Air travel after sinus lift and bone grafting

How to avoid complications after implantation

• How to behave after surgery
• Postoperative nutrition
• How long does it take to heal?
• How are sutures removed?
• Postoperative complications
• Swelling after dental implantation
• Inflammation and temperature
• Numbness
• Antibiotics after implantation
• Simultaneous (immediate) implantation

During implantation, the dentist places an artificial tooth root into the gum, which then becomes the basis for a removable or fixed denture. The operation is always complex and multi-stage, and to achieve success it requires the joint work of the doctor and the patient. Even at the current level of development of medicine, it is impossible to completely guarantee the absence of complications: aching pain, hematomas, swelling, bleeding, infection, fever. It is also possible for the implant to fail.

But if you follow the recommendations, it will be easier to avoid complications, and the implant will take root faster.

So, what to do after dental implantation to quickly relieve the consequences of surgery and the best healing of the gums?

Why is it important to follow the rules?

The success of implantation - the correct engraftment of the implant into the bone - depends on a number of factors. Among them:

• A thorough examination before surgery. It is very important that before starting dental restoration using the implantation method, all contraindications are taken into account. Ignoring them can lead to serious complications and implant rejection.
• Competent planning, compliance of the implant and its position with the prosthesis that will be installed on it. The work of the surgeon and orthopedist must be coordinated to achieve an optimal result.
• Using a high-quality implantation system. The implant and all accompanying elements must be original, and the installation procedure must be strictly followed. Provided all manufacturer requirements are met, the risk of complications is minimal.
• The patient's compliance with all doctor's instructions. The choice of implant and its implantation are only the first stages on the path to successful prosthetics. How the patient behaves after the procedure also plays a huge role. Compliance with rules and restrictions is the key to success.

How to behave after surgery

Doctors give the following recommendations after dental implantation:

1. Do not use irrigators. Any treatment of the oral cavity should be as soft and gentle as possible. Oral baths are indicated. Active rinsing with antiseptic solutions is prohibited before the sutures are removed.
2. Brush your teeth with gentle movements using a soft brush (your doctor will recommend a brush). You can use dental floss and superfloss. But it is better to clean your teeth directly at the operation site only with a cotton swab dipped in a 3% hydrogen peroxide solution.
3. Avoid involuntary sneezing, coughing and blowing your nose, especially if the implantation is associated with sinus lift surgery. A sharp increase in pressure in the maxillary sinus can lead to mechanical damage to the bone tissue and displacement of the implant.
4. Avoid extreme temperature changes. For this reason, it is better not to visit baths and saunas.
5. Air travel can also be harmful because rapid changes in altitude make it difficult to avoid a surge in pressure in the ear-nose-throat system.

What to do after implantation? Expert advice

The chief doctor talks about whether implantation is painful or not, how quickly it is carried out, how the implant is engrafted and, of course, what recommendations should be followed after implantation so that engraftment occurs as quickly and comfortably as possible.

German Implantology Center - Magomed Dakhkilgov, Candidate of Medical Sciences, surgeon, implantologist, orthopedist.
The total experience as an implantologist is more than 27 years
, experience in bone grafting is
more than 15 years
, more than 5 thousand operations performed.

Why is it so important to follow the recommendations? The patient must understand that after the operation there will be a wound in place of part of the gum, stitches will be placed and the planned healing process must begin. But you should not be afraid of this, since an experienced implantologist will do everything competently and, I repeat, painlessly. And you will be fine. Let's start with the main question that worries patients before implantation - does it hurt?

?

About pain during dental implantation

As I said earlier, the answer is no. Dental implantation is not painful. For example, tooth extraction is more traumatic than implant placement. Even if we remove the tooth in the most atraumatic way with cutting the roots. Why? Because the tooth is located in a special hole in which there are a lot of nerve endings, and the implant is not placed in this hole, the implant is placed in the bone, which has no nerve endings inside. Therefore, if everything is done correctly by the implant surgeon, there will be no pain during implantation.

Implantation is completely painless and unnoticeable with sedation. If you experience anxiety or fears, sedation will completely solve these problems, and the operation time will fly by.

Attention!

If you have some pain after implantation, not only on the first day, but in subsequent days, especially after the third day, then this is certainly a signal for you to contact your doctor and try to explain this situation to him.

Three different cases of implantation

I will now show two photographs and one video, three different life and, accordingly, three different clinical cases - with an open sinus lift and a closed sinus lift with implantation, which will give an idea of ​​​​what type of gum a patient may have after dental implantation .

These recommendations are basic for patients and apply both to cases of classic dental implantation and to aggravating factors, for example, implantation in conditions of insulin-dependent diabetes mellitus.

