Generally, before implant treatment, in order to avoid related risks and unnecessary complications, it is generally necessary to exclude contraindications.
First of all, we must understand the patient’s past and current medical history, including the following aspects:
- Systemic disease;
- Mental symptoms;
- Infectious diseases;
- History of allergies;
- Poor oral habits;
Usually, contraindications are divided into absolute contraindications and relative contraindications. Absolute contraindications are defined as: systemic medication or systemic disease damaging the body’s bone regeneration ability, leading to increased bone healing and bone tuberculosis risk after implant implantation.
Up to now, many dental implant manufacturers and dentists have regarded intravenous infusion of bisphosphonates as an absolute contraindication. The drug can be deposited in the bone tissue for a long time which is the main cause of osteonecrosis. Bone tissue releases high concentrations of bisphosphonates, causing osteoclast dysfunction, which destroys the process of bone healing and new bone formation, and is toxic to soft tissues.
It is generally recommended that patients who take oral bisphosphonic acid should stop taking the drug for 4 months and observe until the bone heals in the operation area, and then choose minimally invasive surgery.
Among the relative risk factors, the relatively common ones are as follows:
Diastolic blood pressure ≥90mmHg, systolic blood pressure ≥140mmHg, usually we divided it into 3 levels:
- Mild (140~159)/(90~99) mmHg
- Moderate (160~179)/(100~109) mmHg
- Severely ≥180/≥110mmHg
For mild hypertension patients, implant surgery can be performed. For reasons such as emotional stress or increased blood pressure, sedative drugs can be taken one hour before surgery.
Patients with moderate hypertension should control their blood pressure within the range of normal or mild hypertension for implant surgery.
In addition, in the choice of anesthetics, since epinephrine can raise blood pressure, avoid choosing anesthesia containing epinephrine during the operation.
If you are a hyperglycemic patient, you can’t use simple current blood glucose parameters as an indicator. Peripheral blood glycated hemoglobin should be tested. The normal value is 4% to 6%.
3. Glenn Syndrome
An autoimmune disease involving mainly exocrine glands, mainly invading lacrimal glands and salivary glands, manifested as keratoconjunctivitis sicca, dry mouth and associated rheumatoid arthritis.
Due to the decreased secretion of salivary glands, loss of bacteriostatic enzyme activity, dental caries, and other oral inflammations, these patients have a high risk of implantation, prone to implant loss and peri-implant inflammation.
4. Cardiovascular Disease
If angina pectoris occurs frequently or within the past 3 months, implant surgery should be delayed. If myocardial infarction, cerebral embolism, or stroke occurs in the past 6 months, implant surgery should not be applied.
5. Blood Diseases
Anemia is one of the longest blood diseases, which can cause bone density reduction, abnormal bleeding, postoperative infection, and inflammation. Generally, it is recommended that hemoglobin is above 10mg/dL and implant surgery can be performed.
For platelet diseases and liver diseases, because of the high risk of surgery, corrective treatment is required before surgery, and the physician should be consulted on whether surgery can be performed and then the surgery plan will be made.
The first to third and seventh to ninth months of pregnancy are relative contraindications to implantation.
The implantation failure rate of smoking patients is 250% higher than that of non-smokers.
It is recommended that girls over the age of 18 and boys over the age of 19 can receive implant surgery.