Possible complications of injections. Complications when performing various injections. Complications that arise when installing an intrauterine device

Dental prosthetics has a long history - it is one of the most developed methods of restoring lost teeth. This treatment takes place quite quickly, there are no consequences, so complications after dental prosthetics are quite rare. But it still occurs periodically and mainly comes down to the appearance of inflammatory processes on the gums due to the uncomfortable design of the artificial jaw, or allergic reactions to the materials used.

Complications after dental prosthetics

Causes of complications after dental prosthetics

Stomatitis under dentures- a quite common phenomenon, especially in cases where the prosthesis causes particular discomfort during the first time after installation. Inflammation of the gums and even the formation of small pustules appears due to the excessively strong adherence of the prosthesis to the gums, as a result of which blood vessels are squeezed and soft tissue cells gradually die off - bedsores are formed.

Treatment is very simple - just contact your doctor to adjust the prosthesis, and also use special ointments, antiseptic solutions and gels that relieve inflammation from the gums.

Dental diseases under dentures- as a rule, supporting teeth are susceptible to caries or even pulpitis. Diseases can occur due to insufficient oral hygiene. There is usually a small space between the denture and the gum, which is necessary to ensure that the denture does not put too much pressure on the soft gums. But, like artificial teeth, this small hole must be carefully monitored - rinse it with water, use dental floss to remove food debris, and visit a doctor for professional oral hygiene. Otherwise, bacteria will accumulate between the gums and the denture, which will lead to tooth damage and bad breath.

Peeling off a permanent dental bridge or crown after installation- the causes of this complication are usually considered to be a change in the bite, or the removal of any teeth and a gradual shift of the remaining ones towards the empty space. Damage to the supporting teeth or excessive load can also cause the prosthesis to come off. Depending on the degree of damage to the prosthesis, it is either returned to its place by re-gluing, or (if the supporting teeth cannot withstand the new loads) is replaced with an alternative type of prosthetics.

Discomfort after installation of dentures -
a frequent phenomenon, especially typical for removable structures. As a rule, in the first couple of weeks you will have to deal with unpleasant sensations in your mouth - new and unusual teeth, or hooks may rub your gums or the inside of your cheeks. Speech will also change - there may be some problems with the pronunciation of sounds. There will be profuse salivation due to the presence of a foreign body in the mouth. The discomfort goes away on its own, as the habit of using the prosthesis gradually develops. If the unpleasant sensations are characterized by pain and are caused by fastening elements, you should definitely inform your doctor about this so that the fastenings can be adjusted.

Loosening the fixation of removable structures occurs gradually as the product approaches the end of its official life. Daily wear, regular removal from the mouth - all this affects the prosthesis attachment system. The problem can be solved by using additional creams or dental adhesives, or by adjusting the attachments.

Allergy to materials, used to create dentures - this is the most common complication after dental prosthetics. Modern scientists are trying to minimize the occurrence of the body's reaction to the materials used, however, the more different prostheses appear, the more often new allergic reactions occur.

Allergy occurs mainly when the prosthesis comes into contact with the gums and is characterized by symptoms such as a rash on the skin of the face or hands, swelling, rashes and redness of the oral mucosa, an asthma attack, inflammation of the salivary gland, burning and dry mouth. An allergic reaction can occur immediately or several hours or even days after installation of the prosthesis. If symptoms occur, it is important to consult a doctor immediately and choose a different type of denture.

Galvanic syndrome occurs as a result of the presence of various metals in the oral cavity - for example, used as the basis of a denture or as part of dental crowns. When saliva enters (it acts as an electrolyte), the metals acquire different potentials, which leads to the formation of galvanic currents.

There are several symptoms of the disease: a metallic taste in the mouth, headaches, darkening of metal dentures, allergic reactions, sleep disturbances and general condition of the body. The problem is solved by replacing dentures - it is important that only the same metals are available in the oral cavity.

Table 1

PERSONAL HYGIENE OF THE PATIENT

Patient's hair care

As a rule, a person combs his hair several times a day. If you don't do this, your hair will become tangled and dirty faster. The nurse combs them for the patient when he cannot do it himself. The brush or comb should have blunt teeth so as not to injure the head or cause pain. When tangled, use a wide-tooth comb. It is certainly easier to comb hair when the patient is sitting. When brushing a bedridden patient, you should turn his head one way, then the other.

Target: maintaining personal hygiene.

Indications: care deficit.

Equipment: comb, weak vinegar solution, mirror, towel, dirty laundry bag, gloves, container with disinfectant solution.

Algorithm of the nurse's actions:

I. Preparation for the procedure

1. Patient information about the upcoming procedure.

2. Obtain the patient's consent to the procedure.

3. Cover the patient's shoulders with a towel (if he is lying down, place the towel under his head and shoulders).

4. Wear gloves.

II. Executing the procedure

5. Moisten the comb in a weak vinegar solution.

6. Comb your hair slowly and carefully, start combing your hair from the ends (but not from the roots!), gradually moving towards the roots of the hair.

