andrey mikhailovich matveev andrey mikhailovich will tell you in detail about new modern technologies of belarusian dentistry. hello, we are glad to see you in our studio. hello until recently, dental implantation was a know-how or elite procedure. that's how things are today, progress does not stand still, and along with it, our dentists, orthopedic surgeons, have joined this method of treatment, and this method is developing more and more often in the republic. he has been working for a long time not only in the capital in minsk but also in regional cities and districts about 10 years ago. uh, the number of implants that were placed with us was found, then i’m there at 10-12.000, which today is almost more than 20-25.000 implants are inserted per year throughout the country, as far as it the procedure is shown to absolutely everyone today, already having experience and implemented technologies. uh, according to statistics, uh, the number of survival rates or there the percentage of survival rate of implants is about 90-96%, that is, in case of rejection, not very big people. anyway, today they are afraid to put implants, because they tell a lot of stories , it doesn’t work out, but there is some kind of individual intolerance. these philistine opinions, they say, probably most of all, to a greater extent, the patient himself is to blame first, if he, during a conversation, with by a doctor during the preliminary collection of an anamnesis. no, he said, he didn’t give the doctor all the information about himself. that is, this is a past disease, a concomitant disease, especially such as oncological diseases associated with a decrease. eh, precisely the resilience of man. diabetes mellitus is not compensated form. this is the first. the second is when e the patient is recommended, for example, after the introduction of implants after the operation, not to visit, for example, a bath, because an increase is associated with a sufficiently large rush of blood temperature and possibly these negative consequences. well, that's a plus. e, when the patient does not observe oral hygiene after the removal of the implants. there is such a saying. she implants love cleanliness, the patient should take care of oral hygiene and especially the hygiene of implants around the neck of the implants. to do this, today there are irrigators. the so-called, which allow, but under the pressure of water, without causing injury to the mucosa. eh, without him the end. uh, rinse clean out of there. all uh, food leftovers that can get under the crown and respectively be on the neck of the implants. what are the main age restrictions, but it is not always possible to put an implant. we do not recommend placing implants before the age of 18, because before that time the bone skeleton is being formed and, accordingly, uh, this implant may shift its positioning in the bone and, accordingly, then, when it is made, uh, a crown or some kind of then the protest, it can move along with the implant with the bone, that is, we do not recommend it, although in some cases it is possible to go for it. the so-called temporary implantation, as regards the age of the elder. there are practically no restrictions here, but you can do this even at 60-70 and 80 years old. i personally had in my practice, and plantations with subsequent prosthetics of a woman aged, in my opinion, she was 78 and i saw her, probably three or four years ago, she successfully used prostheses. which we once installed, there she was 10 years ago 15 the introduction of implants in more e, mature age we will say so it helps to preserve the oval of the face, the preservation of e turgor of muscle tension through the archery area. well, it unloads the jaw joints. that's right, because a decrease in the dentition leads to an additional load on the masticatory muscles. and this is generally additional pain in the head area, evolutionarily, a person stops chewing solid food, the load, respectively, uh, the jaw on the joints decreases, they shift, the height of the lower case of the face changes and, accordingly. uh, maybe these functions of the temporomandibular joint. what diagnostics do you use in order to determine the methodology and tactics of implantation to a specific person, and today in the arsenal. dentists, implantologists, and there is, uh, such an x-ray machine as uh, a linear computed tomograph. it allows you to determine the volume of the tissues of the maxillofacial region of the bone tissue. it allows you to determine the thickness of the e bone tissue, in addition, the software that is in this complex allows you to. uh, immediately after this procedure, computed tomography to the doctor of the implantologist to calculate the dimension of the implants. that is. uh, what kind of implant will he put there, uh, 6-7 mm or 10-12 mm and the thickness is the same, that is, but computed tomography allows you to reproduce in volume. e, the human jaw and, accordingly , topographically orient the placement of these implants. if many implants are placed. there, more than 6-8 so -called chi templates are used, when, during the preparation of this patient, holes are made in this template on a special machine so that later the doctor-implantologist during the introduction of these implants observes their parallelism so that later they are, respectively, an orthopedic doctor who will prosthetics, and did not experience great difficulties in selecting the angularity there, that is, those parts that are already attached to the actual crowns. but there is another important part in implantology - this is implantation, and implants in areas where there are sinuses. i am now talking about the upper jaw, where we have the upper jaw sinuses, and nature has taken care to create these sinuses so that we have a certain speech timbre, and this is very important for the respiratory system. but here certain problems arise already for dentists, because very often we lose teeth in the projection of the maxillary sinuses. and there, as a rule, the bone is very thin , especially with the anatomical structure of the upper jaw. as you said, this is the presence of grooves, in addition to the fact that the bone is there, but thin, and this depends on the previous development of the disease. this is periodontal tissue, when