What are vasodilators and how do they work. What are the main types of vasodilators used to treat cardiovascular conditions. What are the potential side effects and precautions to be aware of when taking vasodilator medications.

Understanding Vasodilators and Their Mechanism of Action

Vasodilators are a class of medications that work by dilating or opening blood vessels, allowing blood to flow more freely throughout the body. This action helps reduce blood pressure and improve overall cardiovascular function. But how exactly do these drugs work?

The mechanism of action for vasodilators involves relaxing the smooth muscle in blood vessel walls. This relaxation causes the blood vessels to widen, decreasing resistance and allowing blood to flow more easily. As a result, the heart doesn’t have to work as hard to pump blood, which can help alleviate various cardiovascular conditions.

When Does Vasodilation Occur?

Vasodilation is a natural process that occurs in the body under certain circumstances, such as during exercise or in response to temperature changes. However, in some individuals, this process may be impaired, leading to various cardiovascular issues. This is where vasodilator medications come into play, artificially inducing vasodilation to improve circulation and overall heart health.

Primary Uses of Vasodilator Medications

Vasodilators are prescribed to treat or prevent several cardiovascular conditions. The main uses of these medications include:

• Treating high blood pressure (hypertension)
• Managing heart failure
• Preventing preeclampsia during pregnancy
• Alleviating angina (chest pain caused by reduced blood flow to the heart)
• Addressing pulmonary hypertension

It’s important to note that vasodilators are often used in combination with other medications and are rarely prescribed as standalone treatments. This multi-faceted approach allows for more comprehensive management of cardiovascular conditions.

Types of Vasodilators: Arterial, Venous, and Mixed Dilators

Vasodilators can be categorized based on their primary site of action within the cardiovascular system. Understanding these distinctions can help patients and healthcare providers choose the most appropriate medication for specific conditions.

Arterial Dilators

Arterial dilators primarily affect the arteries, which are responsible for carrying oxygenated blood away from the heart to the body’s tissues. These medications are typically prescribed for conditions such as high blood pressure and heart failure. By dilating the arteries, they reduce the resistance against which the heart must pump, thereby lowering blood pressure and easing the heart’s workload.

Venous Dilators

Venous dilators, as the name suggests, mainly affect the veins. These blood vessels are responsible for returning deoxygenated blood back to the heart. Venous dilators are particularly effective in treating angina and heart failure. By dilating the veins, they reduce the amount of blood returning to the heart, which can help alleviate symptoms associated with these conditions.

Mixed Dilators

Mixed dilators affect both arteries and veins. These medications offer a more comprehensive approach to vasodilation, providing benefits associated with both arterial and venous dilation. The choice between these types of vasodilators depends on the specific cardiovascular condition being treated and the individual patient’s needs.

Common Vasodilator Medications and Their Applications

Several vasodilator medications are commonly prescribed for various cardiovascular conditions. Some of the most frequently used vasodilators include:

1. Hydralazine: This medication is primarily used to treat high blood pressure and heart failure. It works by relaxing the smooth muscle in arterial walls, leading to vasodilation.
2. ACE inhibitors: While not strictly vasodilators, ACE inhibitors indirectly cause vasodilation by inhibiting the production of angiotensin II, a hormone that causes blood vessels to constrict. They are commonly used to treat hypertension and heart failure.
3. Minoxidil: Originally developed as a blood pressure medication, minoxidil is now more commonly known for its use in treating hair loss. However, it remains an effective vasodilator for managing severe hypertension.

Other vasodilators include calcium channel blockers, nitrates, and alpha-blockers. The choice of medication depends on the specific condition being treated, the patient’s overall health, and potential interactions with other medications.

Potential Side Effects of Vasodilator Medications

While vasodilators can be highly effective in managing cardiovascular conditions, they may also cause certain side effects. It’s crucial for patients to be aware of these potential adverse reactions and report any concerning symptoms to their healthcare provider.

Common side effects of vasodilators may include:

• Chest pain
• Heart palpitations or rapid heartbeat
• Fluid retention
• Nausea or vomiting
• Dizziness
• Headache
• Flushing
• Excessive hair growth
• Nasal congestion

The severity and frequency of these side effects can vary depending on the specific medication and individual patient factors. In some cases, the benefits of vasodilator therapy may outweigh the potential risks of side effects.