7. Do not use force when combing tangled hair!

8. Wet your hair, it will be easier to comb (you need to wash your hair after it has been untangled).

9. Style the patient's hair in a way that he likes.

10. Offer a mirror after the procedure.

III. Completing the procedure

11. Remove the towel from the patient's shoulders (or from under the head and shoulders) and place in the laundry bag.

12. Remove gloves and place in disinfectant. solution.

13. Wash your hands (hygienic level).

14. Dry your hands.

Rice. 31. Caring for the patient's hair

What are post-injection complications? The role of the nurse in the prevention of complications after injections. What results from non-compliance with asepsis rules.

Types of injections

Post-injection complications (PIC), as the name suggests, are complications that occur after an injection (injection). What is it injection? Wikipedia tells us that an injection is a way of introducing various solutions (for example, medicines) into the body using a syringe and a hollow needles. Depending on where exactly this solution needs to be delivered, there are several types of injections:

• subcutaneous;
• intramuscular;
• vniturivennaya;
• intraosseous;
• intradermal;
• intra-arterial;

The role of the nurse in the prevention of post-injection complications

According to a recent survey, most patients, especially the older generation, prefer injections or droppers as one of the ways to introduce drugs into the body. That is, people do not know or underestimate the risk of post-injection complications.

The role of the nurse is not only to correctly perform the injection itself, in compliance with all aseptic rules, but also to provide the necessary advice on the prevention of PIO. Many nurses simply neglect this. Upon completion of the procedure, it is necessary to make an appropriate entry in the journal.

Complications, which can occur after injections (injections) are divided into 3 groups according to the factor of their occurrence:

Failure to comply with asepsis rules

Asepsis- preventing various microorganisms from entering an open wound.
Post-injection infiltrate- occurs, as a rule, after subcutaneous and intramuscular injections. The reason for the development may be

serve incorrect choice of length needles or low quality of its execution. And if in treatment rooms, where they are most often performed injections, nurses are trained in the rules for choosing the length of the needle, it is quite difficult to answer for the quality of the injection itself (we all know that some people have a “light” hand, while others have the opposite). There are many companies producing disposable injection needles, but only a few do it conscientiously.

Also, the cause of post-injection infiltration may be incorrect determination of the site for injection, administration of the medicine to the sites of previous injections, or too rapid administration of the medicine.
Violation of sterility during injection is the No. 1 reason for the development of post-injection infiltrate.

Abscess– formation of an inflamed cavity with purulent contents inside the soft tissues. The reason for the occurrence of a post-injection abscess is the same as for infiltrates, only with the obligatory addition of infection.

Most often, the injection is given into the gluteal muscles. Accordingly, to reduce the chance of an abscess, a number of factors should be taken into account:

• Do not inject twice into the same point, be sure to change sides. Each injection is already a kind of microtrauma for the muscle. Multiple injections into one point can cause a post-injection abscess, even with full compliance with the rules of asepsis.
• The amount of the drug recommended for one injection, if repeated at the same point, can lead to tissue necrosis.
• The patient’s weak immunity and disturbances in the blood supply to tissues can also lead to an abscess.

Phlegmon- acute diffuse purulent inflammation of the cellular spaces; unlike an abscess, it has no clear boundaries. There are several types: subcutaneous, subfascial, intermuscular, retroperitoneal, perirenal (paranephritis), perirectal (paraproctitis), mediastinal tissue, phlegmon of the foot, hand, etc.

The cause of the occurrence is the entry of pathogenic bacteria into the fiber through damaged skin or from nearby foci of infection (boils, dental caries, suppurating lymph nodes, etc.); sometimes they are carried in the bloodstream (hematogenously) from distant foci.

Hepatitis B and C, HIV– the most unpleasant and long-lasting consequences that can be obtained during injections in violation of the rules asepsis. Fortunately, modern options for using disposable syringes minimize the risk of infection through injections.

More detailed information about the types of infiltrates and methods of their treatment can be found in the article ““.

Wrong choice of injection site

Damage to nerve endings– occurs more often with intramuscular injections, if the injection site is chosen higher than acceptable, closer to the lower back. Let us remind you that for the optimal intramuscular injection you should choose the upper outer quadrant of the buttock. Irritation of the nerve trunk by a needle or injected medication can lead to severe lumbodynia(severe pain in the lumbar region) and sciatica and even to neuritis And paralysis.

Damage to the periosteum- can occur when a needle that is too long is chosen for an intramuscular injection into the thigh.

Vascular damage a needle or medicine that irritates the walls of the vessel.

Incorrect injection technique

Needle breakage– occurs due to a violation of the intramuscular injection technique (performing the injection while standing and/or without warning), which leads to a sharp spasm of the gluteal muscles. Poor quality needles can be either a concomitant or a separate factor. Lack of experience with intramuscular injections should also be taken into account.

Oil or air embolism- in both cases it occurs due to the entry of an oily medicinal solution or air from a syringe into a vein. The prevention of such a dangerous complication is to check whether the needle has entered the vessel (pull the plunger slightly and make sure that there is no blood in the syringe).

Blood clots– this complication occurs when the same vein is used for a long time to administer the drug.

