Dental implantation during pregnancy - is it possible?

First I want to show you one piece of work. Very simple. This is the so-called and widely advertised “implantation without incisions.”

Stage 1. Creating access:

Stage 2. Preparing the hole for the implant:

Stage 3. Implant installation. In this case – Dentsply Astratech:

Stage 4. Installation of the healing abutment:

All. The operation is completed. No seams.

Next - observation and postoperative examinations. Usually few people show this, but for me it is fundamentally important what happens to the patient after the operation and how he feels.

Appearance of the operation area every other day.

Appearance of the operation area after a week:

Everything is fine? It seems like, yes. We wait two and a half months - and begin prosthetics.

View of the implantation area three months after surgery:

All! You can safely start prosthetics! In this clinical situation, this implant serves as one of the supports of a large bridge in the upper jaw.

Friends, why am I showing you all this?

There are two reasons.

The first is that there is no “implantation without incisions.” And in this case there is an incision, only it is not linear, but circular, along the perimeter of the implant socket. So, if some advertisement tells you about “implantation in three minutes without incisions” (as well as “laser implantation”, “vector implantation” or “quantum implantation”, etc. nonsense) - it is, to put it mildly, disingenuous. To put it bluntly, he is lying.

The second reason is that with proper planning and implementation, implant treatment is very low-traumatic, painless and predictable . And the point here is not in the implants used, but, again, I repeat, in the correct planning and implementation of this very treatment.

It would seem, what does Luzhkov have to do with our topic today about pregnancy?

I often receive questions via email like:

– Is it possible to get implants during pregnancy?

– How to plan pregnancy and combine it with implantological treatment?

– How do implants affect the course of pregnancy? And how does pregnancy affect the survival rate of implants?

Let's try to figure this out.

During what periods of a woman’s life should she be careful?

The female body has physiological characteristics and functions somewhat differently than that of men. Almost every woman in her life goes through stages that have a significant impact on her health, condition, and weaken her immune system:

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• “critical days” (menstruation),
• planning pregnancy or IVF,
• pregnancy,
• lactation,
• menopause.

It is these moments that are the reason for a professional doctor to carefully consider the planning of any intervention in the living tissues of the body or to refuse it altogether. And we are talking here not only about dental implantation, which is a fairly simple procedure even compared to tooth extraction. We are talking about the success of the result during the period of hormonal changes, and about safety for the woman’s health. If you are considering the possibility of dental implantation during pregnancy, you need to think about whether this process will affect the well-being of the baby.

Do not forget that implantation is not limited to the installation of titanium roots; it is accompanied by taking medications, antibiotics and anesthetics, anxiety, and undergoing X-ray examinations. But we’ll tell you about everything in order.

How long after giving birth can an implant be placed?

Turnkey implant installation includes preparatory work, system selection, surgery and rehabilitation period. Young mothers' bodies are weakened after childbirth. It will take at least 12 months for him to fully recover. Therefore, during this period there is no need to expose him to unnecessary stress.

1. An important contraindication to the installation of a pin is the lactation period, when the baby is fed with mother's milk.
2. When breastfeeding, medications are contraindicated for women.
3. Pain and stress are common reasons for stopping breast milk production.
4. The baby needs to be given close attention. Therefore, the parent will not be able to regularly visit the dentist.

When a baby is fed formula, implantation can begin earlier. In any case, you should consult with an orthopedist about starting to restore your dentition. He will suggest the best treatment option for the postpartum period.

Is it possible to carry out implantation at the stage of pregnancy planning?

Dental implantation and conscious pregnancy planning are two mutually exclusive concepts. Especially if a woman is preparing for IVF. This procedure requires complete calm and maintaining the body’s immune forces at a high level.

It’s another matter if you are wondering when you can get pregnant after implantation. You can do this after a few months:

• If implantation was carried out with immediate loading, then it is advisable to wait six months until the implants are guaranteed to take root. After this time, it will be possible to carry out re-prosthetics, but pregnancy will not affect this process in any way - it is completely painless and non-traumatic,
• if implantation was carried out with delayed loading, then the minimum period is 2 months. But here you need to understand that after the implant takes root, you will need to install a permanent prosthesis, and to do this, cut the gum, remove the plug and fix the abutment. This should not be done during pregnancy. Therefore, if pregnancy has occurred, you will have to wait with prosthetics. Or immediately postpone the date until you receive a prosthesis.

