Preparation for operation.

Implantation is an operative intervention during which the foreign substance is implanted in the jaw bone . Therefore, as for any operation, for implantation there are obligatory conditions that should be observed without fail, namely:

1. Sanitation (improvement) of an oral cavity with elimination of any pathological pestholes: ablation of spot and dental deposit, filling of carious cavities, retreatment of badly filled teeth and channels.

2. Strict observance of oral cavity hygiene in conformity with doctor - stomatologist's instructions

3. Diagnostics. The patient should not have such diseases, as severe heart diseases, High arterial pressure, hormonal derangements ( diabetes, diseases of a thyroid gland, As they negatively influence regeneration and exchange processes of bone tissue), bruxism (involuntary tooth-grinding) that causes superfluous masticating pressure (absence or presence of the diseases is found out during interrogation of a patient). It is recommended to pass the general examination with the attending physician before the treatment beginning, because other diseases negatively influencing on implant adaptation, can cause contra-indication to implantation.

4. If contra-indications are not revealed, they go to the next stage - to definition of the tooth-jaw system condition. It includes, X-ray research (orthopantonogram - a survey picture of both jaws) and if it is possible the computer-tomographic research (the level-by-level image of all tooth-jaw system in three planes with reception of the three-dimensional image). These objective data in in the aggregate allow to see not only anatomic (quantity of teeth and a bone tissue), but tooth-jaw system functional condition. In the end of examination they start planning treatment. It is the most important part of a preparatory stage. It requires the detailed analysis of all received data during the examination with participation of various experts: therapist, surgeon, orthopedist, dentist.

Making of confidential attitudes with the patient

For discussion of the problem of mutual relations with patients has been organized the meeting with 20 stomatologists. During discussion there were such questions: « How is it possible to inspire confidence in safe result to the patient who is afraid of pain appearance during or after operation? How is it possible to convince the patient of painlessness of procedure? »

After some reflections participants gave the following answers:

• Comfort of the patient can be provided with the help of assignments of anesthetizing drugs
• Surgical intervention connected with implantation is less painful than extraction of the wisdom tooth
• Before implantation there can be made the computer tomography for confirmation of indications
• Patient is recommended to discuss a problem of pain appearance with a surgeon

the practising experts who were taking part in the meeting, had experience of implantation to several patients (from five and more). Doctors were asked whether their patients complained of pain during operation or after it. Doctors admit that patients were pleasantly surprised having only insignificant soreness and some discomfort.

Full mutual understanding with the patient is irreplaceable in work of stomatologist - not the way he can convince the patient to place an implant at any cost, but from the point of view of the best understanding of patient requirements and the answer to his doubts.

we think that doctors should not impose treatment - they should prove it!

Thus, each doctor should give the patient enough time to understand his motivation better. To create good mutual understanding with the patient, it is necessary for the doctor first of all to define and try to lower a level of concern over forthcoming treatment. Then - it is possible to go to the detailed elaboration of medical action. Discussion of these questions outside of operating-room is the best way to establish confidential attitudes and mutual understanding between doctor and patient. During a consultation before implantation patients almost always ask similar questions. It is very important to not ignore them, and to prepare the truthful answers which can give confidence to the patient.

Concern of patients usually develops from the six items:

Whether
• Does it hurt?
• How long do implants serve?
• I have an acquainted who had 6 implants placed, and five of them have already fall out
• So can artificial materials get accustomed?
• How much is it? The price seems very high?
• Implant fall out sometimes

Whether it is hurt?

All stages of operation are made very accurately, as in microsurgery. Intervention much less traumatic than extraction of wisdom tooth. The only expected consequence can be a hypostasis, intensity of which can be different depending on the patient. Necessity for reception of sedatives usually disappears in a day after operation.

How long do implants serve?

The statistics data show that implants can serve til the end of patient's life. Depending on clinical situation the factor of success varies from 90 up to 99 %. The denture with implant support are considered to be as natural teeth because such dentures similarly to teeth react on various influences. Bad hygiene leads to the increase of risk of the inflammation of tissue that surrounds the implant. It is necessarily to have regular stomatologic examination.

Do artificial materials really can get accustomed?

The only material that has shown during long-term researches the acceptable results on integration with a bone, is the commercially pure titan. Other materials are considered to be experimental. The choice of reliable, in other words world - proved implant system is very important

How much is it? The price seems very high?

Cost of treatment remains rather high. However even more often the cost of implantation treatments comes nearer to the traditional prosthetics, but surpasses it from the point of view of the long-term forecast. Before beginning the treatment it is necessary to make a thorough financial estimation. Sometimes the definition of final cost is necessary to postpone before making prior examination (computer tomography, diagnostic models, etc.)

Implants sometimes fall out.

There are no immunologic falling out of titanic implants. Commercially pure titan is ideal biocompatible material. It does not mean that such implants are integrated into 100 % of cases, but the implant inconsistency is shown by its easy mobility and sensitivity around it. In such cases it can be extracted or replaced by new one.

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