Tissue necrosis after injection. Essentially, necrosis is the process of cell death. Agree, a very unpleasant phenomenon. It is formed due to various damage to the cells of the body, if caution is not observed during vein puncture and the administration of irritating drugs in addition to the veins (subcutaneously, intramuscularly). It is imperative to check the presence of a needle in the vein when injecting chloride (10% calcium chloride solution).

Hematoma occurs due to a through puncture of the vein, due to which blood flows into the surrounding tissues. You can eliminate the hematoma with a warm compress.

Administering the medication too quickly may cause dizziness and disturbances in heart rhythm.

Allergic reactions(urticaria, Quincke's edema up to anaphylactic shock) arise as a result of an unclear allergic history in the patient. They usually appear 30 minutes after administration of the drug, but can appear earlier and immediately after the injection. The basic rules for preventing this complication are: finding out the allergy history before the injection, especially before the first one, and monitoring the patient for the first 30 minutes after injections, if the drug was administered for the first time in life.

In addition to these three factors, post-injection complications are classified according to the timing of their appearance:

• immediate– occur on the first day after the injection (allergic reaction);
• short-term– period of appearance from several days to a week (infiltration);
• deferred– may appear even after a few months (hepatitis, HIV).

As a rule, injections are performed in a hospital. institutions, and this is mainly done by nurses; accordingly, to prevent post-injection complications, the nurse must follow a number of rules:

1. Be careful when preparing the medicine for injection. Each patient should receive only the medicine prescribed by the doctor.
2. Follow the rules of asepsis and antiseptics.
3. Follow the rules for administering medications.
4. Follow the injection technique.
5. Light massage of the injection area promotes better absorption of the medicine.
6. Avoid administering the medicine to the same point.

Almost 80% of cases of PIO occur due to injections given outside medical institutions and by unqualified performers. In particular, injections at home.

Gentlemen, students and future doctors, you definitely won’t find a ready-made essay on the topic of preventing complications after injections here. Do you know what a patient is most afraid of hearing before starting an operation? The phrase " Ok Google..." I don’t think you want to see such a doctor.

The most common reasons for failures and complications during peripheral venous catheterization are the lack of practical skills among medical personnel, as well as violations of the technique for placing a venous catheter and caring for it.

All complications associated with peripheral vein catheterization can be divided into general and local. Local ones develop at the site of catheter installation or in the immediate vicinity of it (for example, along the vein in which the PVK is located), these include hematoma, infiltration, phlebitis and vein thrombosis. General complications are associated with the generalization of local complications or initially develop away from the location of the intravenous catheter (air embolism, thromboembolism, catheter sepsis). They cause severe disruption of the general condition of the body.

Local complications

A hematoma is an accumulation of blood in tissues. A hematoma can form as a result of blood leaking from a vessel into the tissues adjacent to the site of the catheter. This may occur as a result of unsuccessful vein puncture immediately at the time of PVK establishment or as a result of the subsequent removal of the catheter. Therefore, in order to avoid the formation of a hematoma caused by the installation of a PVK, it is necessary to ensure adequate filling of the vein, as well as to carefully select the location of the catheter.
Prevention: do not perform venipuncture on poorly contoured vessels. The formation of a hematoma when removing the catheter can be avoided by applying pressure to the venipuncture site for 3-4 minutes after removing the PVK. You can also elevate the limb.

Vein thrombosis (Fig. 1) occurs when a blood clot forms in the lumen of a vessel. This can happen if there is a mismatch between the diameter of the vein and the size of the catheter, or defects in care.

Rice. 1. Scheme of thrombosis of the vein in which the PVC is located

Prevention. To avoid the development of thrombosis, it is necessary to select the correct catheter size in accordance with the size of the punctured vein and adhere to the rules of care. Cannulas made of high-quality materials (polyurethane, polytetrafluoroethylene, fluoroethylenepropylene copolymer) are less thrombogenic than polyethylene and polypropylene catheters. Prevention of thrombosis is also to lubricate the skin area above the site where the catheter is supposed to be located in the vein with heparin gels (Lioton).

Infiltration occurs when medications or infused solutions enter the skin rather than into a vein. Penetration of certain solutions into tissue, such as hypertonic, alkaline or cytostatic solutions, can cause tissue necrosis. Therefore, it is very important to detect infiltration in the early stages. When the first signs of infiltration occur, the PVC should be removed immediately. To avoid infiltration, use flexible capillary catheters and secure them carefully.
Prevention. Use a tourniquet to stabilize the catheter if the last one is installed at a bend. Check for decreased tissue temperature and any swelling around the catheter insertion site.

