Overview of Implant Placement

The Surgical Procedure for Dental Implants

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jaw bone. For your comfort, the procedure can be performed under general anesthesia or sedation. When you are comfortable, the surgeon makes a small incision in the gum tissue to reveal the bone, creates space using special instruments, and gently inserts the titanium implant. The top of this implant is often visible through the gum. If the implant is completely covered by the gum tissue, this is considered a two-stage treatment. If you are able to see the top of the healing abutment, this is a one-stage treatment. Dr. Kienle, Dr. Steinkeler and Dr. Gunawardena will discuss with you what your best option is at the time of your consultation.

For the first three to six months following surgery, the implants are beneath the surface of the gums gradually bonding with the jaw bone. Dental implants can also be place in a one stage procedure so that a re-entry procedure is eliminated. You should be able to wear temporary dentures, temporary teeth or provisional restorations and eat a soft diet during this time. This is referred to as the integration phase.

After the implant has integrated to the jaw bone, the second phase begins. Drs. Kienle, Steinkeler or Gunawardena will uncover the implants and attach small posts or healing abutments which will act as anchors for the artificial teeth. In single stage surgery this step is eliminated. These posts extend through the gum tissue. Your dentist may use these abutments or place different ones to attach crowns or teeth to the implants. The entire procedure usually takes three to six months. Most patients experience minimal disruption in their daily life.

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Dental implant placement illustration: the upper jaw with all normal teeth
1. Normal
Dental implant placement illustration: the upper jaw missing a front tooth with the jaw bone unhealed
2. Tooth Loss
Dental implant placement illustration: a healed upper jaw bone after a front tooth is gone
3. Healed Bone
Dental implant placement illustration: the initial dental implant placed in the upper front jaw bone
4. Implant Placed
Dental implant placement illustration: upper jaw bone healed after dental implant placement
5. Healing
Dental implant placement illustration: a fully restored upper front tooth using a dental implant
6. Implant Restored

The Healing Phase

Now the healing begins. The length of time varies from person to person, depending upon the quality and quantity of bone. In some cases, implants may be restored immediately after they are placed. The surgeon will advise you on follow-up care and timing. After the initial phase of healing, the surgeon places an abutment (support post) or a healing cap onto the implant during a brief follow-up visit. This allows gum tissue to mature and provides access to the implant for your dentist.

Occasionally, impressions are made at the time the implant is placed. This enables the crown to be ready when the implants have healed. How long your mouth needs to heal is determined by a variety of factors. Follow-up care (one to four appointments) is usually needed to ensure that your mouth is healing well and to determine when you are ready for the restorative phase of your treatment.

It may be beneficial to perform a soft tissue graft to obtain stronger, more easily cleaned and natural appearing gum tissue in the area around the implant. This process involves moving a small amount of gum tissue from one part of your mouth to the area around the implant. Most often, it is a brief and relatively comfortable procedure.

Whether it’s one tooth or all of your teeth that are being replaced, your dentist will complete the restoration by fitting the replacement teeth (crowns) to the dental implant.

Dental Implants Presentation

To provide you with a better understanding of dental implants, we have provided the following multimedia presentation. Many common questions pertaining to dental implants are discussed.

Dental Implants Presentation

When Are Dental Implants Placed?

Implants are often placed 2-4 months after extraction. At times, an implant may be placed immediately after extraction of a tooth. This may involve a little more risk, but it simplifies the process—you won’t have to wait for another appointment to place the implant. When infection or other problems with the bone or tooth are present, immediate implant placement is not the best treatment.

If your tooth has been missing for some time, the adjacent support bone may become thinner and shrink. This occurs because the root of the natural tooth has to be present to stimulate the bone. As much as one third of your jaw’s thickness can be lost in the year following tooth extraction. If you are missing enough bone, you may benefit from having additional bone grafted into the area. This ensures the implant will be adequately supported when it is placed in the jaw.

How Many Implants Do I Need?

Most frequently, one implant per missing tooth is placed. Because many of the larger teeth in the back of your jaws have two or three roots, the most common approach is to replace missing back teeth with larger implants.