Contraindications for Dental Implantation

Relative Contraindications for Implants

Relative contraindications in women

Relative contraindications in the elderly

Absolute Contraindications

There are scenarios where implantation is not viable. In these instances, the implantologist refers the patient to a prosthodontist to find an alternative method of tooth restoration. Alternatives to implants could include bridge, clasp, or acrylic partials.

The absolute contraindications comprise:

1. Hemophilia
2. Pregnancy
3. Cancer
4. Breastfeeding
5. Hypertensive crisis
6. Rheumatoid arthritis
7. Alcohol or drug dependency
8. Being underage (below 18)
9. Diabetes that is not under control
10. Allergy to the materials used in implants
11. Mental health disorders that prevent adherence to medical advice
12. Having undergone heart surgery or experienced a heart attack in the past 6 months

Relative Contraindications – What to Do

There are various diseases considered as relative contraindications for the placement of teeth implants. However, this does not entirely exclude the procedure for the patient. The success of the operation depends on the specific disease and a comprehensive approach by the treating professionals to adjust the patient's health condition.

Diabetes

The chronic disease of the endocrine system leads to an increased blood sugar level, resulting in gum diseases, poor wound healing, and an increased risk of infection complications. Therefore, diabetics were previously not given implants. However, advancements in implantology and endocrinology have made this condition no longer a barrier to a beautiful smile. Scientific studies and the experience of doctors have proven that with proper blood sugar control, implant treatment is successful in 98% of cases. Surgeons apply the classic method of insertion. Initially, an implant with a cap is placed, after 4–6 months a gum former is attached. Two weeks later, impressions are taken, and a crown that properly distributes the chewing force is made.

Cardiovascular Diseases

The surgery is only conducted after a prior consultation with a cardiologist to exclude the risk of aggravating the condition. If the patient is taking anticoagulant medications, their dosage can be reduced or temporarily discontinued with the doctor's permission to prevent postoperative bleeding. During the medical history collection, the implantologist checks whether heart surgeries were performed in the last 6 months or if there were acute cardiovascular diseases, such as bypass surgery or a heart attack. If this information is confirmed, the surgical intervention is postponed to a more favorable time.

Thyroid Diseases

Implantation with thyroid issues is feasible. The decision on the surgery is made together with an endocrinologist. The patient's condition, whether hypothyroidism or hyperthyroidism, must be stable. This is necessary to prevent high blood pressure, emotional instability, and other processes from provoking bleeding or rejection of the implant. Taking prescribed medications is mandatory. Regular checks of thyroid hormone levels and the condition of the jawbone into which the implant is placed are required.

Cancer

Implantation is not performed during cancer treatment. The procedure becomes feasible after completing chemotherapy or radiation therapy, once the individual has fully recovered. It is not possible to specify an exact time since it depends on the radiation dose and the patient's condition. Typically, an oncologist can approve surgical intervention 9 to 12 months later.

Periodontitis, Gingivitis

Gingivitis, a rare disease characterized by the destruction of gums, bone, and ligaments supporting and surrounding the teeth, is not a contraindication. Thus, teeth with mobility are removed, and implants are placed instead. Bone grafting is conducted if necessary.

Periodontitis, an inflammatory disease, is accompanied by gum bleeding during teeth cleaning, pain, exposure, and mobility of teeth, and bad breath. Initially, the infection is eliminated through periodontal cleaning of subgingival deposits, medication is prescribed, and the patient is taught proper oral hygiene. After controlling the inflammation, implants are placed.

Anemia

In most cases, standard dental treatment is ineffective for people with iron-deficiency anemia. Such patients need to identify the cause of anemia, considered a syndrome of some diseases. Medications restoring the optimal iron level in the blood are prescribed, followed by the commencement of implant placement.

Hepatitis B, C, and HIV

Prosthetics on implants for these viral diseases is feasible. Each case is reviewed together with the treating infectious disease doctor. The treatment scheme is selected based on the health status assessed after examination. Test results will clarify for the specialist whether the body can handle the planned operation.

Granulomas, Cysts, Cavities, Dental Tartar

The listed dental diseases are chronic sources of infection that might provoke implant rejection. Therefore, sanitation is conducted before the operation. It includes treating cavities and their complications, gum diseases, removing dental deposits with an ultrasonic, and Airflow powder jet device. In the absence of pathogenic microflora and the toxins they release, the wound heals normally, and the implant integrates into the bone.

Sinusitis

If the implantation is planned for the lower jaw or the upper front teeth, sinusitis is not considered a contraindication. However, its treatment is necessary since any infection reduces immunity. For the restoration of teeth numbers 5, 6, 7, closely located to the sinus floor, an infection is unacceptable as it could lead to the rejection of the implant.

Patients suspected of sinusitis are referred to an ENT doctor. Once the diagnosis is confirmed, the doctor determines the cause of the illness, prescribes medication, or performs surgery. After the inflammatory process in the maxillary sinuses has been eliminated, approximately 1.5–2 months later, the dentist can place the implants.

Specifics of Implantation in Women, Elderly, and Smokers

The implantologist considers not only absolute and relative contraindications. For a successful procedure, the specialist must be aware of certain physiological and pathological changes in the human body. These depend on the patient's gender, age, and existing bad habits.

Risk Factors in Implant Treatment

Several factors can adversely affect the integration of the implant. To eliminate or reduce their impact, the surgeon meticulously collects the patient's medical history and prepares for the implantation.

Risk factors include:

1. Smoking;
2. Inadequate oral hygiene;
3. Inflammatory diseases of teeth and gums;
4. Allergies to medications prescribed post-surgery;
5. Taking medications that interact with drugs prescribed post-surgery;
6. Taking medications that suppress the immune system, affect blood clotting, and influence local and general bone regeneration.

What the success of the operation depends on

For a successful implantation, it is important to consult an experienced dentist. Before starting treatment, the doctor conducts diagnostics and creates a detailed treatment plan. This helps to avoid mistakes and the risk of complications. The restored teeth will be attractive, functional, and durable.