Modern dentistry: simultaneous tooth implantation and extension of the jaw bone through the eyes of the technical director
Hello, Habr!
Today I will tell my story how I had to install the implant and how it really was. I decided to tell my story because the information that is posted on the Internet does not correspond to reality, and sometimes it contradicts.
The purpose of this article: to tell by example how modern dentistry really is, how the implantation of an artificial tooth takes place, and what you should be prepared for.
I am soon 37 years old. Until recently, I boasted that I had all my 32 teeth in place. And indeed, few have all their teeth in place by this age. (and, in principle, nothing surprising: I tried to figure out the costs of dentists, based on today's rates and the amount came out in excess of $ 7.000 or over ₽450.000).
Please note that in the article photographs of the process and the faint of heart I advise you not to look.
Some of the photos are not of the best quality, since the whole process was photographed on mobile phones, but most importantly: all the photos and videos are exclusively mine.
At the end of April, I seriously caught a cold, inflammation of the bronchi began. Together with him, severe pain in the lower jaw began, on the left. I did not attach much importance to the pains, thinking, probably, I got a nerve. Due to inflammation of the bronchi, he injected antibiotics for several days, and the pain in the jaw was drowned out first by Ketorol (a couple of tablets remained), and then by Nimesil.
A week later, the pain subsided and I could already do without painkillers. However, a week later, when probing with my fingers, I felt a seal in the gum.
And then I realized: something went wrong ... I turned to my dentist with this question, who has been observing for the last 15 years. He reminded me that in that area there is a problem with the root of the tooth and recommended taking a picture.
The direction to the picture was sent to me in Viber, showed it to a laboratory employee and she pointed her finger at which fields to fill in the application. It was necessary to take a picture in the Vatech program.
The picture was given to me on disk, and they also sent a link to download it by e-mail. Along with the picture was attached a program in which you can view this picture. Naturally, I installed the program and began to look for pictures, trying to understand what is shown on them.
This picture shows that a cyst has formed around the root of the tooth, which is filled with blood mass.
If you look closely at this picture, you can see the area where the cyst pierced the bone. This is what caused the pain and inflammation in the jaw.
A cyst is a protective reaction of the body, with the help of which the body is fenced off from a problem tooth. The primary cause of the problem is a broken piece of the tool that remained in the tooth when treating it 19 years ago. The tool remaining in the tooth creates the conditions for the inflammatory process.
This projection shows damage to the surface of the bone from a cyst.
(the hole you see on the left, just below - the site of the exit of the mandibular nerve)
Climbing on my computer, I found a picture from 2008. The first minor foci of the inflammatory process are already visible on it.
Such a problem must be monitored and if it passes into the cyst, it is removed.
Apparently, the last 5-6 years, the inflammatory process went into the active stage, but the inflammation was closed, I did not bother, and it seems that under weakened immunity, the process went from closed to acute.
On the appointed day I came to the clinic.
Here is the tooth itself. Outwardly, everything is fine, but inside, no.
4.1. They made anesthesia.
With one injection they anesthetized the whole jaw. The task of the dentist is to get into the nerve region and paralyze it. If the injection is not done correctly, then you will feel pain.
4.2. Proceed to the bore of the tooth, before removal.
The tooth is bored in a special way so that the removal is minimally injured. Boring a tooth, depending on how many roots it has.
After boring, take out in parts. My dentist (orthopedic therapist) was bore the tooth, and the rest of the operations were carried out by his colleague, an implantologist surgeon.
4.3. They took some blood.
3 small test tubes. How much blood, I find it difficult to answer.
And they lowered them into a centrifuge, at 2600 rpm for 12 minutes, to isolate the plasma, which will later be used for the manufacture of bone substance.
4.4. After taking the blood, we started to remove the tooth.
The procedure was completely painless: I could not imagine that the tooth is removed so easily and completely painlessly.
After the removal, I wanted to photograph parts of the extracted tooth, but the surgeon's assistant said that the tooth was already in the urn. So sorry, photos of parts of the tooth will not.
4.5. After tooth extraction, the cyst removal process has begun.
A protective film formed on the walls of the bone, which had to be scraped off the bone. This is necessary in order for the bone material to grow together qualitatively.
Personally, this procedure seemed a little unpleasant to me: at one moment my head began to feel dizzy, which I immediately reported. The procedure was immediately stopped and allowed me to catch my breath, to recover, to rest, after which they received confirmation of my readiness from me, and continued. As I was told: this sometimes happens and this does not need to be shy.
