number and size of roots.

Other stages of preparation include the improvement of neighboring teeth (removal of plaque, treatment of carious damage), which will serve as a support for the prosthesis. If the tooth is significantly damaged, they resort to extraction, treatment of the canals and their subsequent filling.

For prosthetic treatment of anterior teeth, as for any other manipulation, there are contraindications. They are divided into absolute and relative.

Absolute contraindications include:

• 3-4 stages of cancer;
• Conditions after chemotherapy;
• Immunodeficiency conditions;
• Severe somatic diseases in the stage of decompensated state;

Relative:

• Diabetes mellitus (especially type 1);
• Diseases of the heart and blood vessels, such as hypertension with crisis and angina pectoris;
• Smoking, alcoholism;
• Mental disorders;
• Pregnancy;
• Allergic reactions to dental medications and materials.

How much does it cost to get teeth inserted?

Teeth can be inserted in different ways and using different crowns or dentures, so the price of the service can be very different. Below we publish prices for services for restoring damaged or lost teeth, which are offered by our dental clinic in Moscow - “Aesthetica”!

If you want to insert teeth so that the restoration result is both beautiful and high-quality, come to our dentistry! We have created all the conditions for high-quality, painless dental restoration in the most difficult cases!