Managing Side Effects

If a patient experiences side effects from vasodilator medications, their healthcare provider may adjust the dosage or switch to a different medication. In some cases, additional treatments may be prescribed to manage specific side effects. For example, if fluid retention becomes a problem, a diuretic might be added to the treatment regimen.

Important Precautions When Taking Vasodilator Medications

To ensure the safe and effective use of vasodilator medications, patients should be aware of several important precautions:

• Full disclosure of medical history: Patients should inform their healthcare provider about any existing medical conditions before starting vasodilator therapy.
• Ongoing management: While vasodilators can help control high blood pressure, they do not cure the underlying condition. Continued treatment and lifestyle modifications are often necessary.
• Dietary considerations: Healthcare providers may recommend specific dietary changes to complement vasodilator therapy. These instructions should be followed carefully.
• Awareness of side effects: Vasodilators can cause dizziness, which may affect a person’s ability to drive or operate machinery. Patients should exercise caution until they understand how the medication affects them.
• Regular monitoring: Frequent medical check-ups and laboratory tests may be necessary to monitor the body’s response to vasodilator medications.
• Drug interactions: Patients should inform their healthcare provider about all medications they are taking, including over-the-counter drugs, supplements, and recreational substances.

Vasodilators and Lifestyle Considerations

While vasodilator medications can be highly effective in managing cardiovascular conditions, their efficacy can be influenced by various lifestyle factors. Patients taking these medications should be aware of how certain aspects of their daily life might interact with their treatment.

Alcohol Consumption and Vasodilators

Alcohol can interfere with how vasodilators work in the body. The combination of alcohol and vasodilators may lead to excessive vasodilation, potentially causing a dangerous drop in blood pressure. For this reason, it’s generally recommended to avoid alcohol consumption while taking vasodilator medications. Patients should discuss any concerns about alcohol use with their healthcare provider.

Exercise and Physical Activity

Regular physical activity is generally beneficial for cardiovascular health. However, patients taking vasodilators should be aware that these medications may affect their body’s response to exercise. Some individuals may experience dizziness or lightheadedness during physical activity, especially when first starting vasodilator therapy. It’s important to start any new exercise regimen gradually and under medical supervision.

Diet and Nutrition

A heart-healthy diet can complement the effects of vasodilator medications. Some foods, known as natural vasodilators, can support healthy blood flow. These include:

• Leafy green vegetables
• Citrus fruits
• Nuts and seeds
• Beets
• Dark chocolate

While these foods can be beneficial, patients should always consult with their healthcare provider before making significant changes to their diet.

Vasodilators and Special Populations: Pregnancy and Breastfeeding

The use of vasodilator medications during pregnancy and breastfeeding requires special consideration. Some vasodilators can potentially affect fetal development or be transmitted through breast milk.

Vasodilators During Pregnancy

Pregnant women or those planning to become pregnant should inform their healthcare provider if they are taking vasodilator medications. Some vasodilators may cause unwanted effects in unborn babies, while others are considered relatively safe during pregnancy. The decision to continue or discontinue vasodilator therapy during pregnancy involves carefully weighing the potential risks and benefits for both the mother and the developing fetus.

Vasodilators and Breastfeeding

Women who are breastfeeding should also consult their healthcare provider before taking vasodilator medications. Some of these drugs may pass into breast milk, potentially affecting the nursing infant. In many cases, alternative medications or treatment strategies may be recommended to ensure the health and safety of both mother and child.

It’s crucial for women to have open and honest discussions with their healthcare providers about their medications, pregnancy plans, and breastfeeding intentions to ensure the most appropriate and safe treatment approach.

Vasodilators – Types, Side Effects & Precautions

This class of drugs is often used to treat cardiovascular conditions, such as hypertension.

Vasodilators are a group of medicines that dilate (open) blood vessels, which allows blood to flow more easily.