The cyst was large enough and before the start of the removal there was no understanding of whether the implant could be installed simultaneously. If the cyst is large, then the implant has nowhere to screw in and it is necessary to restore the bone first, and only then you can screw it in, but you will have to wait about 6-8 months until the bone is formed.
After the cyst was cleaned, we came to the conclusion that it is possible to install the implant immediately. Implant placement immediately after tooth extraction is called“Simultaneous implantation” and costs, as a rule, at 10,000 more expensive than two-stage implantation, when the implant is installed 6-8 months after tooth extraction.
Unfortunately, the photo here is terrible: the doctor took pictures on my phone and ... a person can be a very good doctor, but a bad photographer :)
4.6. We continue. Implant placement
First, drill a smaller hole, then more and more.
Several videos were shot, as 3840 x 2160 x @ 60, which combined into one movie.
In the end, the implant itself is already screwed in - serious physical force is already applied here: the implant is screwed at low speeds, with high pressure.
4.7. Restoration of the jawbone using bone mass.
After the implant was screwed in, a bone mass was prepared to fill the cavity in the jaw. To do this, they took my blood out of the centrifuge, which in tubes was divided into plasma (above) and erotricitic suspension (below).
Plasma was separated from the total mass, a substance was added, which is the mineral base for the future bone.
All cavities were filled with this mass.
Photo of the finished work A
rather large amount has gone: it seemed to me, about 3 cubic centimeters.
4.8. The final stages of restoration of the jawbone.
After filling with bone mass, the whole thing was covered with fibrin on top, and on top of the fibrin, the whole thing was covered with a collagen membrane on top. The fact is that if this is not done, the bone mass will constantly shift, the healing process is complicated, the mass grows worse with blood vessels, and the likelihood of infections increases significantly.
There are 2 main sources of membrane production:
Both options have their pros and cons: the finished material is stronger, but native biomaterial is native biomaterial, which is absorbed 100%, and the probability of rejection is within zero probability.
In my case, the second option was used - the manufacture of a membrane from my plasma.
Photo after the membrane was installed.
In the end, the whole thing was sewn with several seams.
Now it remains to wait until everything grows together, heals. After that, what will be eventually a tooth will be designed, manufactured and installed.
The fact is that installing an implant is far from a tooth.
An implant is the base that is screwed into the bone.
Further, what looks like a tooth is already put on this foundation: it can be either an integral structure or a collapsible one, consisting separately of an abutment and a crown.
One-stage is considered more effective than two-stage, since it is installed immediately in the bone, without the use of materials for bone growth. In this case, the implant survives better, holds on more firmly, and, as a result, is able to last longer (I’ll tell you about the life expectancy below).
However, the procedure of simultaneous implantation is more complicated: it is far from always possible to establish it perfectly, which is why in any case it is necessary to use an abutment, the form of which is ordered individually, which in turn additionally affects the cost of the procedure. Due to additional complexity and nuances, simultaneous implantation is more expensive.
7.1. If we begin to study the sites of dental clinics, we will see a fairly large selection. Here is a brief example: Mid-Moscow prices and these figures include an unlimited amount of anesthesia and all necessary supplies.
Brand A implant (Germany)
- simple - ₽ 19.800, one-time - ₽ 29.800
Brand B implant (Germany)
- simple - ₽ 35,000, one-stage - ₽ 45,000
Implant "Brand C" (Switzerland)
- simple - ₽ 40,000, one-stage - ₽ 50,000
Implant "Brand D" (Switzerland)
- simple - ₽ 55,000, one-time - ₽ 65,000
Seeing such a scatter, 20-35- 40-55 thousand, the question arises: what is the difference?
What is such an overpayment for and how much is it due to?
After a direct question to the implantologist, you are likely to get an answer, something like: “Brand D - is a leading leader in the field of prosthetics, which spends a lot of money on research and in fact creates this area. She has all the most advanced technologies, her implants are made better, take root better, live longer, etc. ”
Also, you will learn that all the accessories produced by the same“ Brand D ”are of higher quality than the accessories other manufacturers. Thanks to this, there are fewer gaps, less environment for the growth of bacteria, it is easier to maintain hygiene, etc.
In principle, he will be right, but there are nuances.
Indeed, the Swiss company “Brand D” is a pioneer in the field of implants: it conducts research, creates new technologies. But, there are other companies that study her research, then, purchase her products and clone her.
Yes, the quality is not so high as that of Brand D, but if we talk about specific figures, for example, survival rate, or service life, then everything here depends entirely on 2 factors:
1. Professionalism of the dentist.
When the dentist performs a one-time implantation for ₽ 65,000, then for sure, not a Yandex Food or Delivery Club courier is sitting in his chair, but a serious uncle. And in the event that the implantologist coughs up, it is likely that strong brothers will come into his office one evening, tie him to a chair and screw into his skull all the supplies of implants that were currently in the clinic.