Phlebitis is an inflammation of the intima of a vein, which can occur as a result of chemical, mechanical irritation or infection. The most common causative agents of catheter infections are coagulase-negative staphylococci and Staphylococcus aureus, enterococci, Candida (often against the background of antibiotic therapy), resistant to many antimicrobial drugs.
In addition to inflammation, a blood clot can also form, which leads to the development of thrombophlebitis. Of all the factors that contribute to the development of phlebitis (such as the size of the catheter, the site of venipuncture, etc.), the length of time the catheter remains in the vein and the type of fluid that is injected are especially important. The osmolarity of the drug is important (severe phlebitis develops at an osmolarity of more than 600 mOsm/l, Table 8.1) and the pH of the injected solution (limiting pH values ​​affect the development of phlebitis). All intravenous access should be regularly monitored for symptoms of phlebitis. Any case of phlebitis should be documented. Typically, the incidence of phlebitis is 5% or less.
The first signs of phlebitis are redness and pain at the catheter site. In later stages, swelling and the formation of a palpable “venous strand” are observed. An increase in skin temperature at the site of the catheter may indicate the presence of a local infection. In particularly severe cases, the erythema extends more than 5 cm proximal to the end of the catheter, and pus may be discharged at the site of insertion and removal of the catheter. This can lead to purulent phlebitis and/or septicemia, which are among the most severe complications of intravenous therapy and are associated with a high mortality rate. If there is a blood clot and/or infection of the catheter is suspected, after removing it, the tip of the cannula is excised with sterile scissors, placed in a sterile tube and sent to a bacteriological laboratory for examination. If purulent phlebitis or septicemia occurs, it is necessary to take a blood culture and examine the cito!
To prevent phlebitis: when performing PVC, one should strictly adhere to the rules of asepsis and antiseptics; give preference to the smallest possible catheter size for a specific therapy program; ensure reliable fixation of the PVK; choose high quality catheters; Before administering medications, dilute them and practice slow infusion; lubricate the skin over the site where the catheter is supposed to be located in the vein with anti-inflammatory agents in combination with heparinized gels (Fastum-gel, Lyoton); before applying the gel, degrease the skin with an alcohol solution. For preventive purposes, it is also recommended to regularly change the vein in which the peripheral venous catheter is located (every 48-72 hours), however, in a clinical setting this requirement is difficult to comply with, so if there are no signs of phlebitis or other complications, modern high-quality peripheral venous catheters can be kept in vein all the time necessary to carry out infusion therapy.

General complications

Thromboembolism occurs when a blood clot on a catheter or vein wall breaks off and travels through the bloodstream to the heart or pulmonary circulatory system. The risk of blood clots can be significantly reduced by using a small catheter to ensure satisfactory blood flow around the catheter at all times.
Prevention. Avoid inserting PVK into the veins of the lower extremities, because in this case the risk of thrombosis is higher. If the infusion is stopped due to the formation of a blood clot at the end of the catheter, it should be removed and a new one inserted according to the scheme for changing the location of its installation. Flushing a catheter obstructed by a thrombus can lead to the clot breaking off and migrating towards the heart.

Air embolism may occur during any type of intravenous therapy. However, with peripheral catheterization, the risk of air embolism is limited by positive peripheral venous pressure. Negative pressure can form in the peripheral veins if the catheter is installed above the level of the heart.
Prevention. Air must be completely removed from all elements of the infusion system before connecting it to the PVC. You can remove air by lowering the system's initial opening below the level of the infusion bottle and draining some of the solution, thereby stopping the flow of air into the infusion system. In addition, reliable fixation of all Luer-Lock connections plays an important role in preventing air embolism.
The most rare complication is the rupture and migration of a peripheral venous catheter.

• What kind of complications after dental implantation can await you on the way to restoring the ability to chew normally and a beautiful smile;
• What problems sometimes arise immediately at the time of surgery, and what problems arise several days, weeks, months and even years after the installation of implants;
• List of contraindications for implantation and their connection with the development of dangerous complications;
• How can you recognize the problem in time - what is considered a harmless side effect and what is considered a dangerous complication;
• How to protect yourself as much as possible from possible troubles;
• What types of implants are characterized by the lowest risk of complications;

...As well as other nuances that are interesting from a practical point of view regarding possible complications during dental implantation.

Unfortunately, if a person’s permanent teeth are lost or seriously damaged, they are not able to recover on their own and require artificial replacement, since a violation of the chewing function not only causes significant damage to the digestive system, but also negatively affects the quality of life in general. In order to restore aesthetics and normal chewing of food, dentists already at the end of the 18th - beginning of the 19th centuries began to use the first, then still primitive, dental implants made of wood, various metals, porcelain and other available materials. However, very frequent complications after dental implantation operations forced doctors to constantly look for new technologies and more advanced materials suitable as implants.

It is thanks to such continuous research and successful experiments of doctors who are supporters of dental implantation that at the end of the last century this direction in dentistry became one of the most popular and in demand among the general population. The most important result of such hard work was that complications after dental implantation ceased to be regular and quite expected, and dental surgeons learned to one degree or another to minimize damage to health even in the event of certain problems.

Currently, prosthetics on implants is gradually replacing “conventional” dental prosthetics, which often requires grinding down healthy teeth, or using partial or complete removable dentures, which are popularly often called “false jaws.”

However, is it possible today, when we are already in the 21st century, to say with complete confidence that complications after dental implantation and the corresponding risks of problems during and after the operation are completely a thing of the past? Well, the answer here is quite clear, and, unfortunately, it is negative - complications are still often encountered in the practice of implantologists. But why?