They’re used to treat or prevent:

• High blood pressure (hypertension)
• Heart failure
• Preeclampsia (high blood pressure during pregnancy)
• Angina (chest pain caused by reduced blood flow to the heart)
• Pulmonary hypertension (high blood pressure that affects the arteries in your lungs)

Vasodilators are often combined with other drugs and are rarely used alone.

Types of Vasodilators

There are different types of vasodilators, including:

• Arterial dilators (mainly affect the arteries)
• Venous dilators (mainly affect the veins)
• Mixed dilators (affect veins and arteries)

Arterial dilators are typically prescribed to treat high blood pressure and heart failure, while venous dilators are effective for angina and heart failure.

Your doctor will decide which vasodilator is right for you.

Common Vasodilators

The following are commonly prescribed vasodilators:

• Hydralazine
• ACE inhibitors
• Minoxidil

Side Effects of Vasodilators

Side Effects of vasodilators may include:

• Chest pain
• Heart palpitations (fluttering or pounding heartbeat)
• Rapid heartbeat
• Fluid retention
• Nausea or vomiting
• Dizziness
• Headache
• Flushing
• Excessive hair growth
• Nasal congestion

Vasodilator Precautions

Tell your doctor about any other medical conditions you have before starting on a vasodilator.

Vasodilators may help control your high blood pressure, but they won’t cure the condition.

Your doctor may suggest that you follow a special diet while taking vasodilators. Follow these instructions carefully.

Vasodilators can cause dizziness. Don’t drive or perform activities that require alertness until you know how these medicines affect you.

Tell your healthcare provider that you’re taking a vasodilator before having any type of medical procedure, including dental procedures.

Your doctor will want to perform frequent tests to monitor your body’s response to these medicines. Keep all appointments with your doctor’s office and laboratory.

Let your doctor know about all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs you’re taking before starting on a vasodilator.

Vasodilators and Alcohol

Alcohol may interfere with how vasodilators work in your body.

Avoid drinking alcohol while taking these medicines.

Vasodilators and Pregnancy

Tell your doctor if you’re pregnant or might become pregnant while taking a vasodilator.

Some of these medicines can cause unwanted effects in unborn babies.

You’ll have to discuss the risks and benefits of taking vasodilators during pregnancy.

Also, talk to your healthcare provider before taking a vasodilator if you’re breastfeeding.

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20 Best Vasodilator Foods for Circulation – NutriGardens

When does vasodilation happen?

Vasodilation happens when the smooth muscular wall of our blood vessels formed by endothelial cells relax and widen. This occurrence allows for maximum nutrients and oxygen to flow to all areas of the body – and in fact, all organs are affected by vasodilation. It’s a mechanism that we want to nurture for that reason. When vasodilation decreases, this is called vasoconstriction; meaning the flow of oxygen and nutrients carried by our blood vessels is constricted. So improvement of vasodilation can occur by removing stimuli that cause blood vessels to contract or by adding stimuli that supports blood vessel relaxation. 

A healthy individual with a plant-based diet full of vasodilator foods and daily exercise can expect to have consistent vasodilation. Certain conditions impact vasodilation, some in our control, such as lifestyle choices and other unavoidable factors, like age.  

Why is vasodilation necessary?

Vasodilation is a natural occurrence in our bodies. In response to a need for increased nutrients and oxygen, say during an intense workout, our tissue will release nitric oxide which dilates blood vessels. Or, when we go up high in elevation where there’s less oxygen, we need vasodilation to kick in and compensate for the reduction in oxygen. Our bodies need to have this response so that there’s a healthy, level-appropriate supply of oxygen and nutrients sent to our vital organs and muscles to help us perform at our best. To be vasodilation-vigilant means to remove factors that decrease it and increase factors that improve it.

What are the factors that decrease vasodilation?

Stress – stress contributes to vasoconstriction because it activates the sympathetic nervous system, our flight or fight response. 

Age – Aging decreases the functioning of vasodilation; for example, the vasodilating gas nitric oxide is produced 10% less every decade. As we age, we have to work against this natural deterioration. 

Weight – Being overweight affects the function of vasodilation and it is thought that the hyperactivity mode of the sympathetic neural system for overweight people is a big part of this reaction.