Of course, I exaggerate a little, but the fact remains: his jamb can cost him a lot of money. Therefore, he will be more attentive to his work.
But if you take, for example, a specialist at level 75lvl who loves his job, who installed the Brand B implant for ₽35,000 and specialist at 60lvl who just does his job, who installed the implant Brand B for $ 55,000, then the first one will be more correct established, lower risk of rejection and will last longer than the second.
2. Your attitude to an artificial tooth.
In the first 2 months, you need to seriously change your lifestyle.
Do you smoke? Throw or seriously reduce the number of cigarettes.
Are you drinking Tie it up.
Seriously doing sports? Reduce workloads: it is not necessary to completely stop, but it is necessary to seriously reduce it.
If you used to brush your teeth poorly, you should change your attitude towards hygiene.
If you used to break nuts with your teeth - forget about it. For life.
As a result, after a thorough analysis, we get a rather interesting situation in which the brand of the implant manufacturer originally selected plays a meager role compared to the professionalism of the dentist and your attitude to the tooth.
By the way, if we talk about the life spans of implants, then all manufacturers call the term: "the implant serves as much as a real tooth."
In fact, the difference in quality between implants of different manufacturers is scanty. Here I will make a reservation right away that the phrase “different manufacturers” does not mean implants bought on Aliexpress, but ... if we project the situation on smartphone manufacturers, we get something like Apple, Samsung, LG, Lenovo, Huawei, Xiaomi, Meizu.
Leading companies, such as the same “Brand D”, annually invest crazy money in research and development. But they somehow need to recoup their costs - therefore, they are ultimately superimposed on the value of the products. In order not to go far, fot you a link to Forbes, clicking on which and reading the article, you will be greatly surprised.
If the implant is used by “second tier” manufacturers who don’t spend on research, but copy, whether it is black copies or licensed, then the absence of research costs is the key factor why their products are significantly cheaper.
7.3. As I wrote above, an implanted tooth consists of several parts.
So, famous brands have their own ecosystem, about the same as Apple: if their implant is used, then their accessories should be used, as well as their crowns.
Thus, a rather serious additional amount will be added to the cost of the implant, and the total cost of work may approach the mark of $ 200,000!
If the implant is used by manufacturers of the "second tier", then they do not have their own ecosystem and the opportunity arises to use a huge number of the same abutments and crowns of other manufacturers, which are not much inferior in quality to the famous manufacturers, but are significantly cheaper.
Before moving on to the numbers, I’ll say right away that you don’t need to discuss them, such as: “but in Mukhosransk you would be 2 times cheaper”.
At the clinic in which I underwent this procedure, more than half of the patients had people who had been treated for their teeth in Mukhosransk at half the price and now they are recovering the consequences of cheap work (in fact, in my case a similar situation happened).
The preliminary cost of the work is as follows:
(the cost of the work is indicated taking into account the personal discount)
+ tooth extraction - ₽0
+ simultaneous implantation of the Brand B system (Germany) - ₽45.000
+ bone mass production and restoration of the jaw bone - ₽15.000
+ manufacturing and installation of fibrin and a collagen membrane - ₽15.000
After 3 months:
+ installation of the healing abutment - ₽0
Another 10 days:
Temporary crown with a transocclusal screw - ₽12.000
This crown is used as a draft on which the future design is worked out and, most importantly, the bed for the individual formation of the gums for a permanent construction. The fact is that it is immediately impossible to foresee all the nuances, for example, features of the bite, chewing food and other points.
After another 15-30 days, a permanent construction is already set.
There were 2 options to choose from:
a) Permanent design with a transocclusion screw - ₽45,000
b) Individual zirconium abutment - ₽30,000
+ all-zirconium crown - ₽25,000 (we get a total of ₽55,000).
The second option, namely, the use of an individual zirconium abutment and an all-zirconium crown, is more preferable, as it simplifies the procedure of tooth installation (more accurate bite formation), and also, if, for example, the crown is damaged, it will be possible to order a new crown.
The total cost, including discounts, goes from ₽132.000 to ₽142.000. But since the second option was eventually selected, in my case, the cost is ₽142,000.
Plus ₽3,000 for medicines (it is described below).
Total ~ ₽145.000.
For one tooth.
... before I myself came across the topic of implants, I was more likely to relate to this: in my opinion, the cost of a tooth was about 4 times lower ...