Due to the proliferation of numerous implant systems, various methods and technologies of implantation, as well as the training of many hundreds of practicing maxillofacial surgeons, at least 20 thousand implants are installed in our country alone per year. And along with this, the number of unsuccessful operations and negative reviews on the Internet quite naturally increases - problems can begin due to the fault of an insufficiently qualified doctor, due to the choice of low-quality implants (rarely, but it happens), as well as due to the fault of the patient in the dental clinic.

How to minimize the risk of problems during dental implantation, how to avoid the most common problem with implants – their “rejection”, as well as what to do if problems do arise - we will talk about all this further and in more detail...

Complications that may arise during the dental implant procedure itself

It is useful to keep in mind that some complications may arise directly during the dental implantation procedure, right on the dental chair. Moreover, the nature of the undesirable consequences may depend on whether the implant is installed on the upper or lower jaw.

Below is a short list of possible complications that may occur during the implantation procedure (in descending order of frequency):

• Heavy bleeding;
• Pain;
• Perforation of the bottom of the maxillary sinus and nasal cavity;
• Damage to the wall of the mandibular canal and nerves of the lower jaw.

Let's look at these complications in order.

Heavy bleeding

During dental implantation, minor bleeding is considered normal and in most cases can be easily controlled with conventional hemostatic techniques. Heavy bleeding can occur both due to the fault of the doctor and the fault of the patient himself.

It is within the power of every person who sits in a dental chair to reduce the risk of developing this complication. Most often, bleeding from a wound occurs with increased blood pressure, as well as with a blood clotting disorder (taking blood thinners, cardiovascular pathology, etc.).

Blood pressure control, timely intake of medications under the supervision of a cardiologist or therapist, proper medication and psychotherapeutic sedative (relieving nervous tension) preparation, as well as mandatory informing the implant dentist about existing diseases will help avoid not only early bleeding during implantation, but also in the delayed period. In order to prevent complications, it is also important to follow all recommendations after dental implantation, when a fresh wound is an area of ​​increased attention, especially if more than 4-5 dental implants were installed in one day.

From the practice of a dentist

Bleeding due to the fault of the dentist occurs much less frequently than most people think (after all, what thoughts might a patient have: “Here, he tore up my entire jaw, now the bleeding doesn’t stop, couldn’t you have cut more carefully...”)

However, doctors who are just starting their work in the field of dental implantation and getting their first bumps do sometimes have unpleasant flaws in their work. However, even if errors are made during a surgical operation, even a less experienced surgeon can easily use modern hemostatic techniques and means to eliminate the negative consequences. Only injury to large vessels located deep in the jaw, for example, with an incorrectly selected implant, can pose a threat to the patient’s life, but this is very, very rare (virtually excluded).

Pain during dental implantation

Sometimes, during the dental implantation procedure, quite severe painful sensations may occur, which, however, can usually be easily eliminated with an additional dose of anesthesia.

But in rare cases, it happens that anesthesia does not work well. This is most often due to the individual characteristics of a person. This situation is resolved simply: dental implantation is carried out under anesthesia, in other words, when consciousness is turned off.

Therefore, if you have been injected with an anesthetic, but you still feel pain, you do not need to endure and remain silent - you should definitely and immediately tell the doctor about it.

Perforation of the bottom of the maxillary sinus and nasal cavity

Currently, this complication of implantation is much less common than it used to be. Advances have been made largely due to the ability to accurately determine the distance to cavities using panoramic images and computed tomography (CT).

In order to reduce the risk of this complication to almost zero, you need to trust only an experienced doctor with extensive experience, and in case of doubt, consult with other implantologists. If the maxillary sinus is close to the bottom of the nasal cavity, bone augmentation (sinus lift) can be done first, and then no problems arise.

The photo below shows an example of bone tissue augmentation before tooth implantation:

Damage to the wall of the mandibular canal and nerves of the lower jaw

This complication during dental implantation does not always have long-term negative consequences, since, despite the frightening name, in fact it usually manifests itself only as numbness in the lower jaw (most often the lips become numb). Even without treatment, these symptoms can go away on their own within 2-3 weeks, maximum 2-3 months.

In addition, it is worth keeping in mind that a feeling of numbness on the corresponding side of the face can also be a consequence of compression of the nerve in the mandibular canal. This sometimes occurs due to bleeding in the bone marrow spaces - blood can escape not only towards the oral cavity, but also gradually move through the spaces of the bone, because the intraosseous tissue of the jaw is not “solid”, but cellular. The entry of even a relatively small amount of blood into the area where the mandibular nerve passes through the canal creates temporary compression. Gradually, the blood masses dissolve, but it takes time for the nerve to recover from such a compressive effect (usually no more than 5-7 days).

On a note

Complications such as fracture of the instrument during surgery, fracture of the wall of the alveolar process, insufficient fixation of the implant, pushing it into the sinus of the upper jaw, etc., are even less common. The myth that a dental implant can come out of the eye or emerge from the jaw through the cheek makes some people afraid of implantation. In fact, no doctor in his right mind would deliberately harm your health by using implants of the wrong length and thoughtlessly screwing them in “all the way.” Therefore, this situation can only be viewed from the point of view of popular horror films.

What complications sometimes arise after the installation of implants?

Complications after the installation of dental implants can be divided into early ones, which manifest themselves within a few days after the operation, and late ones, which occur weeks, months, and sometimes years after implantation.