What are the factors that improve vasodilation?

Exercise – exercise-induced vasodilation happens when a boost in demand for oxygen happens by the exertion of muscles. 

Temperature – heat increases vasodilation as blood vessels push heat out through the skin to keep core temperatures cool. 

Elevation – The decrease in oxygen that occurs as we go up in elevation causes the body to respond by increasing vasodilation to help maintain oxygen levels throughout the body. 

Diet – One of the greatest factors that impact vasodilation is the foods we eat. Higher fat, salt, and sugar content in foods produce vasoconstricting effects, while a plant-based diet high in vasodilator foods help keep arteries and blood vessels relaxed and transport vital nutrients and oxygen.  

Top 20 Vasodilator Foods

Beets 

Considered a major vasodilator food for its intense oxygen delivery, beets increase nitrate intake, which the body converts to nitric oxide. This potent vasodilating gas is a marker of health and vitality. Beets have been a core subject of study and usage in promoting overall health and sports supplementation. 

Red Spinach 

Red spinach is the new beet. The amaranth plant (not technically spinach) has been discordant to have an even higher nitrate concentration per weight than beets. It’s a durable plant that is challenging to find in the market but can be sourced clean from red spinach plant to powder with no additives. Because of its high nitrate content, top athletes leverage red spinach for the ultimate nitric oxide boost. 

Green Spinach

Ubiquitous in any market, is associated with cardiovascular health because of its powerful vasodilating property, a rise in nitric oxide levels.

Pomegranate 

According to research, the polyphenols in pomegranates are more powerful in their vasodilating properties than other fruits containing polyphenols.

Tart Cherry 

In clinical studies, many varieties of tart cherry juice have proven time and time again as a powerful weapon for health and reduced cardiovascular events. 

Swiss Chard

A part of the Chenopodiaceae subfamily of the higher Amaranthaceae family of plants is related to beets and spinach. As a chenopodium plant, it induces relaxation of smooth muscle around blood vessel walls. 

Oranges

Hesperidin is a flavinoid in orange juice that has been associated with a remarkable impact on vasodilation, according to research. Citrus fruits contain Vitamin C, a powerful antioxidant; as a group, they are also responsible for protecting and increasing the lifespan of nitric oxide in the body.

Garlic

The gasses that garlic helps the body produce and regulate are its biggest contributors to vasodilation. The polysulfides in garlic stimulate the production of vascular hydrogen sulfide as well as regulate the production of endothelial nitric oxide, both of which are types of signaling molecules that help the body communicate and transport vital oxygen and nutrients.  

Arugula, Kale, and other Leafy Greens 

Leafy greens contain high amounts of nitrate, which help facilitate more nitric oxide production via the nitrate‐nitrite‐NO pathway. Leafy green’s potassium contents also help counteract heavy salt intake helping to make leafy greens a vital dietary contributor to vasodilation.

Beans

Legumes are recommended to eat for longevity and heart health. Many components contribute to this dietary staple, including a high rate of dietary nitrate. Studies show that intake of legumes four times a week can significantly improve cardiovascular health.

Walnuts

A regarded source of L-arginine, a nitric oxide precursor, walnuts contain some of the highest antioxidants of any nuts, making it a top nut for vasodilation. 

Watermelon

one of the greatest known sources of L-citrulline which makes L-arginine bioavailable for nitric oxide synthase and boosts vasodilation. 

Berries

 Including blueberries, strawberries, raspberries, and blackberries, c contain powerful flavonoids which include anthocyanin and proanthocyanidin that substances reduce cell damage and have been shown to increase the production of nitric oxide in blood vessels.

Tea

Both green tea and black tea help vasodilation by way of EGCG and theaflavins, respectively. Studies conclude that tea is a powerful contributor to cardiovascular and metabolic health.

Almonds

Contributing to healthy cholesterol levels, almost produce a boost of L-Arginine to the system that prompts nitric oxide production which improves vasodilation.

Chickpeas

 containing some of the highest rates of L-arginine, chickpeas not only help vasodilation by direct supply of the important amino acid but also help in weight management.

