Toothlessness causes unhealthy nutrition in people and is psychologically wearing.
‘‘It should not be forgotten; Body’s systemic health is most important. The overall health is more important than anything else. “
In implant applications, as in any medical treatment there may be situations that should not be present. These situations are called contraindications. If contraindications are well detected, harmful treatments will not be performed, and we will detect people who do not have contraindications and do the necessary treatments and we will not leave them toothless.
Contraindications can be divided into local and systemic. The presence of systemic diseases plays an important role in the planning and implementation of implant treatment. There are certain systemic diseases that affect bone metabolism, wound healing in tissues and ultimately the success of implant treatment. In addition, systemic diseases treated with medication or other methods have the potential to affect implants and surrounding tissues.
Cardiovascular (Cardiovascular) Diseases
“Patients suffering from heart diseases, especially if they use blood thinners, should be monitored and visited by physicians carrying out the treatment after adequate anamnesis.”
In certain diseases such as hypertension, atherosclerosis, vascular stenosis, coronary artery disease and congestive heart failure, it has been observed that although it causes suppression of the blood flow, decrease in oxygen density and malnutrition of tissues, it does not prevent the implant from integrating into the bone and as a result, cardiovascular diseases do not have a negative effect on the clinical success of the implants.
Studies have shown that calcium channel blockers such as Nifedipine (Adalat, Nidilat etc.) used in the treatment of congestive heart failure and hypertension patients can reduce bone resorption by providing direct calcium entry into the cell. Likewise, they showed that calcium channel blockers reduce bone resorption by up to 50% depending on the dose. This shows the positive effect mechanism of some heart medications.
‘‘Implants can be placed in many cases by following the scientific values of diabetic patients. In our clinic, we have cases with a history of up to 14 years and follow-up. “
If you are a diabetic willing to have implants, it will be possible for you to have your dental treatments done after consulting your physician and getting all the medical papers confirming that you are fit to apply for such treatments,
Diabetes has various systemic complications such as eye, kidney, brain vessels, micro and macrovascular disorders and wound healing disorders. In the mouth, it is associated with dryness, widespread caries, fungal and gum disease.
According to the data obtained from the articles investigating the implant success of diabetic patients with more than one implant placed, it was concluded that the rate of implant loss in diabetic patients under control is within normal limits. The results of implant treatment applied to diabetic patients under control in our clinic also support this view.
According to the data of these studies, a good maintenance of glycemic control before and after surgery is necessary to ensure the osseointegration of the implants and to prevent delay in soft tissue healing. For this, the HbA1c test is performed, showing the average blood-glucose concentration in the last 6 to 8 weeks. Implant application is evaluated by evaluating the results with clinical control and anamnesis.
Dental Treatment for People Using Cortisone (Corticosteroids)
‘‘As with all drugs, duration and dosing are important in cortisone use. The decision about implant application should be made by the physician by performing general anamnesis and a clinical control of the patient. “
Corticosteroids are drugs with strong anti-inflammatory effects that are used in the treatment of many systemic diseases.
These drugs reduce inflammation and are effective in reducing swelling and pain associated with it. However, it also reduces protein synthesis and delays wound healing. In addition, it reduces the number of leukocytes and lowers the patient’s resistance to infection. Therefore, appropriate antibiotics should be used for 3-5 days after the initial dose.
Dental Relationship with Bone Melting (Osteoporosis)
‘‘ In light of the following data, it can be concluded that osteoporosis does not constitute a contraindication for dental implant treatment. However, it is still recommended to provide complete oral hygiene before general control, evaluation and surgical procedure. “
It is a bone disease affecting the skeleton with the thinning of the protein mesh in the bone as a result of the decrease in bone mass with age making the bones very fragile. Osteoporotic (bone resorption) changes in the jaws are similar to those in other bones of the body.
(Osteoporosis is not a contraindication for immediate stabilization of implants, as it causes greater loss of trabecular bone density than cortical bone. Many postmenopausal clinical studies have shown similar loss rates in other patients, and hormone replacement therapy (HRT) has been reported not to affect the loss rate.)
In a meta-analysis by Chen et al. (Analysis of numerous literature studies), the relationship between osteoporosis and dental implant loss was not found to be statistically significant.
Bisphosphonate Use and Implant Treatment
‘‘The bisphosphonates taken through the vein pose a high risk for implant surgery. Apply the treatment with the serum CTX test when necessary, by evaluating the duration and doses of these oral drugs, other diseases and the drugs used, general clinical examination and anamnesis and then the decision should be made by the doctor. “
Bisphosphonates are a group of drugs commonly used for many bone diseases and are approved by the US Food and Drug Administration (FDA) for the treatment of osteoporosis, metastatic bone tumours, and Paget’s disease. Bisphosphonates act by suppressing osteoclasts or reducing bone resorption.
The relationship between radiotherapy and implant treatment
‘‘Head and neck radiotherapy causes oxygen deficiency in tissues, shrinkage in vessels and tissue deterioration. “It cannot be reshaped due to the decrease in tissue vitality and the risk of bone destruction has increased.”
The risk of a non-integration of the implant increased 2-3 times more in patients who received radiotherapy. It has been reported that the use of hyperbaric oxygen for 20 times with a pressure above 1 ATM before and after the procedure increases the success in patients with this condition.
Another issue is the post-implant radiotherapy application. The duration after which the implant is placed and the treatment dosage have a remarkable effect on the result. It has been reported that the risk is less with old implants.
Ectodermal Dysplasia and implant relationship
‘‘Ectodermal dysplasia is an inherited disease that manifests itself with the disorder of tissues such as hair, skin, nails and teeth. The most common intraoral clinical appearance is single or mostly multiple tooth deficiency. “
Conventional dental treatment and prosthetic techniques often fail because of insufficient tissue support. It is recommended that implant-supported treatment should commence after growth and development completion.
While implant application is not recommended in single tooth deficiency treatments, it has been determined that the lower jaw anterior region is the most suitable area for implant applications in severe hypodontics cases. Studies have reported significantly lower maintenance and success rates in the upper jaw than in the lower jaw.