resorption occurs there is lysis of this tissue, but it is still porous in structure, unlike the lower jaw. that is, the thickness of the fabric decreases, there are two ways to do this. this is the operation of the so-called sinus lift. that is, uh, when a dental implantologist cuts the mucosa, exfoliates it from the bone and gradually uh, pushes this mucosa upwards, there is no shell, which is precisely created for the husband correctly in this cavity. ie he its this is called a pirate. uh, closed sinus lift operation, that is, the integrity of the sinus is not violated. if the integrity of the sinus is violated, this also happens. this is an open sinus lift operation, respectively. better, of course, to carry out, uh, a closed sinus lift operation. faster recovery and survival of this implant together with the bone conglomerate, which is introduced during the operation, is made from a. the bones of cattle, which are mainly bred in new zealand in australia, they are more suitable in their genetic factors for humans, so bone meal or small blocks are made from this material, which allows uh? fix this block with the help of micro screws, and then enter into it. uh, implant through the patient's bone tissue. that is, this is, uh, the operation of a closed sinus lift, just like that, but a short and very quick operation for placing implants, a surgeon, a dentist implantologist makes a small hole, where the root of the tooth was lifted up, the same sinus yes there, but adds certain structures. uh, bone powder or bone tissue to increase the thickness and then the implant is screwed in. as they say in the simultaneous removal of a tooth and the introduction of an implant there, this can be done and should be done when the tooth is not inflamed. that is, he, well, this root or a destroyed tooth stood and stood, because if the tops of the teeth are often we have so-called or razlimotous periodontitis. that is, the likelihood that an infection will be introduced. in this case, two stages, first removal of healing and then treatment again. but, if we talk about hmm implantation itself and implants, and they have also changed and are constantly being modernized when we just started, uh, implantation in our country. eh, and not only us apart in the world. it was the so-called band implants, when. well, here's a band like that , and she had 2-3 there. e such heads. that's something with the course of e development of science and technology came to the so-called. e plan there, which represent. the tooth root is a high degree and purity of titanium in which it has an affinity for human bone and the porous-porosity of this material allows bone tissue to penetrate through it, in addition to the implant. uh, in the implant itself. there is a so-called cutting or carving, uh, which different firms, uh, have different pitches, different depths, and so on. well, this is again done for individual selection by a doctor implantologist. e chooses the implant that, from his point of view of experience, from the state of the patient's bone tissue, will be the most acceptable in this situation. so this is the most-plant, he is in e. during the operation, it is introduced into the bone tissue. and there should be more. uh, the cap is the so -called cap. she closes. uh, the entrance to the implant so that the mucosa does not penetrate inside and does not grow into the implant there inserted. the so-called abutment, on which it is actually possible to fix any structure e in the oral cavity, when two adjacent absolutely healthy teeth, so as not to drill them correctly, do not cut and give a person the opportunity to still use their natural teeth here, just the same implantology is and there is, the very solution is correct, which allows you to simply replace a specific defective area, and all two healthy teeth are inserted into the gap between them with an implant. and i think it will be seen, uh it is in the bone tissue, there are so-called abutments on top and we close it. restoring the integrity of the dentition with the least defective lateral section two implants cement-retained bridge prosthesis . here is one of the fixation methods, when the so-called screw fixation, when this bridge is fixed with screws. and then these tunnels, the so-called holes, are closed with filling material. well, as i understand it, this type of implantation will be good for people who really have problems with bone fabric, just the same here, implants work like such piles correctly, on which they are very clear and good. you can plant, for example, two or three teeth there correctly and immediately we close a large defect. here is an example of how we assume that a patient has a complete secondary intension of the lower jaw on her e there was nothing we introduce. four implants we connect them with a beam, that is, like this well , to increase rigidity, so that they hold on top. the invoice and everything a person uses, or, if we assume, here is also another option, when e is less the number of implants they are, well, for some reason. properties cannot be entered there 4-6 implants, then we introduce two. uh, so -called balls or balls are fixed on them. and, in principle, it is also the same design, it snaps into place and the patient uses, again, they actively use this prosthesis. andreiilovich is just this metal one, but a prosthesis or metal implants. and what is this model? this is some other model, all implants, ranging from the famous swiss ones to new ones, which appear on the principle of their one, but they differ once again i repeat the aggressiveness, that is, the depth, uh, of the carving step. this carving is, of course, the point of the ultimate choice. the end result of implantation should be the restoration of the function of the lost tooth or system there. and here are the implants. they are similar to each other depending on the frequency of the implant used. if the world manufacturers are among the leaders, then there is the frequency of the titanium metal itself, it is higher, respectively, it will be more expensive and such an implant will be. andrei mikhailovich let's summarize. what are today advantages of implants? uh, the main advantage they allow you to restore, uh, the integrity of the dentition without, uh, using, let's say next to, standing