Spirulina 

Studies on the SP6 peptide in spirulina show dramatic support in endothelial vasorelaxation and are an extremely useful food for heart health.

Watercress

Packs in powerful amounts of nitrate and antioxidants, especially carotenoids that aid in reducing the oxygen necessary for executing exhaustive tasks and also support a healthy heart by way of increasing vasodilation.

Mango

Studies show that within 2 hours of consuming mangoes, relaxation of blood vessels occurs. Mangoes contain many antioxidants, especially beta-carotene, such as carotenoids help regulate endothelial function.

Sweet potatoes

a well-known heart-healthy food. Orange flesh sweet potatoes contain higher concentrations of protein, flavonoids, anthocyanins, and carotenoids than white flesh sweet potatoes and promote vasodilation.

How nitric oxide works to increase vasodilation

Nitric oxide is a gaseous molecule that is produced by the body in various ways. It is a signaling molecule produced by almost every cell type in the body. Nitric oxide plays a core role in vasodilation by relaxing the smooth muscle around blood vessels allowing a widening effect to occur. Nitric oxide is a determining health factor according to leading doctors. 

The NutriGarden family of products were made to boost nitric oxide levels for everyday health and punctuated athletic performance. Our labels are the cleanest on the market, providing 100% plant-based, vasodilator food ingredients for nitric oxide boosting that are vegan, Non-GMO, preservative-free, gluten-free, with no added sugar or artificial flavor. 

Resources 

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Harris, C. W., Edwards, J. L., Baruch, A., Riley, W. A., Pusser, B. E., Rejeski, W. J., & Herrington, D. M. (2000). Effects of mental stress on brachial artery flow-mediated vasodilation in healthy normal individuals. American heart journal, 139(3), 405–411. https://doi.org/10.1016/s0002-8703(00)90083-8

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Barnard, N. D., Goldman, D. M., Loomis, J. F., Kahleova, H., Levin, S. M., Neabore, S., & Batts, T. C. (2019). Plant-Based Diets for Cardiovascular Safety and Performance in Endurance Sports. Nutrients, 11(1), 130. https://doi.org/10.3390/nu11010130

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Jovanovski, E. , Bosco, L., Khan, K., Au-Yeung, F., Ho, H., Zurbau, A., Jenkins, A. L., & Vuksan, V. (2015). Effect of Spinach, a High Dietary Nitrate Source, on Arterial Stiffness and Related Hemodynamic Measures: A Randomized, Controlled Trial in Healthy Adults. Clinical nutrition research, 4(3), 160–167. https://doi.org/10.7762/cnr.2015.4.3.160

Roelofs, E. J., Smith-Ryan, A. E., Trexler, E. T., Hirsch, K. R., & Mock, M. G. (2017). Effects of pomegranate extract on blood flow and vessel diameter after high-intensity exercise in young, healthy adults. European journal of sport science, 17(3), 317–325. https://doi.org/10.1080/17461391.2016.1230892

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Implantation technologies without bone grafting

In this article, you can learn about new standards in dental implantation from an implantologist with a total work experience of more than 30 years. Alexander Pavlovich Akhtanin has been installing implants since 1996. Installed more than 20,000 implants. Passed the specialization in Boston, USA with the award of the title of Implant specialist.

Alexander Pavlovich, tell us what, in your opinion, is the key factor for successful implantation?

For many years, the key to successful implantation was the placement of long and thick implants. This was motivated by the fact that larger implants are more resistant to chewing loads. In turn, a large amount of bone tissue was required to install a thick implant. With its shortage, bone grafting was performed, sometimes in quite traumatic ways.

But, decades later, implantologists came to the conclusion that many complications occur just in those cases when it was decided to put a longer or thicker implant in a place where a smaller implant could have been dispensed with. For example, Straumann has shown evidence that complications occur 3.4 times more frequently with thicker implants than with standard-thickness implants or thin implants.

Tell us in more detail, what are the advantages for the patient of the installation of thinner and shorter implants?

