We briefly covered dental implants in our article on Cosmetic Dentistry. A Dental Implant is having an artificial root and tooth placed in your jaw. The implant itself is usually made of titanium and is embedded in the jawbone in a surgical procedure. Dentists use dental implants to replace missing teeth. There are three basic parts to an implant 1) the metal screw like post that acts as the root of the tooth. 2) An abutment (used to attach the crown to the metal post. 3) the crown which is placed over the abutment.
Benefits of dental implants
They provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth. They are durable and will last many years and could last a lifetime. It will help with the problem of deteriorating jaw bone because there will be a “tooth” there to create the force of a natural tooth.
Patients often prefer to get dental implants instead of dentures or bridgework. When there is lack of natural teeth to allow building a denture or bridge, dental implants may be the only option. The major benefit of implants is having solid support for your new teeth.
Stages of the procedure
Dentists typically perform dental implants in stages and as outpatient surgery. Dental implants require healing time between each procedure. The entire process can take many months from start to finish.
Here are the basic procedures:
- Removal of the damaged tooth
- Jawbone preparation (grafting), when needed
- Dental implant placement
- Bone growth and healing
- Abutment placement
- Artificial tooth placement
How to prepare
Because dental implants require one or more surgical procedures, you must have a thorough evaluation prior to getting a dental implant to prepare for the process. The evaluation will consist of:
· Comprehensive dental exam.
You may have dental X-rays and 3D images taken, and have models made of your teeth and jaw.
· Review of your medical history.
Tell your doctor about any medical conditions and any medications you take, including prescription and over-the-counter drugs and supplements. If you have certain heart conditions or orthopedic implants, your doctor may prescribe antibiotics before surgery to help prevent infection.
· Treatment plan.
This plan takes into account factors such as how many teeth you need replaced and the condition of your jawbone and remaining teeth. We make each treatment plan according to the patient’s situation.
The planning process for dental implants may involve a variety of specialists. If you need a specialist your dentist will go over with you why and what the specialist will do.
Is bone grafting necessary?
You may have heard that sometimes bone grafting is necessary. If your jawbone isn't thick enough or is too soft, you may need bone grafting before your dental implant surgery. Bone grafting is a minor surgical procedure that is normally done in a dental office. The dentist makes an incision in your gum to gain access to the bone beneath it, and then grafting material is added. Most often, the grafting material is processed bone minerals around which your body will actually make new bone cells.
It may take several months for the transplanted bone to grow enough new bone to support a dental implant. In some cases, you may need only minor bone grafting, which can be done at the same time as the implant surgery. The condition of your jawbone determines how you proceed.
Placing the dental implant
To place the implants, the surgeon first will make an incision (cut) in your gums to expose the bone. They then drill a hole in the bone and place the implant in the hole. The surgeon probably will take an X-ray of the area to make sure the implant is where it should be. The surgeon will then stitch your gum closed over the implant. At this point, you will still have a gap where your tooth is missing. A type of partial, temporary denture can be placed for appearance, if needed. You can remove this denture for cleaning and while you sleep.
Waiting for bone growth
Once the metal implant post is placed in your jawbone, the jawbone begins to grow and unite with the surface of the dental implant. This process can take several months. It helps provide a solid base for your new artificial tooth.
Placing the abutment
The abutment is the “connecting piece” that joins the implant and the crown together. Once the jawbone and post have fully united, you will be ready to have the abutment placed. This minor surgery is typically done with local anesthesia in an outpatient setting.
To place the abutment:
- Your oral surgeon reopens your gum to expose the dental implant
- The abutment is attached to the dental implant
- The gum tissue is then closed around, but not over, the abutment
In some cases, the abutment is attached to the dental implant metal post when the post is implanted. That means you won't need an extra surgical step. Because the abutment sticks out past the gum line, however, it's visible when you open your mouth. Some people don't like that appearance and prefer to have the abutment placed in a separate procedure.
After the abutment is placed, your gums must heal for about two weeks before the artificial tooth can be attached.
Getting your new crown
Once your gums have healed, the dentist makes impressions of your mouth and remaining teeth. They use these impressions to make the crown that will be placed onto the abutment.
You and your dental specialist can choose artificial teeth that are removable, fixed or a combination of both:
This type is similar to a conventional removable denture and can be a partial or full denture. It contains artificial white teeth surrounded by pink plastic gum. It's mounted on a metal frame that's attached to the implant abutment, and it snaps securely into place. It can be easily removed for repair or daily cleaning.
In this type, an artificial tooth is permanently screwed or cemented onto an individual implant abutment. You can't remove the tooth for cleaning or during sleep. Most of the time, the dentist attaches each crown to its own dental implant. However, because implants are exceptionally strong, several teeth can be replaced by one implant if they're bridged together.
After the procedure
Immediately after the surgery and for a few days you will likely experience some discomfort.
You may experience some of the following with any type of dental surgery, such as:
- Swelling of your gums and face
- Bruising of your skin and gums
- Pain at the implant site
- Minor bleeding
In these cases you may need pain medications or antibiotics after dental implant surgery but any pain should be manageable.
After each stage of surgery, you may be advised to eat soft foods while the surgical site heals. Your surgeon may use stitches that dissolve on their own. If your stitches aren't self-dissolving, your doctor will remove them.
Problems with dental implants are rare and when they do occur they're usually minor and easily treated. However, as there is with any surgery, dental implant surgery poses some health risks. Risks include:
- Infection at the implant site
- Injury or damage to surrounding structures, such as other teeth or blood vessels
- Nerve damage, which can cause pain, numbness or tingling in your natural teeth, gums, lips or chin
- Sinus problems, when dental implants placed in the upper jaw protrude into one of your sinus cavities
When making the decision of whether or not to get implants have your dentists fully discuss the procedure and any risks that may be involved.
Most dental implants are successful. Sometimes, however, the bone fails to fuse sufficiently to the metal implant. For example, smoking can contribute to implant failure and complications. In the case of any failure the surgeon removes the implant and cleans up the bone. Most often a patient can try the procedure again in about three months.
Here are some things you can do to help protect your dental work and preserve your other teeth as well:
- Practice excellent oral hygiene. Just as with your natural teeth, keep implants, artificial teeth and gum tissue clean. Specially designed brushes, such as an interdental brush that slides between teeth, can help clean the nooks and crannies around teeth, gums and metal posts.
- See your dentist regularly. Schedule dental checkups to ensure the health and proper functioning of your implants and follow the advice for professional cleanings.
- Avoid damaging habits. Don't chew hard items, such as ice and hard candy, which can break your crowns — or your natural teeth. Avoid tooth-staining tobacco and caffeine products. Get treatment if you grind your teeth.
We provide dental implants here at Dr. Susan Bracker, D.D.S., Rochester, New York. We welcome patients to come in and find out all about implants and if they are right for you. Schedule your appointment now at (585) 225-5600.
Dr. Susan Bracker, D.D.S.