Before agreeing to the procedure, I compared the prices with other Moscow clinics. In the process of analysis, I went over the sites of 8 clinics. After that, I personally visited 3 clinics located near the house, in which he asked me to paint the whole plan in more detail, in order to understand how much money I should prepare. As a result, the price spread turned out to be relatively small, approximately + -15%.
After finishing the whole procedure, I calmly returned to the office and continued my work.
After 10 hours: excellent condition. If I don’t open my mouth, it’s as if they didn’t do anything at all. This is most likely due to the fact that a very strong hormonal anesthesia was used, which works for about a day. I’ve finished the draft article and it’s time to sleep - tomorrow for work.
After a day: everything is fine, there is no pain. I do not drink additional painkillers. There is no tumor.
After 2 days: everything is fine, there is no pain. I do not drink additional painkillers. There is no tumor.
The wound heals.
On day 4, I was supposed to come for a follow-up examination, however, because of work, I could not, I arrived only on the 5th day. Status photo
There is no special secret that everything is going well, no: they gave me a list of medicines that I must take, as well as recommendations. Having received the list, I went to the nearest pharmacy, in which I left the pharmacist at the checkout the amount a little more than ₽3,000.
He put everything in a food container, which he found in a cabinet in the kitchen, which he put on the refrigerator. I accept everything strictly on the recommendation.
After some time, an artificial tooth will stand in place of the joints, which visually will not differ from my other teeth. In a few months there will be an addition to the article: I’ll tell you how the abutment and crown were designed, manufactured and installed. Accordingly, there will be an interesting addition to this article, along with real photos of the work done.
Who cares, I advise you to subscribe to it and periodically look into it.
Perhaps I missed some points that seem obvious to me, but at the same time they are not fully understood by other habrozhitelami. Therefore, if you have any questions, write in the comments and I will definitely supplement the article.
I am an IT specialist, technical director and patient of the described process.
Velibekov Elman Sabirovich, an orthopedic therapist who has been leading my teeth for the past 15 years.
+ preliminary boring of a tooth before removal;
+ all other work related to the abutment and crown (future continuation of the article).
Nebezhev Zaur Babievich, an implantologist surgeon who performed for me:
+ tooth extraction;
+ cyst removal;
+ implantation;
+ bone restoration;
+ membrane installation and final seams.
Venue: "32 Pearls."
06/01/19. 20:59.
I asked the doctor if I could remove the stitches myself, because on Monday the day will be very busy and I will not be able to escape to it. Got an answer:
So, soon a couple more photos will appear in the article, the process of self-removal of stitches.
06/01/19. 23:55.
After reading the comments on this article, the doctor decided for me at the same price to put a gold metal-ceramic crown on an individual gold abutment.
And why this is the best solution - I will tell in one of the future articles.
06/03/19. 5 p.m.
It's time to remove the stitches. Due to the busy schedule, it was not possible to go to the surgeon for removal, and therefore received the approval from him, I decided to remove it myself.
He took his wife’s manicure scissors in one hand, in the other tweezers, which came with a soldering iron ordered from Aliexpress (he had previously sanitized everything: a gum with peroxide and Tantum Verde, and tools with chlorhexidine)
habrastorage.org/webt/qo/ll/a0 /qolla0n-8akdj8sivryv2qiezqu.jpeg
After 5 minutes, the
Desna threads cut from the seams were lying on a napkin after removing the seams.
By the way, on the left, “six” and “seven” were cured by the same doctor, 15 years ago. Since then, fillings have survived about 10-12 AirFlow + Ultrasound procedures.
This is the first stage completed.
In a few months, the second stage is ahead, which I will tell you about.
Today I will tell my story how I had to install the implant and how it really was. I decided to tell my story because the information that is posted on the Internet does not correspond to reality, and sometimes it contradicts.
The purpose of this article: to tell by example how modern dentistry really is, how the implantation of an artificial tooth takes place, and what you should be prepared for.
Attention! The publication contains images that can cause unpleasant emotions in readers. If you are an impressionable person, do not read the article for food.
We also remind you that it is not necessary to take the mentioned drugs without consulting a doctor.
Moderator .
Shortly about myself
I am soon 37 years old. Until recently, I boasted that I had all my 32 teeth in place. And indeed, few have all their teeth in place by this age. (and, in principle, nothing surprising: I tried to figure out the costs of dentists, based on today's rates and the amount came out in excess of $ 7.000 or over ₽450.000).
Please note that in the article photographs of the process and the faint of heart I advise you not to look.
Some of the photos are not of the best quality, since the whole process was photographed on mobile phones, but most importantly: all the photos and videos are exclusively mine.