Firstly, the implant installation procedure itself is less traumatic. After all, the larger the size of the implant, the larger the hole for it needs to be made in the bone tissue. When installing a thinner implant, the bone tissue around it is maximally preserved, and it just depends on it whether the implant will last for many years. So why sacrifice your own bone for the sake of the size of the implant?

Secondly, the use of thin or short implants makes it possible to do without bone tissue augmentation, without sinus lifting. In addition to reducing the treatment time, reducing trauma, this reduces the risk of nerve damage in the lower jaw and the maxillary sinus in the upper. If you think you’re taking a risk with a short or thin implant, don’t forget that bone augmentation also comes with additional risks. Unfortunately, in medicine there are no methods with a 100% success rate.

For many patients, the installation of short or thin implants is the only way to restore the lost dentition, especially in the absence of teeth.

Does this apply to thin and short implants of all brands?

Not really. It is necessary to follow the recommendations of the implant manufacturers, and the thin/short implants of most of them are not designed for a large chewing load. They will simply break, and this will become a big problem.

It is worth mentioning the company Straumann. They invented the material Roxolid, an alloy of titanium and zirconium. It has the same biocompatibility as pure titanium, but is many times stronger than it. Therefore, thin and short Straumann Roxolid implants can be used without bone augmentation and without sinus lift, being absolutely confident in the result.

It is important to note that Straumann Roxolid are NOT mini implants. They are classic implants made of a stronger alloy (85% titanium, 15% zirconium).

It should also be noted the German implants Ankylos. They were originally designed in such a way that their standard implant is thinner than standard implants from other companies. But this does not prevent him from withstanding heavy loads, which was proved at the University of Frankfurt in the course of a 20-year study. There is no difference between thick and thin, long and short implants. The most important thing is the presence of bone around the implant.

Ankylos thin implants placed at 1992 (left), x-ray 20 years later (right) shows excellent bone condition around the implants

And what do European and American colleagues think about this?

Just they have not been afraid to put into practice short and thin implants for a long time. And they do it right! For example, our Italian colleague, president of a large implant association, conducted the following study. He installed two crowns on a Straumann Roxolid implant just 4 mm long! That is, he deliberately doubled the load on the implant. And what do you think, the success of implantation after 5 years was 95%. What can we say about if the work is done according to the protocol.

At one of the last meetings of ITI – the international association of implantologists – the undiscovered potential of thinner and shorter implants was actively discussed. Implantologists around the world are coming to the conclusion that it is better to avoid additional bone augmentation surgeries. After all, a patient does not come to us for us to perform a “cool operation” on him. He needs new teeth, a new smile and a better quality of life. And for this, you can get by with smaller implants.

What is the difference between foreign dentistry and ours?

Communicating with our foreign colleagues, I draw your attention to the fact that in our country there are many more patients who already have all their teeth missing, or they need to be removed and implants installed. Accordingly, there are much more patients with bone tissue atrophy.

Is it possible to install short/thin implants in the absence of teeth?

Of course, sometimes this is the only way out for those who want to get a fixed structure on implants that completely imitates their own teeth. Without volumetric operations to increase bone tissue. But for this it is desirable to use Straumann Roxolid or Ankylos implants.

Another option is to install thin/short implants, but in larger numbers. If 6 implants are to be placed for a fixed jaw prosthesis, 8 short or thin ones can be placed as an alternative. This will evenly distribute the chewing load between them. The installation of an additional two implants is much less traumatic than bone augmentation procedures, and the cost of treatment is less or the same.

Tell me, can you still do bone grafting and put a big implant?

Indeed, there is always a choice of what is best to do. Let’s look at what problems arise during bone grafting.

Firstly, it is the traumatic nature of the procedure. The gold standard for bone grafting is the harvesting and grafting of the patient’s own bone. The bone block is sawn off from the angle of the lower jaw, from the chin area, or completely outside the oral cavity (ilium, rib). The more bone tissue needs to be grown, the more surgical procedures the patient needs to undergo.

Second, duration. Bone augmentation procedures are often performed independently without implants. The total duration of treatment can be a year and a half.

Although they do not save on health, one cannot but say about the high cost. The cost of bone augmentation can cost as much as implantation followed by prosthetics.

