Is there a non-surgical dental implant without a gum incision?

The authors | Last update: 2019

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Next you will learn:

Is there really non-surgical implantation of teeth, during which the implant is installed in the jaw without a gum section?
What is actually understood today as non-surgical implantation and what the advertisement of clinics is bashfully silent about;
What is express implantation and what advantages does it give in comparison with the classical technique;
Is it possible to implant implants through a puncture in the gum and what are the features of transgingival implantation;
What dental implantation technique is still better and what is useful to know about prices.

Perhaps, from the very moment the technology of dental implantation appeared and up to the present there are certain myths associated with fears of implant placement: it’s generally accepted by default that this procedure is very painful and traumatic. Recently, however, references to the so-called non-surgical implantation of teeth have come across more and more often, and it is claimed that implants are installed without a gum incision.

It looks very tempting, but is it believable? After all, it would seem how this is possible: implants should be installed in the jaw bone, and there are soft gum tissues above this bone. And how, one wonders, can this same dental implant be inserted into the bone without cutting the gum?

Let's try to understand all the intricacies of this problem, and see if there really is a completely painless and non-traumatic non-surgical implantation of teeth, which implies the complete absence of gum cuts and the installation of the implant in the jaw in some special way ...

Dental implants without gingival incisions: myth or reality?

Generally speaking, the so-called non-surgical implantation of teeth, that is, carried out without classical gum cutting, has many alternative names:

Transgingival implantation;
Minimally invasive;
Seamless
Bloodless;
Endoscopic;
Laser

In addition, in some cases, dental clinics may also use the following names when positioning “non-surgical implantation”:

Express implantation;
Momentary;
Immediate
One-stage.

It is important to understand that dentists most often use the term “rapid implantation” (and similar ones from the second group) in order to characterize the process of installing dental implants in one visit - usually immediately after tooth extraction. That is, in this case, you don’t need to cut anything, because an open wound gapes in the gum after extraction of the diseased tooth, ready (though not always) to install the implant with the gum shaper fixed on it.

As for transgingival implantation - if you read the advertising materials, it is performed through the so-called "puncture" of the gums. In fact, the most true incision is made in the form of a circle with the help of a circular mucotome. That is, although the advertisement says that the implantation is non-surgical, and that, they say, is performed without an incision, but only through a “puncture”, however, strictly speaking, there is a small operation with a circular incision of the gums.

This is the beauty of advertising - if the incision is not a classic longitudinal one, then why not call it not a cut at all, but a puncture. After all, the "cut" - it sounds somehow frightening, but the "puncture" is a completely different matter ...

On a note

However, regardless of whether the implantation of the teeth is performed “non-operatively”, or according to the classical technology, in any case today this process is not highly traumatic, and in the vast majority of cases everything can be done without terrible wounds and cutting pieces of the jaw.

Do not confuse dental implants with complicated surgical operations on the maxillofacial area after severe accidents and injuries, when doctors restore the jaw, face and teeth of the patient literally bit by bit, like a puzzle.

Benefits of Express Implantation

Immediate dental implantation (that is, immediately after extraction of a diseased tooth) is gaining more and more popularity every year. For some specialists in this field, the number of immediate implants is 40-50% of the total volume of work, and the success of such operations directly depends on the professionalism of the doctor and the availability of necessary equipment in the dental clinic.

Before speaking about the many advantages of immediate implantation, we recall once again that this process is called non-surgical, as they say, “language does not turn around”. And yes, there may not be a gingival incision, since it is not needed, because a fresh hole in a tooth that has just been removed is often already suitable for implant placement without additional manipulations with a scalpel.

It is important to note the fact that not all and not in all cases such a simultaneous procedure is suitable. Example: suppose, for some reason, the patient would like to have implants installed immediately after tooth extraction (advertising, acceptable cost, little time, etc.), and the doctor sees that there are signs of acute inflammation in the tooth extraction area . In this case, the success of the event, to put it mildly, is doubtful, and it is important for the doctor to explain this to the patient.

With severe bone deficiency in the implantation zone against the background of severe periodontitis or periodontal cysts, it is also impossible to remove a tooth and install implants at a time (due to the presence of direct contraindications to this procedure).