1. Foreword
At the end of April, I seriously caught a cold, inflammation of the bronchi began. Together with him, severe pain in the lower jaw began, on the left. I did not attach much importance to the pains, thinking, probably, I got a nerve. Due to inflammation of the bronchi, he injected antibiotics for several days, and the pain in the jaw was drowned out first by Ketorol (a couple of tablets remained), and then by Nimesil.
A week later, the pain subsided and I could already do without painkillers. However, a week later, when probing with my fingers, I felt a seal in the gum.
And then I realized: something went wrong ... I turned to my dentist with this question, who has been observing for the last 15 years. He reminded me that in that area there is a problem with the root of the tooth and recommended taking a picture.
2. Preliminary diagnosis
The direction to the picture was sent to me in Viber, showed it to a laboratory employee and she pointed her finger at which fields to fill in the application. It was necessary to take a picture in the Vatech program.
The picture was given to me on disk, and they also sent a link to download it by e-mail. Along with the picture was attached a program in which you can view this picture. Naturally, I installed the program and began to look for pictures, trying to understand what is shown on them.
This picture shows that a cyst has formed around the root of the tooth, which is filled with blood mass.
If you look closely at this picture, you can see the area where the cyst pierced the bone. This is what caused the pain and inflammation in the jaw.
3. The cause of the problem
A cyst is a protective reaction of the body, with the help of which the body is fenced off from a problem tooth. The primary cause of the problem is a broken piece of the tool that remained in the tooth when treating it 19 years ago. The tool remaining in the tooth creates the conditions for the inflammatory process.
This projection shows damage to the surface of the bone from a cyst.
(the hole you see on the left, just below - the site of the exit of the mandibular nerve)
Climbing on my computer, I found a picture from 2008. The first minor foci of the inflammatory process are already visible on it.
Such a problem must be monitored and if it passes into the cyst, it is removed.
Apparently, the last 5-6 years, the inflammatory process went into the active stage, but the inflammation was closed, I did not bother, and it seems that under weakened immunity, the process went from closed to acute.
4. A trip to the clinic
On the appointed day I came to the clinic.
Here is the tooth itself. Outwardly, everything is fine, but inside, no.
4.1. They made anesthesia.
With one injection they anesthetized the whole jaw. The task of the dentist is to get into the nerve region and paralyze it. If the injection is not done correctly, then you will feel pain.
4.2. Proceed to the bore of the tooth, before removal.
The tooth is bored in a special way so that the removal is minimally injured. Boring a tooth, depending on how many roots it has.
After boring, take out in parts. My dentist (orthopedic therapist) was bore the tooth, and the rest of the operations were carried out by his colleague, an implantologist surgeon.
4.3. They took some blood.
3 small test tubes. How much blood, I find it difficult to answer.
And they lowered them into a centrifuge, at 2600 rpm for 12 minutes, to isolate the plasma, which will later be used for the manufacture of bone substance.
4.4. After taking the blood, we started to remove the tooth.
The procedure was completely painless: I could not imagine that the tooth is removed so easily and completely painlessly.
After the removal, I wanted to photograph parts of the extracted tooth, but the surgeon's assistant said that the tooth was already in the urn. So sorry, photos of parts of the tooth will not.
4.5. After tooth extraction, the cyst removal process has begun.
A protective film formed on the walls of the bone, which had to be scraped off the bone. This is necessary in order for the bone material to grow together qualitatively.
Personally, this procedure seemed a little unpleasant to me: at one moment my head began to feel dizzy, which I immediately reported. The procedure was immediately stopped and allowed me to catch my breath, to recover, to rest, after which they received confirmation of my readiness from me, and continued. As I was told: this sometimes happens and this does not need to be shy.
The cyst was large enough and before the start of the removal there was no understanding of whether the implant could be installed simultaneously. If the cyst is large, then the implant has nowhere to screw in and it is necessary to restore the bone first, and only then you can screw it in, but you will have to wait about 6-8 months until the bone is formed.
After the cyst was cleaned, we came to the conclusion that it is possible to install the implant immediately. Implant placement immediately after tooth extraction is called“Simultaneous implantation” and costs, as a rule, at 10,000 more expensive than two-stage implantation, when the implant is installed 6-8 months after tooth extraction.
Unfortunately, the photo here is terrible: the doctor took pictures on my phone and ... a person can be a very good doctor, but a bad photographer :)
4.6. We continue. Implant placement
First, drill a smaller hole, then more and more.
Several videos were shot, as 3840 x 2160 x @ 60, which combined into one movie.