Early complications include:

• Painful sensations;
• Edema;
• Bleeding;
• Increased body temperature;
• Seams coming apart.

Generally speaking, pain is a normal reaction of the body in response to the traumatic intervention of a dental surgeon during dental implantation, and such pain appears after the anesthesia wears off.

Analgesics prescribed by a doctor usually effectively relieve pain, and the healing process does not bring too much discomfort to the patient. Normally, pain should not bother you for more than 2-3 days, during which medication is indicated. If severe pain lasts longer, this is an alarming sign.

Swelling of soft tissues is a consequence of almost any surgical operation, including dental implantation. Moderate swelling is a natural reaction of the body to injuries and “invasion”, in general, of a foreign implant, and rarely leads to complications. Typically, tissue swelling lasts no more than 5-7 days.

You can prevent a possible complication in the form of excessive swelling by applying cold immediately after surgery to the area of ​​the face where the implants were placed. In this case, you should be careful and adhere to basic common sense so as not to cause frostbite and tissue necrosis (that is, comrades who simply take something icy from the freezer, apply it to their cheek and hold it there for two hours - this is wrong and very dangerous) .

Mild bleeding in the area where dental implants are installed can be observed within a couple of hours after implantation, when the vasoconstrictor effect of adrenaline added to the anesthetic ends. Even if such bleeding drags on for a whole day, this is not a cause for concern. It is important to distinguish ichor (bloody fluid) from severe and continuous bleeding for more than 5-8 hours, which does not stop.

It should be remembered that a common cause of bleeding is the person’s inattention to existing problems. For example, taking aspirin and a number of other drugs impair blood clotting, and increased blood pressure prevents the formation of a clot in the wound; a number of diseases of the cardiovascular system make almost all home methods of stopping bleeding ineffective. It is always important to timely and competently assess the scale of the problem and notify your doctor in advance about such nuances.

As for the slight increase in body temperature after implantation, this is also a completely normal reaction, which reflects one or another stage of the local inflammatory process after surgery. On the first day, the temperature can even rise to 38.0°C, but there is no need to worry– the problem can be solved with the help of antipyretic drugs, which the doctor himself will most likely mention.

However, if, say, closer to night, the temperature on the first day after implantation “exceeded” far beyond 38 degrees, and antipyretic drugs do not help, then it is advisable to call an ambulance, make a lytic mixture, and consult with your dentist in the morning, since this may be a sign of complications after dental implantation.

Most often, the temperature does not rise to such high values, but can remain within the range of 37.0-37.3 ° C for several days, which is a reaction of the body that is within normal limits.

Perhaps it is also worth mentioning the dehiscence of sutures, often placed on the wound after implantation. The photo below shows an example of the normal state of the sutures immediately after surgery:

Suture dehiscence, as a complication, is almost never a sign of unsuccessful dental implantation, since it largely characterizes the result of the person’s behavior. Violations can be very different: from non-compliance with the principles of oral hygiene and ignoring doctor’s recommendations, to unauthorized “picking” in the oral cavity with fingers, toothpicks, etc., which leads either to mechanical damage to the sutures or contributes to the onset of the inflammatory process. This provokes seam divergence in the future.

Late complications

Among the late complications that sometimes occur after a long period of time after dental implantation are the following:

1. Peri-implantitis;
2. Implant rejection.

These complications can occur regardless of whether implants were installed on the upper or lower jaw, whether several or just one were installed, whether expensive or not very expensive implants were used. The risk of rejection and peri-implantitis (inflammation in the implant area) is always present, although, of course, the likelihood of such an unpleasant outcome is influenced by certain factors.

Popular medical forums, where many people’s reviews of the results of dental implantation are published, are often full of descriptions of various problems after seemingly successfully installed implants. Moreover, violations associated with the “engraftment” of implants are usually among the first.

In fact, peri-implantitis and implant failure are not as common today as one might think after reading the corresponding negative reviews. Each large clinic keeps official statistics on its unsuccessful cases, and the percentage of rejection of all registered implantations is no more than 3-5%.

Moreover, such cases often involve people who were warned about the risks of rejection of dental implants due to existing contraindications, or who regularly violated recommendations for the care of their dentures on implants and had bad habits.

On a note

Peri-implantitis is an inflammation of the tissues surrounding the implant. An infection that occurs due to poor hygiene (most often) or improper implant installation technique (extremely rare) can literally eat away at the bone, leading to swelling, suppuration and severe pain. This complication is sometimes accompanied by the appearance of something unpleasant.

Further progression of peri-implantitis in case of failure to provide timely assistance leads to rejection of the implant - in such cases it is better to remove it immediately, without waiting for the inflammatory process to lead to much more serious complications.

Implant rejection is often accompanied by mobility and pain when loaded (pressure). However, modern dentistry sometimes makes it possible to solve even this, at first glance, the most terrible problem for many patients. However, we are not talking about the fact that the rejected implant will take root safely after some manipulations by the doctor - no, it usually needs to be removed and re-implanted.