What risk factors prevent implantation during pregnancy?

Pregnancy is a period of hormonal changes, when the mineralization and strength of enamel is disrupted and immunity decreases. The mother’s body practically gives everything to the future baby, who “takes” useful elements from the woman’s teeth, bone and muscle tissue. Due to hormonal imbalance in a pregnant woman, the structure of the gums changes, the mucous membrane becomes loose, the risk of getting gingivitis and any infectious disease increases, the protective functions of saliva worsen and its pH changes. Any wounds in a woman’s body during this period heal very poorly, which can ultimately lead to peri-implantitis, rejection of the structure, and difficulties and risks during the rehabilitation period.

Why else do specialists refuse implantation for pregnant women:

• it is necessary to undergo an x-ray: the radiation dose of modern tomographs and radiovisiographs is minimal, and there is also no information that x-rays have a negative effect on the fetus. However, experts insist that taking pictures of pregnant women is only possible when the potential benefit is many times greater than the possible risk. In addition, you will have to undergo radiography not once, but at least three times,
• the need to undergo additional manipulations: for example, implantation cannot be carried out without prior sanitation of the oral cavity. Those. it is necessary to cure all dental problems, remove decayed teeth, if any. Perhaps the patient has bone tissue atrophy and cannot do without its augmentation. And if it is not advisable to carry out dental treatment during pregnancy, it is allowed in the second trimester, then surgery to build bone, removal is contraindicated due to the traumatic nature, difficult rehabilitation,
• getting into a stressful situation: any person is worried, even if he understands that the procedure will be completely painless and successful. But dental implantation during pregnancy is double stress for a woman, there is no doubt about it,

When there is excitement in the body, cortisol is produced in increased quantities, and scientists have proven that the hormone also negatively affects the fetus. Babies whose mothers were nervous had an increased risk of developing diabetes and cardiovascular pathologies. Women themselves, due to the production of the hormone, risk increasing toxicosis, uterine tone, and increase the risk of miscarriage in the early stages and premature birth in the later stages.

• pain reactions: firstly, during pregnancy the pain threshold decreases, i.e. even the slightest intervention causes very severe pain, plus the woman may not be affected by anesthesia, which in itself is harmful, penetrates the placental barrier and leads to the development of abnormalities in the fetus. Secondly, without anesthetics it is impossible to carry out dental implantation and calmly go through the rehabilitation period. Thirdly, the feeling of pain again causes increased activation of adrenaline in the blood, which leads to uterine tone,
• lack of calcium in the body: it would seem that this factor only harms the baby. But in fact, it also affects the quality of implant healing and its fusion with the jaw bone tissue. If there is a lack of an element, and successful osseointegration requires a lot of it, the implant may simply not take root and will be rejected,
• risk of infection: implantation involves inserting an implant either through a puncture, through surgical guides, or through incisions. Even with the most minimally invasive intervention, a wound is formed that requires time to heal. And given that in pregnant women it will take a long time to heal, it cannot be ruled out that bacteria will penetrate there, especially against the background of weakened immunity,
• taking antibiotics and medications: often during the rehabilitation period, doctors prescribe various drugs to patients to maintain immunity for rapid recovery, healing of wounds and relieving the inflammatory process. Antibiotic therapy is contraindicated for pregnant women.

What to do if pregnancy occurs before the surgical stage

Is it possible to have dental implants during an unplanned pregnancy? When pregnancy has become a pleasant surprise for you, and you have already set a date with your doctor and have gone through the preparatory period, you need to postpone the process of installing the implant until you give birth and stop breastfeeding your baby.

Why is it important? In the first trimester of pregnancy, the vital organs of the baby are formed, and the woman has a very high risk of miscarriage. These two factors should be decisive for you if you do not want problems and complications.