But the main problem is that the grown bone tissue is different from your own. There is a risk of its resorption 2-3 years after the installation of implants. Then it turns out that the patient endured all these procedures in vain.

But this does not mean that you should completely abandon the procedures for increasing bone tissue.

In which cases would you still recommend bone augmentation?

Most often when it comes to sinus lift. His technique has been worked out decades ago, so this is a really reliable procedure. When implanting in the complete absence of teeth, it is sometimes advisable to do a sinus lift with simultaneous installation of implants than to install them at an angle, bypassing the maxillary sinuses. But in each case, everything is decided individually.

It is also worth mentioning those cases when it is necessary to restore aesthetics after an injury. Without bone tissue augmentation, it is sometimes simply impossible to create a beautiful gingival contour and, as a result, a beautiful smile.

Describe cases where short/thin implants were placed.

The patient came to me with the need to implant the entire jaw. Periodontitis has led to the loss of many teeth and bone atrophy. If we wanted to install standard implants, then it would be necessary to remove all the teeth, wait 3-4 months. Then perform bone grafting, wait the same amount, and then install the implants. The total duration of treatment would be about one and a half years, during which she would use a removable prosthesis. Not the most comfortable thing in the world.

Instead, simultaneously with the extraction of teeth, short and thin implants were installed without sinus lifts, but in a larger quantity – 8 pieces. This was enough to install a fixed plastic prosthesis immediately after implantation. The whole procedure lasted about 2-3 hours. The patient was very pleased with her new smile!

The last question, what are the prospects for this method of implantation?

To date, the successful use of thin and short implants without bone augmentation is a proven fact. Let’s keep up with new trends in implantology.

Endoscopic dental implantation

Implant placement

Implantation of several teeth in a row

New technologies of implantation without bone grafting

Bone augmentation: 5 different types of osteoplasty

Bone augmentation is one of the most common ancillary procedures in dentistry. For decades, it has been the only way to place an implant in patients with a lack of jaw volume. Now, when there are thin implants made of ultra-strong roxolid alloy, the technique is used less frequently, but does not lose its relevance.

The choice in its favor is made in case of poor condition of the bone tissue, after injuries, operations and tumors, as well as in the presence of factors that make one-stage express implantation impossible. With the help of the operation, it is possible to solve the issue of bone tissue deficiency and subsequently perform implantation in those patients to whom it was previously inaccessible.

What is bone augmentation?

Bone augmentation, also called bone augmentation, is a surgical procedure. The operation involves the creation of an artificial cavity in the bone, into which osteoplastic material is introduced or donor bone tissue is implanted. The methods of its implementation have their own characteristics, indications and contraindications, but lead to a single result – replenishment of the bone volume.

Why does the bone resorb? What types of bone deficiency exist? Where does the jaw drop faster?

Normal functioning of bone tissue requires a constant compression load. It is absent in the place of the removed or fallen out tooth. The tissues cease to be supplied with blood normally, their nutrition is disturbed, and the cells cease to actively divide.

Bone undergoes resorption (resorption) as early as 3 months after tooth loss. The process affects the middle layer, which can lose volume in different directions:

• in height, and then it is impossible to implant a standard implant 1 cm long;
• in width, while it will not be possible to implant a structure of normal thickness.
• combined – both in height and width.

In different parts of the oral cavity, resorption processes proceed unevenly. On the lower jaw, the width decreases faster, on the upper jaw, the height decreases. The upper jaw is especially susceptible to resorption in the region of the bottom of the maxillary sinus. Therefore, molars from above are the most difficult to replace with implants.

What methods are used for bone augmentation?

The history of dentistry knows many ways of building. Some of them have lost their relevance today. Others have been modified and are being used successfully. The choice is determined by the degree of bone tissue insufficiency, the location of the defect, and a number of other reasons.

