DENTAL IMPLANTS

Dental Implants: Consultation, Procedure, Recovery and Aftercare 

Authored By: Allison DiMatteo
Reviewed By: W. Peter Nordland, DMD


Dental implants are artificial tooth roots used to support a restoration for a missing tooth or teeth, helping to stop or prevent jaw bone loss. The dental implant procedure is categorized as a form of prosthetic (artificial replacement) dentistry, but also is considered a form of cosmetic dentistry.
People who have lost teeth might feel too self-conscious to smile or talk. Additionally, biting irregularities caused by tooth loss can have a negative effect on eating habits, leading to secondary health problems like malnutrition.
By replacing missing tooth roots, dental implants provide people with the strength and stability required to eat all the foods they love, without struggling to chew. Additionally, dental implants stimulate and maintain jaw bone, preventing bone loss and helping to maintain facial features.

Tooth Loss

Teeth are lost because of:

• Tooth decay
• Root canal failure
• Gum disease (Periodontitis)
• Trauma to the mouth (tooth injury)
• Excessive wear and tear
• Congenital defects

Dental Implants: Consultation, Placement, and Recovery

To determine if implants are right for you, a consultation with your dentist, oral surgeon, and/or periodontist or prosthodontist is needed. During this appointment, your dental professional will thoroughly examine your teeth and gums and evaluate bone density and quantity. This may involve X-rays and computer tomography scans (CT scans) to ensure there is sufficient bone structure for placing the implant(s), and to determine exactly where the implant should be placed.
Based on the condition of your oral tissues, oral hygiene and personal habits, and commitment to follow aftercare instructions, your dentist will advise you of the most appropriate dental implant treatment plan. Some patients with insufficient bone or gum tissue require bone or soft tissue grafts and/or the use of small diameter implants (also called mini implants).
Depending on your situation, your dental professional will advise you of how long the entire treatment process will take, how many appointments will be necessary and what you can expect after each procedure. During the consultation, options for local anesthesia (to numb the affected and surrounding areas) and sedation dentistry, if necessary, also will be discussed.

The Dental Implant Placement Procedure

Today's dental implant restorations are virtually indistinguishable from other teeth. This appearance is aided in part by the structural and functional connection between the dental implant and the living bone. Implants are typically placed in a single sitting but require a period of osseointegration.
Osseointegration is the process by which the dental implant anchors to the jaw bone. Osseointegrated implants are the most commonly used and successful type of dental implant. An osseointegrated implant takes anywhere from three to six months to anchor and heal, at which point your dentist can complete the procedure by placing a crown restoration. If osseointegration does not occur, the implant will fail.
Dental implantation, which is performed to replace missing teeth, can be done any time after adolescence or when bone growth is complete. Certain medical conditions, such as active diabetes, cancer or periodontal disease, may require additional treatment before the implant procedure can be performed.
Detailed procedural steps are as follows:
Preparing the Jaw for Implantation: A dental implant restoration is commonly composed of a titanium material screw and a crown. A small-diameter hole (pilot hole) is drilled at edentulous (where there is no tooth) jaw sites in order to guide the titanium screw that holds a dental implant in place. To avoid damaging vital jaw and face structures like the inferior alveolar nerve in the mandible (lower jaw), a dentist must use great skill and expertise when boring the pilot hole and sizing the jaw bone. In many instances dentists use surgical guides created based on the CT scans when placing the dental implants.
Placement of the Implant: After the initial pilot hole has been drilled into the appropriate jaw site, it is slowly widened to allow placement of the implant screw. Once in place, surrounding gum tissue is secured over the implant and a protective cover screw is placed on top to allow the site to heal and osseointegration to occur. After up to six months of healing, your dentist will uncover the implant and attach an abutment (which holds the crown or tooth-like replacement) to the implant. In some cases, the abutment may be attached during the initial procedure. When the abutment is in place, your dentist then will create a temporary crown. The temporary crown serves as a template around which the gum grows and shapes itself in a natural way. The process is completed when the temporary crown is replaced with a permanent crown.

Dental Implants Recovery

Dental implant recovery depends on a number of factors, one of which includes the various procedures required to complete your treatment. However, it is generally recognized that once an implant has been placed, maintaining diligent oral hygiene habits is required to ensure proper fusing of the implant and bone structure. If cared for properly, an implant restoration can remain in place for more than 40 years.
After the initial surgical procedure, discomfort should be minimal. Swelling of your gums and face may occur, as well as minor bleeding and bruising of the implant site. Prescription pain medications may be prescribed by your dentist to relieve any pain or discomfort you feel after the procedure.
Healing from the surgical procedure to place the dental implant(s) takes up to six months, while the fitting and seating of the crown(s) can take up to two months. Again, this timeframe depends on individual cases and treatments. Follow-up appointments with your treatment coordinators are essential for monitoring your progress.

Implant Surgery Follow-up and Aftercare

For five to seven days after surgery, your diet should be restricted to soft foods. If stitches are present, they may need to be removed by your dentist; however, self-dissolving stitches that do not require removal are typically used.
If provisional restorations were placed along with the dental implant, it will be important to clean them as you would your natural teeth to ensure the best possible healing and fusing of the implant.
Failure to floss and brush is a leading cause of implant failure, and infection can occur if the implant and surrounding areas are not cleaned properly. Smoking also is attributed to high failure rates with dental implants and should be avoided following implant procedures.
Failure to floss and brush is a leading cause of implant failure, and infection can occur if the implant and surrounding areas are not cleaned properly. Smoking also is attributed to high failure rates with dental implants and should be avoided following implant procedures.