Content

• Is it possible to undergo implantation for pregnant women?
• Implantation planning
• Bottom line

When undergoing examination during registration, the expectant mother must visit the dentist. The sooner a pregnant woman resolves dental issues, the easier this period will pass and with less damage to her teeth in the long term. If dental problems are identified, the doctor may recommend implantation.

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What to do if the implant is already installed

Such situations also occur: you find out about pregnancy at the most active moment of osseointegration, i.e. implant engraftment in the jaw bone tissue. Naturally, the job has already been done, so the main thing that is required of you is to follow a few rules.

Rule No. 1: notify the implantologist and gynecologist

From now on, all your actions must be coordinated with these doctors. Also, truthful and timely information will help specialists adjust the treatment schedule and prescribe the safest medications for you, and strengthen control over your health.

The safest analgesics during pregnancy are No-shpa, Papaverine, Paracetamol, and Ibuprofen. Among antibiotics, cephalosporins pose the least risk to the mother and fetus, but tetracycline and doxycycline drugs are contraindicated due to toxicity and the effect on the baby’s tooth buds and bone structure.

Rule #2: Calm down

There is no need for unnecessary worry now, especially since you have already completed the preparation for implantation, including treatment of teeth and gums, oral sanitation, professional hygiene and installation of the implant itself, which means that part of the important stage is left behind. You should also be pleased with a positive thought: if conception occurred during the period of osseointegration of the artificial root, it means that the bone tissue is healing well, and the mother of the unborn baby can boast of good health.

Rule #3: Strengthen your oral hygiene

Pregnancy is often accompanied by such unpleasant phenomena as increased sensitivity of the gums and the development of an inflammatory process in the mucous membrane. A woman’s situation can be complicated by gingivitis and periodontitis, which is a threat to the successful implantation. Therefore, after each snack, rinse your mouth with water or mouthwash, purchase a floss and irrigator, and fill your diet with foods useful for improving blood circulation in the gums. Also, do not skip any hygienic brushing of your teeth and change your toothbrush more often (once a month) so that bacteria do not have time to accumulate on it.

Rule #4: Start taking vitamins

For high-quality osseointegration, the condition of all body systems is very important - vitamins such as C and B are needed, as well as microelements - calcium, phosphorus, fluorine. Consult with your attending physicians (both an implantologist and a gynecologist) regarding the introduction of vitamins. It is important to do this harmoniously and at the right time so as not to harm the baby.

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Pregnancy became known when the abutment or prosthesis remained to be installed

In the case of fixing the prosthesis, you should not have any worries. This is the final and most enjoyable stage of implantation. This means that the fusion of the implant with the bone tissue was successful. Prosthetics do not require medications or anesthesia, because It is completely painless and does not require surgical intervention. But the abutment and gum former require a tissue incision, so you still have to wait either until the end of pregnancy, or at least until the second trimester, which is considered safer in terms of external interventions.

Author: Dzhutova A. V. (Thank you for your help in writing the article and the information provided)

Carrying out bone grafting

There are several types of bone grafting, which will determine the technique used to perform it. The following options for restoring bone deficiency are distinguished:

• Autogenous transplantation. It is a transplant of one’s own bone tissue, and therefore requires additional traumatic manipulation - taking a graft from the lower or upper jaws, chin or hard palate.
• Splitting of the alveolar process. The optimal operation for replenishing the width of bone tissue. First, the patient's alveolar ridge is sawed, and then it is expanded and the graft is immersed inside.
• Sinus lift. It is performed when there is a deficiency of bone height in the area of ​​the maxillary sinuses. The operation consists of lifting the soft tissue of the sinus and filling the space with osteogenic substances.
• Barrier membranes. Replantation of a bone block, which involves the additional attachment of a special membrane. This design maintains the shape of the graft and prevents unfavorable elements from penetrating into the operated area.

Any of the listed manipulations is quite traumatic and unfavorable for pregnant girls. It should also be noted that dental implantation is also not carried out during the gestational period, so it will not be possible to use alternative methods for treating bone deficiency.