The first case of implantation is less invasive

Here we present the installation of implantation with simultaneous closed sinus lift. A situation that occurs quite often in life is that a patient’s tooth on the upper jaw has cracked, the first molar on the left, the so-called 26th tooth, commonly known as “six”. The tooth was not subject to retreatment (more on this in a separate detailed article).

Why was the decision made to perform a one-step removal with simultaneous sinus lift and the decision to install an implant at the same time? This decision was due to the fact that with simultaneous removal and implantation, we can maximally preserve the volume of bone tissue and soft tissue surrounding the tooth, since after removal, even after 3 months, remodeling of bone tissue occurs, especially the vestibular plate and bone tissue of the upper jaw, which has very fine structure. And due to this, there is a very rapid collapse of these tissues, that is, retraction, and it looks like a failure of the vestibular (cheek) side on the bone.

To avoid all the possible negative consequences I described above, we performed tooth extraction with simultaneous sinus lift and installed a Nobel implant - NobelParallel.

So, here is the view after implantation (don't be scared):

The second case of implantation is more invasive

And the next picture will show a case of implantation in place of the same 26th tooth, but the patient decided to install it... for 15 years

(!). The tooth was removed more than 15 years ago. But he did not notice the empty space in the upper jaw in the area of ​​the sixth tooth, because he was very afraid of the sinus lift procedure itself.

The problem with long-extracted teeth for the patient is that the bone tissue in the place of the missing tooth changes greatly, and the effects of edentia affect it. In this case (more about this in a separate article), the patient had literally only two millimeters of maxillary sinus bone left. And I carried out bone grafting using the open sinus lift method with the simultaneous installation of the Bone Level implant from Straumann. This operation is more complicated, and there are correspondingly more stitches after it.

Look, here is the view after such implantation (don’t be alarmed):

The third case of dental implantation with video is my personal

Yes, don’t be surprised, dentists also need to install implants. This case is completely new; I was given implantation and sinus lifting in November 2022 by my colleague, implant surgeon at the Research Center Gleb Valerievich Kolushev. I told and showed how the operation took place and my feelings in the following video:

Looking at the pictures and videos, you probably already understand the need to follow a number of recommendations, right? Indeed, despite the successful outcome of implantation, the healing time and rehabilitation period of the patient largely depends on the discipline of the patient himself.

I would also like to draw your attention to the fact that after a sinus lift there are additional recommendations, which you can read about here.

If tooth implantation has been or will be carried out simultaneously with bone grafting, then it is advisable to familiarize yourself with this material.

Postoperative nutrition

Avoid hot foods until the anesthesia wears off. If you eat or drink something too hot, you can accidentally burn your gums because they won't feel the temperature.

In the first two days, do not drink coffee: it increases blood pressure and this can lead to bleeding. This also explains the requirement to exclude alcohol and smoking.

Within 10 days after surgery, to strengthen injured bone tissue, include calcium-containing foods in your diet: cottage cheese, kefir, yogurt.

Do not eat salty, spicy, very hot or frozen foods, as well as rough foods - crackers, nuts. The load on the teeth should be reduced as much as possible, so you should avoid foods that require careful active chewing - for example, tough meat.

The best option for a postoperative diet is pureed, semi-liquid, moderately warm food (soups, cereals, smoothies), or finely chopped.

Prohibitions

It is very important that the patient himself is aware that after the operation he will have to radically change his usual lifestyle. Of course, this does not need to be done forever: strict prohibitions will remain in place for several months. At first, you cannot engage in active sports, go to the pool, fly on an airplane, climb mountains or visit the sauna. All this can lead to a surge in pressure and the onset of bleeding.

Dentists also strongly recommend that you stop drinking alcohol; even a small amount of beer can lead to irreversible consequences. The same goes for quitting smoking. Cigarettes do not provide any health benefits at all, and during rehabilitation they can cause implant rejection. It is recommended to give up this bad habit, at least partially, but for the rest of your life.

If, before the operation, a lack of bone tissue was diagnosed, due to which a procedure called sinus lift had to be performed, then for the first few days after this, even sneezing and coughing must be done very carefully. Following these simple rules will speed up the healing of the injured area.

How long does it take to heal?

Bone tissue and gums heal after dental implantation on average from three to six months, and the period is different for the upper and lower jaws. The lower jaw will heal in three to four months, but the upper jaw will take longer: four to six months. This is due to the greater bone density of the lower jaw.

Sometimes the healing rate deviates from the average time frame, because it depends on the individual characteristics of the patient’s body: the speed of regeneration, the strength of the immune system, the pain threshold. Even such factors as gender, age, lifestyle, diet and daily routine of the patient are important.

In any case, recovery after surgery takes some time. Following medical recommendations will help protect yourself from complications during healing.

Features of the suture removal procedure

After placing the artificial root, the dentist may use absorbable suture material to connect the edges of the wound. In this case, after the gums have healed, nothing needs to be removed. This is not required when “implanting” an implant in a bloodless manner, through punctures of soft tissue. In other cases, such manipulation cannot be avoided.

