Dental implantation of category I

An implant is not simply placed where a tooth was lost. First, the doctor assesses the bone, the position of neighbouring roots and what the future crown will look like. Category I means placing an implant into existing bone without separate bone grafting. At UKRMED Maxillofacial Surgery, the surgical stage is performed by Anna Kravchenko, who trained in implantology in Lithuania, Italy, Brazil and Germany.

What a dental implant is

A dental implant is a titanium screw that replaces a tooth root. The bone fuses with its surface (osseointegration), and an abutment and crown are then fitted. An implant replaces a single tooth without grinding down the neighbours, or supports a bridge.

All implant options, including for patients with no teeth, are covered on the dental implants page.

What category I means

Category I covers cases where:

• there is enough bone height and width;
• no sinus lift or bone grafting is needed;
• the gums are healthy and free of inflammation.

If bone is lacking, alveolar ridge augmentation comes first and the case moves to a higher category.

Implant systems

UKRMED works with four systems: Straumann (Switzerland), BioHorizons (USA), MegaGen AnyOne (South Korea) and NeoDent (Brazil). All have long-term clinical data. They differ in shape, surface, abutment range and price. The doctor chooses a system based on bone density, the area and your budget.

Preparation

• CT of the jaw to measure the bone and see the nerve, sinus and neighbouring roots. More on 2D and 3D diagnostics.
• Oral health: treating decay and gum inflammation, professional cleaning.
• Extraction of a failing tooth, if still present. The implant is sometimes placed straight into the socket, sometimes after healing.
• General health: diabetes should be well controlled; stopping smoking is advisable. A meta-analysis of over 150,000 implants found that smokers have a 2.4 times higher risk of implant failure.

Implant placement steps

1. Anaesthesia — local or treatment under sedation.
2. Access: a small gum incision or punch.
3. Preparing the site in the bone with sequential drills.
4. Placing the implant, checking position and stability.
5. A healing cap or closing the gum with stitches.

Category I implant surgery takes 30–60 minutes.

Healing and loading

Osseointegration takes 2–4 months in the lower jaw and 3–6 in the upper. A Cochrane review found no substantial difference between immediate and delayed loading in carefully selected patients, so a temporary crown is sometimes fitted straight away if the implant is stable. The doctor decides.

The first days after surgery

Swelling and moderate pain last two to three days. Cold packs, soft food, no smoking and careful hygiene. Stitches are removed after 7–10 days.

Contraindications

• Jaw growth not complete — implants are not placed in teenagers, as an implant does not "grow" with the bone.
• Uncontrolled diabetes — blood sugar is brought under control first.
• Intravenous bisphosphonates or other antiresorptive drugs for cancer, or jaw radiotherapy — a high risk of bone necrosis; the decision is made together with the oncologist.
• Active periodontitis — bacteria from gum pockets also affect tissue around an implant, so the gums are treated before surgery.
• Pregnancy — implant surgery is postponed.

Smoking and bruxism are not absolute bars, but they raise the risk, so they are discussed in advance.

Risks and complications

• Implant failure — rare, and it shows in the first months. The implant is removed and a new one placed after healing.
• Peri-implantitis — inflammation of the gum and bone around the implant years later. The main protection is hygiene and professional cleaning every six months.
• Nerve or sinus injury — CT and planning keep this risk to a minimum.
• Swelling, bruising and pain — expected in the first days.

Prices at UKRMED

The price depends on the implant system. The abutment and crown are a separate prosthetic stage.

Sources

1. Esposito M., Grusovin M. G., Maghaireh H., Worthington H. V. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database Syst Rev, 2013. https://doi.org/10.1002/14651858.CD003878.pub5
2. Mustapha A. D., Salame Z., Chrcanovic B. R. Smoking and Dental Implants: A Systematic Review and Meta-Analysis. Medicina (Kaunas), 2021. https://doi.org/10.3390/medicina58010039