In the end, the implant itself is already screwed in - serious physical force is already applied here: the implant is screwed at low speeds, with high pressure.
4.7. Restoration of the jawbone using bone mass.
After the implant was screwed in, a bone mass was prepared to fill the cavity in the jaw. To do this, they took my blood out of the centrifuge, which in tubes was divided into plasma (above) and erotricitic suspension (below).
Plasma was separated from the total mass, a substance was added, which is the mineral base for the future bone.
All cavities were filled with this mass.
Photo of the finished work A
rather large amount has gone: it seemed to me, about 3 cubic centimeters.
4.8. The final stages of restoration of the jawbone.
After filling with bone mass, the whole thing was covered with fibrin on top, and on top of the fibrin, the whole thing was covered with a collagen membrane on top. The fact is that if this is not done, the bone mass will constantly shift, the healing process is complicated, the mass grows worse with blood vessels, and the likelihood of infections increases significantly.
There are 2 main sources of membrane production:
- Purchase of finished material. There are a number of manufacturers who offer a turnkey solution.
- Use as a material coagulated patient plasma.
Both options have their pros and cons: the finished material is stronger, but native biomaterial is native biomaterial, which is absorbed 100%, and the probability of rejection is within zero probability.
In my case, the second option was used - the manufacture of a membrane from my plasma.
Photo after the membrane was installed.
In the end, the whole thing was sewn with several seams.
5. General theory and practice
Now it remains to wait until everything grows together, heals. After that, what will be eventually a tooth will be designed, manufactured and installed.
The fact is that installing an implant is far from a tooth.
An implant is the base that is screwed into the bone.
Further, what looks like a tooth is already put on this foundation: it can be either an integral structure or a collapsible one, consisting separately of an abutment and a crown.
6. One-stage and two-stage implantation
One-stage is considered more effective than two-stage, since it is installed immediately in the bone, without the use of materials for bone growth. In this case, the implant survives better, holds on more firmly, and, as a result, is able to last longer (I’ll tell you about the life expectancy below).
However, the procedure of simultaneous implantation is more complicated: it is far from always possible to establish it perfectly, which is why in any case it is necessary to use an abutment, the form of which is ordered individually, which in turn additionally affects the cost of the procedure. Due to additional complexity and nuances, simultaneous implantation is more expensive.
7. A few words about the implants themselves
7.1. If we begin to study the sites of dental clinics, we will see a fairly large selection. Here is a brief example: Mid-Moscow prices and these figures include an unlimited amount of anesthesia and all necessary supplies.
Brand A implant (Germany)
- simple - ₽ 19.800, one-time - ₽ 29.800
Brand B implant (Germany)
- simple - ₽ 35,000, one-stage - ₽ 45,000
Implant "Brand C" (Switzerland)
- simple - ₽ 40,000, one-stage - ₽ 50,000
Implant "Brand D" (Switzerland)
- simple - ₽ 55,000, one-time - ₽ 65,000
Seeing such a scatter, 20-35- 40-55 thousand, the question arises: what is the difference?
What is such an overpayment for and how much is it due to?
After a direct question to the implantologist, you are likely to get an answer, something like: “Brand D - is a leading leader in the field of prosthetics, which spends a lot of money on research and in fact creates this area. She has all the most advanced technologies, her implants are made better, take root better, live longer, etc. ”
Also, you will learn that all the accessories produced by the same“ Brand D ”are of higher quality than the accessories other manufacturers. Thanks to this, there are fewer gaps, less environment for the growth of bacteria, it is easier to maintain hygiene, etc.
In principle, he will be right, but there are nuances.
Indeed, the Swiss company “Brand D” is a pioneer in the field of implants: it conducts research, creates new technologies. But, there are other companies that study her research, then, purchase her products and clone her.
Yes, the quality is not so high as that of Brand D, but if we talk about specific figures, for example, survival rate, or service life, then everything here depends entirely on 2 factors:
- Professionalism of an implantologist.
- Your attitude to an artificial tooth.
1. Professionalism of the dentist.
When the dentist performs a one-time implantation for ₽ 65,000, then for sure, not a Yandex Food or Delivery Club courier is sitting in his chair, but a serious uncle. And in the event that the implantologist coughs up, it is likely that strong brothers will come into his office one evening, tie him to a chair and screw into his skull all the supplies of implants that were currently in the clinic.
Of course, I exaggerate a little, but the fact remains: his jamb can cost him a lot of money. Therefore, he will be more attentive to his work.
But if you take, for example, a specialist at level 75lvl who loves his job, who installed the Brand B implant for ₽35,000 and specialist at 60lvl who just does his job, who installed the implant Brand B for $ 55,000, then the first one will be more correct established, lower risk of rejection and will last longer than the second.