How to remove sutures from the gums after implantation:

• the doctor makes sure that the wound has healed;
• the area above the implant is treated with antiseptic agents;
• the seams are carefully cut with scissors;
• then removed using special tweezers.

After removing the sutures, the gums are re-disinfected and a sterile bandage is applied. There is nothing complicated in the procedure for removing sutures; it can also be carried out by an assistant. Anesthesia is usually not required. But if necessary, the physician can apply an anesthetic gel or spray to the gums.

How are sutures removed?

Sutures after dental implantation are usually removed 10-14 days after surgery, unless otherwise indicated. Throughout this period, surgical sutures need careful, delicate handling. After suturing, there may be some discharge or slight pain. It is permissible to use painkillers (Nise, Ketanov or another remedy recommended by a doctor).

Modern dentistry uses strong synthetic threads that do not break even with active chewing of food, so dental sutures now rarely come apart. But suture dehiscence is still possible - however, it is most often associated with violations of medical recommendations, most often with mechanical damage to the operation area.

Removal of sutures does not require anesthesia and is completely painless.

Care instructions

Regular treatment of the operated mucosal area promotes successful healing. The procedure consists of several stages.

1. Daily three-time antimicrobial rinses with Tantum Verde solution.
2. To protect the tongue from damage by the hard ends of the threads, it is necessary to smear the operated area with Solcoseryl adhesive paste. It promotes rapid regeneration of the damaged area.
3. Drug therapy includes taking Calcium d3 Nycomed, multivitamin complexes, painkillers (if the gums hurt). Anti-inflammatory drugs are prescribed to reduce swelling.

Additionally, the following rules must be observed:

• give up solid food, hot dishes, drinks, hot spices, coffee (increases blood pressure);
• do not use a hard toothbrush;
• avoid intense training and heavy lifting;
• do not visit the sauna, bathhouse;
• stop smoking: cigarette smoke negatively affects the mucous membranes and increases the risk of inflammation.
• The diet should include pureed soups, boiled porridges, and broths.

It is important to maintain oral hygiene to avoid the proliferation of pathogenic microorganisms. You need to brush your teeth carefully, without touching the operated area.

Postoperative complications

The most common complications after dental implantation are:

1. Pain syndrome. The norm is mild soreness of the gums in the area of ​​implantation for 1-2 days. In cases where severe pain does not go away even after taking the generally recommended painkiller, you should consult a doctor, because this is most often a symptom of a complication.
2. Inflammation.
3. Seams coming apart.
4. Hemorrhages. After surgery, ichor often separates from the gums, the amount of which quickly decreases and disappears. It is enough to remove it with cotton swabs. But if the bleeding becomes more intense, you should consult a doctor immediately.

There are also complications such as inflammation of the sinuses, peri-implantitis (inflammation of the tissue around the implant, leading to destruction of the supporting bone tissue), mucosal hyperplasia (pathological growth of the mucous membrane in the area of ​​the implant), damage to the implant and prosthesis.

What foods can you eat after surgery?

Since implantation leads to a violation of the integrity of the bone, its restoration requires food rich in calcium - fermented milk products. Yogurt, kefir, cottage cheese, sour cream will help quickly restore calcium deficiency in the body.

Food requirements:

• Food should not be solid.
• You cannot eat hot or cold foods.
• The temperature should be average.
• Broths, soups, purees, chopped vegetables and fruits are suitable for nutrition. Even cereals need to be ground in a blender.

You should eat extremely carefully, chew on the side opposite the operated area, without touching the sutures with your tongue.

It is necessary to follow the rules during the first few weeks after implantation.

Sample menu for the day

Breakfast:

• Cottage cheese with sour cream, or with the addition of honey.
• Warm tea, preferably green or white.

Dinner:

• Puree soup from any favorite vegetables, mashed potatoes.
• Soft meatballs can be used as a meat additive.

Dinner:

• Soft porridge with chopped fish or meat.
• Turkey, veal or chicken fillet. You should not eat beef or pork.

Bananas, cottage cheese, fruit purees, and smoothies are useful snacks Kefir will help satisfy hunger before bed and during the day.

If food particles accidentally get into the implant area, just rinse your mouth with warm chamomile infusion or water.

Fluid intake

The patient can drink the following drinks:

• water,
• black, white, green tea,
• milkshakes,
• smoothie,
• kefir,
• milk.

Any drinks taken after implantation should not be cold or hot.

Swelling after dental implantation

In the first three days after implantation, swelling may occur in the gum tissue. This is the body's natural reaction to surgery. Most often, a tumor is an indicator that blood is actively flowing to the operation site.