The photographs below show the removed implants:

After removal of the movable implant, a comprehensive procedure for preparing the socket for the next implantation is carried out, which can be carried out within 1-2 months. For example, if there is significant loss of bone tissue or proximity to the maxillary sinus, it may be necessary to build up the jaw bone for a dental implant (sinus lift surgery).

Indications and contraindications for dental implantation and their relationship with possible complications

The indication for implantation is the absence of one or more teeth, as well as the impossibility of classical prosthetics. However, errors and complications when installing implants most often occur among those dentists who are guided to a greater extent by indications rather than fully taking into account contraindications to implantation (sometimes this approach is due to commercial considerations, because no one wants to lose “expensive” patients).

Absolute contraindications to dental implantation:

• Chronic diseases in the decompensated stage;
• Serious disturbances of hemostasis;
• HIV and a number of other seropositive infections;
• Some mental illnesses.

Relative contraindications:

• Diseases in the acute stage, especially acute viral infections;
• Chronic infectious diseases;
• Condition after heart attack and stroke;
• Pregnancy and breastfeeding;
• Risk of bacteremia in patients with prosthetic heart valves who have had rheumatism or endocarditis;
• Exacerbation of chronic forms of diseases;
• Treatment with medications that impair tissue regeneration.

Relative contraindications give the doctor the right to delay the dental implantation procedure. For example: after a complete cure of a viral disease, a year after a heart attack, after finishing breastfeeding a child, stopping taking medications that create risks of complications during and after implantation, etc., All this is necessary to minimize the risks of developing negative consequences during dental implantation.

This is interesting

Until recently, diabetes was an absolute contraindication to dental implantation. But at the moment it has been proven that type 2 diabetes mellitus in the compensation stage does not affect the progress of implantation and does not create a risk of implant rejection. However, the operation takes place under the strict supervision of an endocrinologist with mandatory monitoring of blood glucose levels (significant fluctuations in glucose levels are unacceptable).

Some people who at all costs want to get a beautiful smile as soon as possible after dental implantation sometimes have reasonable questions:

• Or maybe it’s still possible to have dental implants done during pregnancy?
• And during an acute infectious process?

So, the simultaneous removal and implantation of teeth during pregnancy can, in some cases, have serious negative consequences for the fetus, and it is difficult to imagine a situation where the operation is simply urgently necessary. It's better to wait anyway. Pregnancy itself does not in any way affect the process of “engraftment” of implants, but drug therapy, which is necessary after their installation, can have a negative impact on the developing fetus.

Even in the event of an emergency, for example an acute injury that led to a fracture of a tooth or root and its subsequent removal, there is no need to rush into implantation during pregnancy. It is clear that an aesthetic problem that arises in a young girl can lead to stress and a nervous breakdown, but the health of the unborn child should come first.

As for implantation during acute infectious processes, the body is weakened due to the infection, and there is an increased risk of peri-implantitis when implants are installed at this time. However, this does not mean that implants cannot be placed in the socket of a tooth removed due to exacerbation of chronic periodontitis. Adequate drug therapy, competent selection of the system and implantation technology can, of course, minimize the risks of complications even in such extreme cases, although in general it can be unreasonable and dangerous to neglect contraindications, especially when this is done by a doctor only for the purpose of obtaining commercial gain.

How to recognize a problem in time: from harmless side effects to dangerous complications

Despite the associated risks, a huge number of people around the world get implants, get a Hollywood smile and the ability to chew food normally. As for possible complications, some are more lucky, some are less fortunate, but the positive effect of implantation directly depends not only on the professionalism and intuition of the dental surgeon, but also on the patient himself.

Not every person has the knowledge to promptly recognize a problem that has arisen and promptly direct the situation to their advantage. And if you paraphrase a well-known saying, you will get a kind of formula for a successful rehabilitation period after dental implantation: “Whoever has the information controls the situation.”

Suspicious symptoms most often occur on the day of implantation or within 1-2 days after it.

Side effects can be observed even after augmentation of the jaw bone for a dental implant, which, however, does not always indicate the possibility of developing a dangerous complication. Sinus lifting is carried out for a good purpose, for example, to build up bone tissue near the bottom of the maxillary sinus, so as not to perforate it during installation of implants.

In general, bone grafting is almost always well tolerated and is often performed simultaneously with implant placement. But sometimes there are completely harmless temporary side effects that disguise themselves as complications that can frighten.

For example:

• Temperature rises to 37.5 degrees;
• Feeling of heaviness in the maxillary sinus;
• Swelling of the face;
• Small hematomas.

The fact is that the tissues of the maxillofacial area have an abundant blood supply (especially the lower jaw), and almost any surgical intervention can be accompanied by phenomena that sometimes frighten even informed patients. However, the terrifying appearance of edema and hematomas in 90-95% of cases does not correspond to their real danger - that is, it all looks scary, but is not dangerous to health and does not lead to serious complications.

A decrease in the severity of such edema and hematomas is observed already in the first days after dental implantation (and sinus lift), and they usually disappear completely after 1-2 weeks.

In general, any surgical methods of dental implantation, as well as stages of bone grafting, are not without side effects, although in most cases it is not reasonable to consider them complications.