On a note

It is also possible to note cases that are not associated with contraindications for immediate implantation, but are closely related to the presence or absence of appropriate equipment and tools. Not all clinics have the appropriate equipment, as well as not all doctors have the technology of implant placement at once.

When there are no contraindications for immediate implantation, and the doctor has the necessary experience and technical support, then the procedure provides significant advantages over classical implantation:

In the case of simultaneous implantation, tooth extraction, installation of an implant and a gum former are performed in one visit to the clinic;
Lower cost (including in connection with the above item);
In the area of tooth extraction, bone deficiency does not have time to form due to a prolonged absence of chewing load. This means that the installation of the implant does not require a sinus lift operation (bone extension);
The success rate is about 99%;
It is easier for the doctor to adjust the implant in the space of a fresh hole, which helps to correctly calculate and control the installation process, and this, in turn, has a positive effect on the final result and ease of use of future orthopedic structures (bridges, crowns, etc.).

It is also useful to read: About basal implantation: consider all the pros and cons of this technology

Features of transgingival implantation and its stages

As noted above, transgingival implantation of teeth is positioned today by some clinics as the technology of installing dental implants without cutting the gums, that is, through a puncture of the mucosa. What this “puncture” is, we have already figured out - in reality, in reality, a puncture is called a circular incision of the gum using a mucotome.

In contrast to the classical technique, during transgingival implantation, soft tissue injuries are less significant - the incision looks very neat, almost the diameter of the gum former installed on the abutment of the implant. That is, an “implant without surgery” is, of course, a myth and an advertising ploy, but with minimal trauma to the gum tissue, implantation is quite possible.

On a note

The fact that the gum during “non-surgical” implantation is minimally injured does not at all preclude the need for drilling the jaw bone using a consistent set of cutters. After all, the leg of the implant is a kind of titanium screw that you need to literally screw into the hole.

Accordingly, after performing a circular incision with a mucotome and removing the excised gingival circle, a completely standard stage of preparing the hole for implant placement follows - expansion and deepening of the cutters.

If the implant installation is carried out without special surgical templates, then it consists of the following main steps, which are carried out on the same day:

A circular cut is performed (“puncture”);
The hole expands to the desired diameter and deepens;
Then follows the installation of the implant and control the depth of its introduction;
After this, the gingiva former is installed;
In conclusion, the patient fulfills the recommendations prescribed by the doctor (antibiotic therapy, sparing regimen, etc.).

Feedback

“Six months ago I learned from a friend that there are such dental implants that can be installed immediately after tooth extraction. Two teeth did not give me life, I had to go, although I am panicky afraid of even one kind of drill. It lasted about 30 minutes, and the teeth were quickly removed altogether. Everything was done under an injection, so I just drove back and forth with my eyes and did not feel pain. They installed implants instead of teeth, prescribed painkillers, an antibiotic, and even little things. Then the gums ached a little when the freeze passed, but in the morning everything became normal. After 4 months, the implants took root, they made beautiful crowns, so now I eat everything ... ”

Oksana, St. Petersburg

Thanks to the less traumatic transgingival method of implant administration, almost always 1-2 days after the patient’s follow-up examination, most of the appointments are canceled. This is done if there are no pains, swelling, hanging temperature, etc. Compared to the classical implantation technique, the “non-surgical” (transgingival) method of introducing implants is characterized by a reduced likelihood of developing any complications (after all, the smaller the wound, the less chance of problems due to the bacterial factor).

Speaking about non-surgical implantation of teeth, one should probably also mention the intra-mucosal implantation, which is used to improve the fixation conditions of a removable denture. Intra mucous implants consist of two parts: the first is implanted in the thickness of the mucous membrane, and the second is installed on a removable prosthesis (that is, these two parts of the implant work like buttons on clothes). Usually, 1-2 intramucosal implants are not enough for stable retention of the prosthesis, and usually at least 10 are required.

After determining the thickness of the mucosa, the points where the implants will be implanted are outlined - these points are in accordance with the protruding parts of the implant on the prosthesis. Then, using local anesthesia with a spherical boron, the necessary number of beds in the mucous membrane is made, where the implants are installed.

Removable prostheses on intra-mucous implants are worn constantly, and they are removed only for the hygiene of the prosthesis and oral cavity.

