What is the exposure of dental implants?

An implant puncher used in dental implantology

An implant puncher used in dental implantology

Exposure is dental jargon for the term "exposure operation" following the successful healing of an implant.

Should the mucosa be sutured closed over the implant after a successful implantation we call this "covered" healing.

The necessity for covered healing crops up when, for example, the quality of the bone isn’t good enough for a load to be placed on the implant immediately, or when supplementing the bone is carried out simultaneously with the implantation.

By closing up the mucosa the implant and bone can be left to heal in peace as it is thereby protected from the bacteria in the oral cavity. The disadvantage is that the implant must be exposed again once it has healed up, the mucosa must therefore be cut open again so that the replacement tooth can be fixed to the implant.

This is done either by cutting it open with a scalpel or by means of a mucosa die. In the picture you can see such a die. In the video you now see first an example of the die variation. The patient had his implant inserted 8 weeks previously and at that time it was decided to opt for covered healing. Now the exposure operation can take place.

The position of the implant under the mucosa is felt with a delicate probe. With the aid of the die the mucosa over the implant is is removed – it is punched out. The intervention takes place under local anaesthetic and is painless. In order to prevent the opening from healing closed again healing caps – known as gingiva formers are screwed onto the implants.

In the scalpel-opening variation an incision is made and the mucosa is moved away then healing caps are once again put in place and the mucosa is partially sutured back together. The gums hardly grow back on the healing caps, that is to say the gingiva formers, though they do heal very well. More about this in the video entitled "Healing Caps" video.

There are no alternatives to such an operation, apart form leaving the gums open to heal themselves. More about this in the video entitled "Implantology".

With an experienced practitioner the risks of such an operation are negligible. Nevertheless complications occasionally occur which make further measures necessary. With every necessary further measure there is a further possibility of complications which could even progress to become life-threatening. Here only the particular complications of exposure are mentioned and these are:

  • Inflammation of the bone (Osteomyelitis)
  • Periimplantitis – implant inflammation, which can lead to loss of implants
  • Injury to nearby structures such as the tongue, cheeks, nerves, blood vessels and neigbouring teeth and roots with the related consequences

Fortunately due to the positive developments in medicine in the last decades such complications have become very rare.

Click here to see the video: Dental Implantology

 

This post is also available in: German

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