But if you want to avoid the discomfort caused by swelling, you can reduce the risk of its occurrence. To do this, in the first two days, apply cold to the operation site: for 5-10 minutes with breaks of 20 minutes. Do not apply ice directly to the skin; it is best to wrap it in a towel. In rare cases, the tumor will require the use of antihistamines, antibiotics (to prevent infection) or treatment with antiseptic solutions.

It will also help to avoid swelling by eliminating sudden stress loads on the body: physical overload, hypothermia, overheating.

Inflammation and temperature after dental implantation

Your body may also react to surgery with a low-grade fever, that is, an increase in general body temperature to 37°C. Even if the temperature stays within these limits for several days, this will remain the norm. You should be wary only when there is a persistent increase in temperature to 37.8-38°C. In this case, it almost certainly means inflammation, which requires immediate intervention (for example, in case of peri-implantitis, this should be sanitation of abscesses, bone regeneration, as well as professional oral hygiene).

In this case, you should not delay visiting a doctor: the inflammation can not only worsen on its own, but also lead to implant rejection.

Restrictions in the first hours after surgery

It is not recommended for everyone to eat immediately after implant placement. The duration of the period without food depends on which implantation method was used:

• Implantation of a titanium rod using classic two-stage technology. You can eat no earlier than two to three hours after surgery. This limitation is due to the presence of sutures in the oral cavity, which must be protected from pathogenic microorganisms.
• One-stage implantation. In this case, a gum former is immediately installed on the implant. Eating is allowed after an hour.
• Implantation under anesthesia. It is advisable not to eat for four hours after surgery.

Regardless of the implant installation method, you should not eat food while the anesthesia is in effect. Otherwise, you may accidentally bite your cheek or gum. Also, after such an operation, eating hot and very cold foods is prohibited.

Numbness after dental implantation

For most patients, anesthesia wears off within four to five hours after implant placement. Then oral sensitivity should return. If numbness persists after this period, then you have cause for concern because it may indicate nerve damage. This is only possible when the operation was performed on the lower jaw, because there are no large nerves in the upper jaw.

Other symptoms of mandibular nerve injury are lack of facial skin sensitivity, excessive salivation, and difficulty speaking and eating. Timely diagnosis will help to establish the nature and extent of the damage and manage the treatment with medications rather than surgical methods.

Recommendations for the first week after implant placement

For five to seven days, it is advisable to give up black tea and coffee so as not to provoke wound bleeding. It is also worth excluding sweet, spicy, sour and salty foods. It is better to chew on the opposite side. Solid foods should not be consumed until the implant has taken root. But if one-stage implantation “All on four/six” was used with an urgent load, then you need to start with soft food, and then it is even recommended to introduce solid food. This will help slow down bone tissue atrophy, improve metabolic processes in it, and increase the reliability of stabilization of titanium rods.

Alcoholic drinks are allowed two weeks after implant placement. You should not use even those that contain a small amount of alcohol. Otherwise, an intense rush of blood to the soft tissues of the oral cavity is possible, which will negatively affect the healing process.

Antibiotics after dental implantation

For preventative purposes, the doctor prescribes a course of antibiotics after surgery. In most cases, this is inevitable, since surgical trauma, even with the modern level of development of medicine, carries a high risk of infection. Therefore, it is better not to ignore antibacterial drugs prescribed by a doctor if you do not want to additionally place unnecessary burden on your immune system to fight infection.

Most often, the course of antibacterial therapy does not exceed 7 days, and broad-spectrum drugs are prescribed - amoxicillin, amoxiclav, cephalosporins. They are characterized by low toxicity and have long proven themselves to be well tolerated by the human body.

Simultaneous (immediate) implantation

This prosthetic method is a one-stage implantation. In this case, the dentist removes the patient’s damaged tooth and immediately installs an artificial root.

Implantation immediately after tooth extraction is only possible if the bone tissue has sufficient volume to accommodate the implant - for example, if the tooth was damaged or lost in an accident. But tooth loss much more often occurs due to diseases when bone tissue is lost. Therefore, this method is not always available.

Dental implantation is an achievement of modern dentistry that allows you to restore lost teeth and use them for the rest of your life. And if you carefully follow your doctor’s recommendations, your smile will always bring joy to your loved ones!

What are the restrictions?

Implantation is a small operation, but still an operation. It involves the introduction of anesthesia, tissue damage, a healing period and, of course, the risk of complications if the rules are not followed. During flight, a person experiences pressure changes. Such jumps are not useful for patients who have unhealed tissue areas, fresh sutures, etc. They can provoke bleeding and increase swelling. Therefore, from the point of view of speedy healing of wounds, flying is undesirable. You can fly, but minimally and with extreme caution.

If implantation was carried out in combination with osteoplasty, the situation is different. In this case, air travel is strictly contraindicated for a month or at least two weeks.