2. Your attitude to an artificial tooth.
In the first 2 months, you need to seriously change your lifestyle.
Do you smoke? Throw or seriously reduce the number of cigarettes.
Are you drinking Tie it up.
Seriously doing sports? Reduce workloads: it is not necessary to completely stop, but it is necessary to seriously reduce it.
If you used to brush your teeth poorly, you should change your attitude towards hygiene.
If you used to break nuts with your teeth - forget about it. For life.
As a result, after a thorough analysis, we get a rather interesting situation in which the brand of the implant manufacturer originally selected plays a meager role compared to the professionalism of the dentist and your attitude to the tooth.
By the way, if we talk about the life spans of implants, then all manufacturers call the term: "the implant serves as much as a real tooth."
7.2. Additional factors affecting the cost of implants
In fact, the difference in quality between implants of different manufacturers is scanty. Here I will make a reservation right away that the phrase “different manufacturers” does not mean implants bought on Aliexpress, but ... if we project the situation on smartphone manufacturers, we get something like Apple, Samsung, LG, Lenovo, Huawei, Xiaomi, Meizu.
Leading companies, such as the same “Brand D”, annually invest crazy money in research and development. But they somehow need to recoup their costs - therefore, they are ultimately superimposed on the value of the products. In order not to go far, fot you a link to Forbes, clicking on which and reading the article, you will be greatly surprised.
If the implant is used by “second tier” manufacturers who don’t spend on research, but copy, whether it is black copies or licensed, then the absence of research costs is the key factor why their products are significantly cheaper.
7.3. As I wrote above, an implanted tooth consists of several parts.
So, famous brands have their own ecosystem, about the same as Apple: if their implant is used, then their accessories should be used, as well as their crowns.
Thus, a rather serious additional amount will be added to the cost of the implant, and the total cost of work may approach the mark of $ 200,000!
If the implant is used by manufacturers of the "second tier", then they do not have their own ecosystem and the opportunity arises to use a huge number of the same abutments and crowns of other manufacturers, which are not much inferior in quality to the famous manufacturers, but are significantly cheaper.
8. The total cost of work
Before moving on to the numbers, I’ll say right away that you don’t need to discuss them, such as: “but in Mukhosransk you would be 2 times cheaper”.
At the clinic in which I underwent this procedure, more than half of the patients had people who had been treated for their teeth in Mukhosransk at half the price and now they are recovering the consequences of cheap work (in fact, in my case a similar situation happened).
The preliminary cost of the work is as follows:
(the cost of the work is indicated taking into account the personal discount)
+ tooth extraction - ₽0
+ simultaneous implantation of the Brand B system (Germany) - ₽45.000
+ bone mass production and restoration of the jaw bone - ₽15.000
+ manufacturing and installation of fibrin and a collagen membrane - ₽15.000
After 3 months:
+ installation of the healing abutment - ₽0
Another 10 days:
Temporary crown with a transocclusal screw - ₽12.000
This crown is used as a draft on which the future design is worked out and, most importantly, the bed for the individual formation of the gums for a permanent construction. The fact is that it is immediately impossible to foresee all the nuances, for example, features of the bite, chewing food and other points.
After another 15-30 days, a permanent construction is already set.
There were 2 options to choose from:
a) Permanent design with a transocclusion screw - ₽45,000
b) Individual zirconium abutment - ₽30,000
+ all-zirconium crown - ₽25,000 (we get a total of ₽55,000).
The second option, namely, the use of an individual zirconium abutment and an all-zirconium crown, is more preferable, as it simplifies the procedure of tooth installation (more accurate bite formation), and also, if, for example, the crown is damaged, it will be possible to order a new crown.
The total cost, including discounts, goes from ₽132.000 to ₽142.000. But since the second option was eventually selected, in my case, the cost is ₽142,000.
Plus ₽3,000 for medicines (it is described below).
Total ~ ₽145.000.
For one tooth.
... before I myself came across the topic of implants, I was more likely to relate to this: in my opinion, the cost of a tooth was about 4 times lower ...
Before agreeing to the procedure, I compared the prices with other Moscow clinics. In the process of analysis, I went over the sites of 8 clinics. After that, I personally visited 3 clinics located near the house, in which he asked me to paint the whole plan in more detail, in order to understand how much money I should prepare. As a result, the price spread turned out to be relatively small, approximately + -15%.
Why did the choice fall on this particular clinic and I didn’t look for who would make all this work cheaper?
Выбор пал не столько на клинику, сколько на конкретного доктора.
