A dental implant is basically an artificial root made of titanium that is surgically placed into the upper or lower jaw bone. Different types of prostheses can be attached to the implant such as: crowns, bridges, removable dentures, and fixed dentures. Implant prostheses can be very natural looking and often enhance or restore a patient’s smile. Dental implants are strong and durable and will last many years. On occasion, they will have to be re-tightened or replaced due to normal wear.
Indications for Dental Implants?
– Single missing tooth
– Multiple missing teeth
– Edentulous (no teeth)
– Improve the retention of a denture
What does getting a dental implant involve?
The process of getting an implant requires a number of visits over several months. The sequence and timeline can vary significantly based on how many dental implants you are receiving, the amount of current bone you have and whether or not teeth are present. Several different scenarios are described below:
Single Missing Tooth: Adequate Bone
First Appointment: Evaluation
– X-rays
– Impressions (molds) of the jaw / teeth
– Analyze bone quality and quantity
– Discuss timeline and fees
Second Appointment: Implant Placement
– Administer local anesthesia
– Make small incision through the gums to access bone
– Drill into the bone to create space for the implant
– Place the dental implant
– Place a small healing cap on the dental implant
Third Appointment: Impression ~3 months later
– Pick a shade for your new crown
– If necessary administer local anesthesia
– Remove healing cap
– Connect an impression post to the implant and take X-ray to verify proper connection
– Take a highly accurate impression of the implant
– Remove impression post, place the healing cap
Fourth Appointment: Deliver implant crown ~2 weeks later
– Remove healing cap
– Try-in and adjust your new crown
– X-ray to ensure proper connection
Single Missing Tooth: Deficient Bone
In this case you are missing a tooth but may not have adequate bone for an implant. You will need a bone graft. If minor bone grafting needs to be done I will do it the same day as the implant placement. If significant grafting is necessary I will graft and allow it to heal for 3 months before placing the implant.
First Appointment: Evaluation
– X-rays
– Impressions (molds) of the jaw / teeth
– Analyze bone quality and quantity
– Discuss necessity of CT Scan
– Discuss timeline and fees
CT Scan Appointment (optional)
– Conventional X-rays provide information in only two dimensions. I can analyze spacing and the available height of bone. If you are missing significant bone I may need to analyze the width of bone to do this I will order a CBCT Scan.
Second Appointment: Bone Graft +/- Implant Placement
– Administer local anesthesia
– Make small incision through the gums to access bone
– Drill into the bone to create space for the implant
– Place the dental implant
– Place bone graft material around the implant and place a biological membrane to cover and protect the area.
– Place several small sutures to hold everything in place
– Place a small healing cap on the dental implant
Third Appointment: Impression ~3 months later
– Pick a shade for your new crown
– If necessary administer local anesthesia
– Remove healing cap
– Connect an impression post to the implant and take X-ray to verify proper connection
– Take a highly accurate impression of the implant
– Remove impression post, place the healing cap
Fourth Appointment: Deliver implant crown ~2 weeks later
– Remove healing cap
– Try-in and adjust your new crown
– X-ray to ensure proper connection
Tooth Still Present
In this case you have a tooth that needs to be extracted (pulled) and we have decided to replace it with an implant. There are 3 different scenarios based on location of the mouth, the shape of teeth, the amount of bone and the presence of infection.
Scenario 1: I extract the tooth and there is plenty of remaining bone to connect to the implant. In this situation I will place the implant the same day as the extraction.
Scenario 2: I extract the tooth and there is not quite enough remaining bone to connect to the implant. In this situation I will place the implant along with a bone graft the same day as the extraction.
Scenario 3: I extract the tooth and there is a significant deficiency of remaining bone to connect to the implant. In this situation I will place grafting material and a biological membrane and allow it to heal for 3-4 months before proceeding with the implant
Frequently Asked Questions
Q: What is Immediate Placement of a Dental Implant
If the area where the implant is to be placed has adequate bone I will move forward with placing the implant immediately. If there is deficient bone or a tooth has just been extracted I will carefully determine whether bone grafting and/or a healing period of up to 4 months is necessary before the implant can be placed. During the period that the bone is healing or the grafting is integrating I can make you a number of devices to temporarily fill in the missing tooth or teeth. A temporary partial denture (flipper) and an essix retainer are two common options for this.
Q: What is Immediate Temporization of a Dental Implant
While the implant is being placed I will evaluate several factors to determine if immediate temporization is indicated. These factors have to do with how dense the bone is and how secure the implant is while it is being placed. If the implant is sufficiently secure into bone it is likely that you will be eligible to have an immediate but temporary crown placed onto the implant the day of the surgery or shortly after. If you are not eligible for the immediate crown, the implant will need several months to become properly integrated into bone before a crown can be placed.