Basic methods of augmentation:

1. Biomembrane after tooth extraction . The use of barrier membranes has a preventive value. Their task is to prevent rapidly dividing soft tissue cells from occupying the cavity of the tooth socket after tooth extraction. In the cavity formed after dental extraction, osteoplastic material is placed and closed with a special membrane.
2. Bone splitting . This method is used when the width of the alveolar ridge is insufficient. The operation involves the division of the bone into two halves. At the end of the procedure, an osteoplastic mass is placed inside and, if necessary, non-load-bearing implantation can be performed. A biomembrane is placed on top of the surgical field, the cavity is closed with a gum flap and sutured. Engraftment time: 3-6 months.
3. Autotransplantation . Most often, this method is resorted to after operations or injuries, when there is a significant lack of bone tissue. The essence of the technique is the transplantation of a small part of one’s own bone tissue into the jaw. Most often, the pelvic bone, the chin area, or the ends of the lower jaw are used for transplantation.
4. Sinus lift . An operation in which the volume of tissues of the alveolar ridge of the upper jaw is restored. This is a necessary condition for implantation in this place, since complications and low primary stabilization are likely due to the proximity of the thinned bone to the bottom of the maxillary sinus. Sinus lift is performed by several methods and is more gentle than autotransplantation. Engraftment time: 3-6 months.
5. Osteoplasty with granules . This method involves the use of artificial material to restore the height of the bone. The operation proceeds with the opening of the gums, filling the holes with special granules, closing the bone mass from above with a bioresorbable membrane. Implants can be placed on request. Then the gum is sutured. Term: 6 months.

The choice of a treatment method is always a medical prerogative. Only a competent implantologist can assess the condition of the patient’s bone tissue and select the treatment option that best suits this particular patient.

How is bone autotransplantation performed? Why is it rarely used?

The operation is traumatic and potentially leaves behind 2 foci that require rehabilitation. In the place where the graft is taken from, a soft tissue incision is made, a piece of bone tissue is cut out, then the surgical field is closed with a biomembrane and sutured.

In the place where the graft is transferred, soft tissues are peeled off, a piece of bone is inserted, which has been given the necessary shape, and screwed with special screws. The sutures around the implanted area are treated with bone chips. The operating field is closed with a biomembrane and a gingival flap, which is sutured.

Among the disadvantages of the procedure is not only high trauma, but also the need for anesthesia. In the case of replacement of large volumes (with injuries and after resection of tumors), general anesthesia can be used, the operation is performed in a hospital and is not used in our clinic.

What is a sinus lift? What methods of implementation exist?

Sinus lift is an operation to increase the volume of bone tissue in the region of the bottom of the maxillary sinus. This place of the alveolar ridge is most susceptible to resorption processes. Performing a sinus lift increases the success rate of implantation of maxillary molars.

Technically, the operation can proceed in two ways:

1. In the open method, when a part of the skin is surgically separated from the side of the jaw, a hole is drilled in the bone, the periosteum is separated from the bone, and osteoplastic material is placed inside. The operation allows you to fill the deficit of up to 7 mm of bone tissue.
2. Closed and minimally invasive when accessed through the implant bed. True, with this option, only a small deficit is restored – 2-3 mm, since the cavity can be created quite small.

Current protocols focus on minimal tissue trauma and may include simultaneous implant placement to reduce overall treatment time.

What materials are used? Which is preferable?

For augmentation, depending on the technique used, an autograft, artificial granular biocompatible mass, bone mass from a donor can be used. The patient’s own bone takes root best, but the plasty process is more traumatic. Therefore, it is used only for very large areas of transplantation. In our clinic, bone-replacing materials Bio Oss by the Swiss company Geistlich are actively used. Also, to stimulate the growth of the patient’s own bone, PRP technology is used – platelet-rich plasma.

Can I smoke after the operation?

Doctors of our clinic recommend smoking cessation for the whole period of implant engraftment and bone growth. Nicotine worsens the blood supply to the bone, disrupting blood microcirculation. Lacking nutrition, cells do not divide as actively as they should, and the total period of bone tissue maturation is significantly extended.

Can I experience pain during surgery? What will I feel? What sensations can be after the operation?

The bone augmentation procedure is performed under local anesthesia. No sensations, and, moreover, no pain. After the operation, as the anesthesia wears off, discomfort may occur.

With significant volumes of interventions, dull, aching pain, temperature changes, paroxysmal pain are possible in the first days.