Познакомил меня с ним мой дальний родственник, работающий зуботехником, занимающийся изготовлением коронок. Он охарактеризовал данного стоматолога как: «конкретный геморройщик, который вечно к чему-то придирается, требует невозможного, из-за чего нередко приходится переделывать изготовленные для него коронки».
После того, как данный стоматолог в 2003 году приехал к ним лично в лабораторию и устроил скандал, с применением нецензурной брани в адрес изготовленной коронки, требуя третью переделку, они познакомились лично. После данного скандала, этот зуботехник сам у этого стоматолога начал лечить свои зубы.».
Познакомил меня с ним мой дальний родственник, работающий зуботехником, занимающийся изготовлением коронок. Он охарактеризовал данного стоматолога как: «конкретный геморройщик, который вечно к чему-то придирается, требует невозможного, из-за чего нередко приходится переделывать изготовленные для него коронки».
После того, как данный стоматолог в 2003 году приехал к ним лично в лабораторию и устроил скандал, с применением нецензурной брани в адрес изготовленной коронки, требуя третью переделку, они познакомились лично. После данного скандала, этот зуботехник сам у этого стоматолога начал лечить свои зубы.».
9. Current situation with my implant
After finishing the whole procedure, I calmly returned to the office and continued my work.
After 10 hours: excellent condition. If I don’t open my mouth, it’s as if they didn’t do anything at all. This is most likely due to the fact that a very strong hormonal anesthesia was used, which works for about a day. I’ve finished the draft article and it’s time to sleep - tomorrow for work.
After a day: everything is fine, there is no pain. I do not drink additional painkillers. There is no tumor.
After 2 days: everything is fine, there is no pain. I do not drink additional painkillers. There is no tumor.
The wound heals.
On day 4, I was supposed to come for a follow-up examination, however, because of work, I could not, I arrived only on the 5th day. Status photo
There is no special secret that everything is going well, no: they gave me a list of medicines that I must take, as well as recommendations. Having received the list, I went to the nearest pharmacy, in which I left the pharmacist at the checkout the amount a little more than ₽3,000.
He put everything in a food container, which he found in a cabinet in the kitchen, which he put on the refrigerator. I accept everything strictly on the recommendation.
10. Epilogue
After some time, an artificial tooth will stand in place of the joints, which visually will not differ from my other teeth. In a few months there will be an addition to the article: I’ll tell you how the abutment and crown were designed, manufactured and installed. Accordingly, there will be an interesting addition to this article, along with real photos of the work done.
Who cares, I advise you to subscribe to it and periodically look into it.
Perhaps I missed some points that seem obvious to me, but at the same time they are not fully understood by other habrozhitelami. Therefore, if you have any questions, write in the comments and I will definitely supplement the article.
11. Cast
I am an IT specialist, technical director and patient of the described process.
Velibekov Elman Sabirovich, an orthopedic therapist who has been leading my teeth for the past 15 years.
+ preliminary boring of a tooth before removal;
+ all other work related to the abutment and crown (future continuation of the article).
Nebezhev Zaur Babievich, an implantologist surgeon who performed for me:
+ tooth extraction;
+ cyst removal;
+ implantation;
+ bone restoration;
+ membrane installation and final seams.
Venue: "32 Pearls."
12. Updates
06/01/19. 20:59.
I asked the doctor if I could remove the stitches myself, because on Monday the day will be very busy and I will not be able to escape to it. Got an answer:
So, soon a couple more photos will appear in the article, the process of self-removal of stitches.
06/01/19. 23:55.
After reading the comments on this article, the doctor decided for me at the same price to put a gold metal-ceramic crown on an individual gold abutment.
And why this is the best solution - I will tell in one of the future articles.
06/03/19. 5 p.m.
It's time to remove the stitches. Due to the busy schedule, it was not possible to go to the surgeon for removal, and therefore received the approval from him, I decided to remove it myself.
He took his wife’s manicure scissors in one hand, in the other tweezers, which came with a soldering iron ordered from Aliexpress (he had previously sanitized everything: a gum with peroxide and Tantum Verde, and tools with chlorhexidine)
habrastorage.org/webt/qo/ll/a0 /qolla0n-8akdj8sivryv2qiezqu.jpeg
After 5 minutes, the
Desna threads cut from the seams were lying on a napkin after removing the seams.
By the way, on the left, “six” and “seven” were cured by the same doctor, 15 years ago. Since then, fillings have survived about 10-12 AirFlow + Ultrasound procedures.
This is the first stage completed.
In a few months, the second stage is ahead, which I will tell you about.