Dental Implant Surgery
The Dental Implant Surgery
After the diagnostic phase and any necessary pre-treatments are completed, the dental implant dentist will complete the treatment planning, decide for the proper type of implant to use and proceed to the next phase of the dental implant procedure by scheduling the dental implant surgery appointment.
1st Surgical phase - The first Dental Implant Surgery
A week before the implant surgery the dentist will prescribe antibiotics to minimize the risk of infection and dental implant complications.
The dental implant surgery is usually performed by an oral surgeon or a periodontist.
- First, the implantation area is numbed with local anesthesia. If the surgery involves multiple implants the surgeon may offer dental sedation as an option instead of local anesthesia to help make the patient more comfortable.
- The oral surgeon first will make an incision in the gums to expose the bone.
- A small diameter hole is drilled in the jaw area where the implant will be placed and then widened to the appropriate size. The exact size of the hole depends on the type and size of implant fixture to be used. The experience and skill of the implant dentist is very important during this procedure in order to keep the hole at the exact measurements required and to avoid damaging any facial structures such as the nerves, sinuses or adjacent teeth roots.
- The implant is screwed into the bone socket. A standard root-form implant is basically a titanium made screw-shaped or cylinder shaped artificial root that is twisted into the bone to anchor the structure to the jaw.
- An x-ray is taken after placement to ensure proper positioning of the implant.
- A protective cap, usually a temporary cover screw, is placed on top of the implant.
- The gum tissue is repositioned over the implant so that it is totally covered and the gums are sutured in place.
- Existing restoration, such as bridges or dentures, may be put back in place.
- The dentist will give the patient after-care hygiene and diet instructions, prescriptions for antibiotics and pain medication, and arrange for a follow-up appointment in a few days. (Read more on dental implant surgery aftercare)
- The first dental implant surgery is completed with the removal of the stitches after 7 to 14 days.
Healing from dental implant surgery - Osseointegration period
After the implant is placed in the jaw, there is a waiting healing period of several months until the implant bonds to the bone. During this period new bone grows around the implant fusing it in the jawbone. The process is called osseointegration and is the most critical factor for the success of the dental implant procedure. An implant that for any reason is unable to osseointegrate properly will almost always lead to implant failure.
The osseointegration period is about 3 months for lower jaw implants and about 6 months for upper jaw implants. The time needed for osseointegration is usually longer if there is low bone density around the implant. Several implant manufacturers claim that special coatings used on some implant types can shorten the healing period. During osseointegration the patient should avoid applying unnecessary pressure on the jawbone. Eating soft foods and avoiding teeth clenching and grinding, in combination with proper daily oral hygiene can help healing.
2nd Surgical phase - The second Dental Implant Surgery
Once the implants have become fused with the surrounding bone, the dentist can proceed to the second surgical phase of the dental implant procedure.
- X-rays are taken to confirm proper osseointegration
- the area is numbed with local anesthesia
- a small incision is made in the gums exactly over the implant to expose it
- an abutment (a small connector post) which will anchor the restoration is screwed or cemented firmly on the top of the exposed implant.
- the gums around the implant are stitched and left to heal for a few days.
- impressions are taken and send to the dental lab in order to prepare the restoration.
- a temporary crown is placed on the abutment
The temporary crown is usually left in place for a few weeks, to allow the gums heal around it just like around natural teeth. By that time, the permanent crown which is made to match the size, shape and color of the patient's natural teeth will be ready. The crown can be either cemented or screwed to the abutment. Once the permanent crown is in place, the replacement implant tooth looks, feels, and functions just like a natural tooth.
Follow Up Care
Proper care of implants should not be limited only to the period immediately after the dental implant surgery, but it must be a continuous goal. After the dental implant procedure is fully completed, the patient must maintain good oral hygiene and visit the dentist regularly in order to ensure the long-term success of the implant treatment. (Read more on dental implant care)