How can you distinguish harmless symptoms that arise after dental implantation from a dangerous complication that develops? Here are some examples:

• Pain. As noted above, this is a normal reaction of the body to a traumatic intervention, as a rule, easily relieved with painkillers. They are prescribed by a doctor after dental implantation or sinus lift. But if severe pain accompanies healing for more than 3 days from the moment of implantation, then a complication can be suspected.

• Swelling is also a common result of the inflammatory process and occurs 2-3 hours after the intervention. Within a week, swelling of the maxillofacial area goes away on its own. If they persist after 7 days from the date of dental implantation, and especially if they increase in size, you must urgently consult a doctor.
  
• Bleeding. Intense bleeding within 8-10 hours after dental implantation most often indicates bleeding disorders or problems in the cardiovascular system. If these main causes are excluded, then the bleeding almost always stops safely. Exceptions include injuries to large vessels during implantation, but such complications are extremely rare and are manifested by severe bleeding, starting from the first day of surgery and for more than 5-7 days with the formation of large hematomas.
• Temperature increase. Just as after sinus lift surgery, an increase in body temperature even up to 37.5 within 2-3 days is normal. In rare cases, the temperature on the day of implant installation may rise to high values ​​(above 38.5), especially after the implantation of more than 6-8 dental implants, but this is not the result of complications or errors made during the operation, but in 90% of cases it is individual body reaction. A serious complication can be suspected if the temperature not only does not decrease within 3-4 days, but also tends to rise slightly, and purulent discharge appears at the sites where the implants are installed (pus may have an unpleasant odor).
• Loss of sensation in the facial area. Loss of sensitivity in part of the face is a rather unpleasant, but very rarely observed complication after dental implantation. Typically, decreased sensitivity lasts no more than 3-5 days. If during implantation the dental surgeon caused serious damage to the nerve, then its independent recovery sometimes ends only within 4-6 months. Recovery can be accelerated by physical therapy and drug therapy, without surgery.

Sometimes the appearance of an unpleasant putrid odor in the area of ​​a recently installed dental implant leads patients to believe that a serious problem has arisen - perhaps there has been a rejection, because “something is rotting and decomposing there”...

In this case, it is useful to know a number of quite characteristic signs that really warn about the onset of implant rejection:

• Heavy bleeding for more than 3-4 days;
• Increased swelling and its persistence for more than 2-3 weeks;
• Gradual increase in pain within 2-3 days from the moment of dental implantation;
• A feeling of a foreign body “moving” in the mouth where the implants were placed.

But as for the appearance of bad breath, everything is not so simple. This smell can be caused by both the formation of pus (which may indicate a serious complication) and completely natural bacterial degradation of organic matter, sometimes even under the implant plug.

How to prevent negative consequences after implantation?

Let us note a number of simple rules, following which you can not only significantly reduce the risk of complications after dental implantation, but also, in some cases, speed up the process of implant healing, making it as comfortable as possible.

These are the rules:

It should be borne in mind that only a dentist can choose an adequate course of medication for you, based on your individual characteristics and concomitant diseases. Therefore, independent choice of one or another home treatment method and drug can be fraught with undesirable consequences (for example, some comrades strive to smear their gums with some ointments: Metrogyl Denta, Solcoseryl dental adhesive paste or others, although this is not always desirable).

It is important to know

Until the stitches are removed, the ideal diet is boiled vegetables, light warm soups and fish dishes (without bones). But hard, sticky, floury and especially spicy and hot foods can contribute to the development of inflammation in the implant area.

After crowns and bridges are placed on implants, it is important to care for them carefully and regularly. You need to brush your teeth twice a day and once a day between your teeth. Where the implant comes into contact with the gums, it is recommended to clean it in the evening from plaque and food debris with a soft interdental brush.

Well, and of course, choosing the right dental clinic, taking into account the reviews of patients who have already visited it, helps to avoid complications. In addition to the clinic itself, no less, or even more, attention should be paid to the choice of a specific doctor who will perform the work, because the final result directly depends on his qualifications.

Which implant systems are characterized by a minimal risk of complications?

At the moment, there are more than 300 types of dental implants, which differ from each other in many ways. However, among all this diversity, there are no implants that would be characterized by a zero risk of developing possible complications after their installation.

Meanwhile, there are several truly well-proven systems that are rejected extremely rarely with correct and professionally performed implantation technology (and the corresponding statistics well confirm this).

You can choose the safest implant system taking into account 5 main selection criteria:

At the moment, dental implants from Sweden, Switzerland and Israel have proven themselves to be the best according to all these 5 criteria. At the same time, recently more and more cheap analogues of Asian origin have appeared from companies that have neither a long history nor sufficient experience in using their products. The low price of dental implantation using such analogues may hide large risks of complications, for which some clinics are not always willing to bear responsibility.

Therefore, in order not to become the hero of the famous saying “The miser pays twice,” you should take the most responsible approach to choosing a clinic, a doctor, an implant manufacturer, and going through the rehabilitation period after surgery. Then the result of dental implantation will be a truly high-quality treatment without any unpleasant complications.

Be healthy!

Interesting video about possible complications that sometimes arise after dental implantation

Implantation or classic prosthetics - what to choose?..