Where the truth ends and the advertisement begins: the disadvantages of non-surgical implantation

Perhaps the biggest drawback of the so-called “non-surgical” implantation is, however paradoxical it may sound, too exaggerated advantages. Here are some very controversial points of view from a medical point of view.

It is also useful to read: Swedish implants Astra Tech

Firstly, any surgical intervention associated with artificial tissue damage is considered an operation, even if it is performed in the most gentle way and without suturing. So cutting out a piece of gum and subsequent drilling of the jawbone is difficult to call an operation.

Secondly, the method of implant placement immediately after tooth extraction (if we talk about rapid dental implantation) is far from suitable in all clinical cases.For example, it is impossible to carry out immediate implantation in the acute inflammatory process, severe pain, swelling near the tooth being removed, as well as a significant bone deficiency and the inability to provide primary stabilization of the implant.

Moreover, even if, according to unofficial statistics, simultaneous dental implants can be performed in 40-50% of cases from all visits, the doctor sometimes simply can not cope with this task. It's simple: not always the dentist-surgeon manages to remove the tooth gently (atraumatically), and as a result, the "mutilated" hole is no longer suitable for simultaneous implantation. If the dentist begins to carry out such an implantation contrary to common sense and indications, then its success is minimal.

So, dental implantation without gum cuts, strictly speaking, does not exist: to cut the gum with something and somehow still have to. Another thing is that there are special tools that can make accurate circular cuts, the diameter of which is minimal.

But here there are pitfalls, and in a significant number of cases, transgingival implantation can be problematic for a number of reasons:

The doctor is not fully aware of the clinical situation (he sees the patient for the first time and has not led him before);
Small volumes of bone tissue and mucous membrane;
Atrophy of the alveolar ridge.

Equally important is the experience and qualification of the doctor. The bottom line is that dental implantation is tied not only to equipment and instruments, but also to the skill of the surgeon.

So what is the best implant placement technique?

In fact, there is no ideal dental implant technique. And to decide whether to choose a classic implantation, “non-surgical”, basal or some other - it is advisable not based on advertising or reviews on the Internet (often also advertising), but in close cooperation with a good doctor who you really trust. There is no such doctor in mind? Well, then you need to find, and already together with him to determine what is best suited exactly in your situation.

To chase after non-surgical implantation just because the gum section is supposedly not being made is not worth much.

On a note

Separately, it is worth mentioning the so-called laser tooth implantation, which is positioned as a less traumatic procedure. Whether an ordinary scalpel or laser scalpel will be used, an incision is still necessary. However, the use of a laser scalpel allows you to make a bloodless section of the gum (and this is just the case when the term "bloodless implantation" is more or less correct).

Proponents of laser implantation rightly point out a number of advantages of this technology: accurate incisions without blood, disinfection of the implant placement zone, shorter wound healing time and, as a result, a reduced risk of complications.

A few words about prices

The cost of dental implantation, including “non-surgical”, is influenced by many factors: from the level of the clinic, the type of implants used, and ending with the number of diplomas from the implantologist who will work with you. However, if the installation of implants is carried out in one step (simultaneously with the extraction of the tooth), then this usually somewhat reduces the price of the procedure compared to the classical two-stage implantation.

However, sometimes this rule may not work. For example, you may need to use expensive surgical templates or 3D modeling. Surgical templates are made according to the imprints of the jaws and allow you to accurately plan the placement of implants, the depth of their immersion, etc. 3D modeling technology allows you to virtually plan the upcoming operation, taking into account its smallest details and significantly reducing the likelihood of a medical error.

All these nuances contribute to the final price for dental implants, sometimes quite a lot.

In order not to overpay for unnecessary manipulations, it is always worth first to carefully and comprehensively examine the clinic where the implantation is to be performed, and trust a professional for whom more than one hundred grateful patients can vouch.

It is especially important to listen to the advice of your doctor regarding further tactics. If an implantologist does not recommend immediate or transgingival implantation, but offers a classic delayed technique, then it makes sense to listen to advice rather than seek another clinic and another doctor who, in pursuit of commercial benefits, will be ready to turn a blind eye to certain contraindications and associated risks.