Dental implantation is a modern method of restoring the dental arch based on the placement of an artificial root followed by the installation of a crown. In some cases, it is the only way to restore both the aesthetics of the smile and proper chewing function. However, since the procedure involves surgical intervention, there are situations in which implantation cannot be performed based on the patient’s medical history. Below, we examine which contraindications to dental implantation are absolute and which are relative or temporary.
Absolute contraindications
Dental implantation is strictly contraindicated in situations where the procedure may lead to severe complications. Conditions associated with a high risk of implant rejection are also considered contraindications. These include serious systemic diseases as well as disorders of the endocrine or nervous systems. When the potential benefit of implantation is significantly lower than the risk, the surgeon will refuse to place a titanium implant in the following cases:
- blood coagulation disorders, thrombocytopenia, hemophilia;
- recent myocardial infarction, ischemic heart disease, or any form of heart failure;
- active-phase oncological disease;
- decompensated diabetes mellitus;
- diseases of the immune system;
- severe forms of hypothyroidism or hyperthyroidism;
- adrenal gland disorders;
- psychiatric conditions;
- epilepsy;
- severe forms of tuberculosis.
Dental implantation: relative contraindications
The concept of relative contraindications implies that implant placement is possible, but with a delay. The most common examples are diseases of the oral cavity that can be treated relatively easily. In cases of periodontosis, periodontitis, or gingival inflammation, implantation may promote the spread of infection, therefore comprehensive oral treatment is performed first.
The presence of pulpitis or dental caries is also a contraindication to immediate implantation. However, preliminary oral sanitation simply postpones implant placement. Even a lack of bone tissue does not prevent restoration of the dental arch — sinus lift procedures or bone block grafting may be used as a solution.
General contraindications include smoking, pregnancy, and the breastfeeding period. If the goal is a healthy and aesthetically pleasing smile, the number of cigarettes should be significantly reduced or smoking should ideally be discontinued both before and after implantation. In the case of pregnancy, it is recommended to postpone the procedure.
Diabetes mellitus is not necessarily a critical contraindication. If the level of glycated hemoglobin is consistently below 7.5%, implantation is possible, provided that more thorough preparation is carried out and continuous monitoring by the treating physician is ensured.
When is postponement required?
There are temporary limitations that prevent implantation during a specific period. Conditions such as tonsillitis, influenza, herpes, or acute respiratory viral infections require a short but necessary postponement. The dentist may also advise delaying the procedure in cases of:
- acute infectious disease;
- exacerbation of a chronic condition;
- recent radiation therapy to the head or neck area.
The use of certain medications, such as anticoagulants and bisphosphonates, requires consultation with the relevant specialist. As a rule, the treatment regimen is adjusted or the medication is temporarily discontinued.
Modern approaches in dentistry
The presence of contraindications to implantation is not a definitive verdict, but rather a preliminary guideline. Continuous improvement of implant placement techniques and advances in surgical dentistry make it possible to find solutions even in complex cases. Bone augmentation, sinus lift procedures, and the use of basal implants help address bone deficiency; comprehensive patient management in cooperation with specialized physicians allows implantation to be performed even in the presence of chronic diseases.
In most cases, the issue can be resolved after appropriate preparation. Even when contraindications to implant placement are absolute, alternative methods of dental arch restoration are available. A key factor is accurate diagnosis and a complete set of laboratory tests prescribed by the dentist following consultation.
