The surgical procedure for dental implant placement depends on the type of implant and the patient's jawbone condition. The implant surgery may involve several stages. The primary benefit of dental implants is providing a stable support for new teeth, which requires a successful osseointegration process where the bone fuses with the implant. Since bone integration takes time, the overall process can extend over several months.
Why is Dental Implant Surgery Needed?
Dental implants are surgically placed in the jawbone, where they serve as the tooth roots for missing teeth. Because implants are made of titanium and integrate with the jawbone, they are not at risk of being rejected or causing damage to the bone. Additionally, the materials used in implants are resistant to decay, making them a more suitable option for supporting dental bridges.
In general, dental implants may be suitable for you if:
- You have one or more missing teeth.
- Your jawbone has fully developed.
- You have enough bone to ensure the stability of the implant or can undergo bone grafting.
- Your gum tissue is healthy.
- Your overall health does not interfere with the osseointegration process.
- You are unable or unwilling to wear dentures.
- You want to improve your speech.
- You are willing to commit several months to the process.
- You do not smoke.
Risks of Dental Implant Surgery
Like any surgical procedure, dental implant surgery carries some health risks. However, these issues are very rare, and when they occur, they are usually mild and easily treatable. The risks include:
- Infection at the implant site.
- Damage to surrounding structures such as blood vessels or adjacent teeth.
- Nerve damage, which can cause pain, numbness, or tingling in the gums, lips, chin, or natural teeth.
- Sinus problems may occur when a dental implant is placed in the upper jaw and protrudes into one of the sinus cavities.
The planning process for dental implant surgery may involve several different specialists, including oral and maxillofacial surgeons (specialists in oral and facial surgery), periodontists (specialists in the supporting structures of the teeth, such as gums and bone), prosthodontists (dentists who design and fit dental prosthetics), or occasionally, otolaryngologists (ENT specialists).
Because dental implant placement involves one or more surgical procedures, careful evaluation is necessary to prepare for the process. This may include:
- General dental examination: You may have dental X-rays and 3D imaging, along with dental impressions of your jaw.
- Medical history review: Inform the dentist about your health status, any acute or chronic conditions, or any medications you are taking, including both prescription and over-the-counter drugs, as well as dietary supplements. If you have certain heart conditions or require orthopedic implants, the dentist may prescribe antibiotics prior to surgery to help prevent infection.
- Treatment planning: Tailored to your condition, this plan takes into account factors such as the number of teeth requiring restoration or replacement, the condition of the jawbone, and the remaining teeth.
To control pain, anesthesia options during the surgical process may include local anesthesia, sedation, or general anesthesia. Discuss with your dentist to determine the most suitable method for you. The dental support team (assistants, hygienists, dentists, etc.) will guide you on proper post-operative care, depending on the type of anesthesia used. If you are under sedation or general anesthesia, plan for someone to accompany you home after surgery and rest for the remainder of the day.
The Dental Implant Procedure
Dental implant surgery is typically an outpatient procedure that is performed in stages, with a healing period between each step. The implant placement process at Champion Dental Clinic involves multiple steps, including:
- Removal of the damaged tooth.
- Bone preparation (bone grafting), if necessary.
- Implant placement.
- Bone regeneration and healing.
- Abutment attachment.
- Crown placement.
The entire process can take several months from start to finish. The majority of the time is dedicated to healing and waiting for new bone growth in the jaw. Depending on the individual's health condition or the materials used, certain steps may sometimes be combined.
When Does Bone Graft Becomes Necessary
If your jawbone is not thick enough or too soft, you may require bone grafting before undergoing implant surgery. This is because the chewing forces exert significant pressure on the jawbone, and if the jawbone is not sturdy enough to support the implant, it may fail in the future. Bone grafting can create a stronger jawbone density to support the implant.
There are various bone grafting materials that can be used to regenerate the jawbone. Options may include autogenous bone grafts, which involve taking bone from another location in the body, or synthetic grafts, such as bone substitute materials that can provide structural support for new bone growth. Discuss with your dentist to determine the most suitable option for you.
It may take several months for the grafted bone to develop enough new bone to support the implant. In some cases, you may only require a minor bone graft, which can be performed concurrently with the implant surgery. The condition of your jawbone will determine the specifics of this process.
Dental Implant Placement
During the surgery for implant placement, an oral surgeon will make an incision to open the gum and expose the underlying bone. Holes are then drilled into the bone where the implant posts will be placed. Since the posts will serve as the tooth roots, they are inserted deep into the bone.
At this point, you will still have a gap where the missing tooth is. A temporary restoration, such as a removable partial denture, can be attached temporarily to ensure aesthetics, if necessary. You can remove this temporary denture for cleaning or while sleeping.
Waiting for Bone Integration
After the implant is placed in the jawbone, the process of bone integration begins. During this process, the jawbone grows and fuses with the surface of the dental implant. This osseointegration process, which can take several months, provides a solid foundation for your new artificial tooth - similar to a natural tooth root.
Once the bone has fully integrated, you may require an additional surgical procedure to attach the final abutment that will support the dental crown. This minor surgery is typically performed on an outpatient basis under local anesthesia.
Attaching the Abutment
- The oral surgeon will reopen the gum to expose the implant.
- The abutment is attached to the implant.
- The gum tissue is then sutured back around, but with the abutment exposed.
In some cases, the abutment is attached to the implant immediately after the implant placement. This means you won't need an additional surgical step. However, because the abutment sits above the gum line, it may be visible when you open your mouth - and it will remain so until your dentist completes the dental restoration. Some people dislike this appearance and prefer to have the abutment placed in a separate procedure.
After the abutment is placed, your gum needs to heal for about two weeks before the dental crown can be attached.
Choosing the Dental Crown
Once the gum is healed, you will have multiple bite impressions taken of your remaining teeth. These impressions are used to fabricate the dental crown - your lifelike artificial tooth. You cannot have the dental crown attached until your jawbone is strong enough to support chewing.
You and your dental specialist can choose between removable, fixed, or a combination of both types of dental crowns:
- Removable: This type is similar to conventional removable dentures and can be a partial or complete denture. It features artificial white teeth surrounded by pink gum-colored resin. It is attached to a metal framework that is connected to the implant abutment. Removable dentures can be easily taken out for repairs or daily cleaning.
- Fixed: In this type, an artificial tooth is either screwed or cemented onto an individual implant abutment. You cannot remove the tooth for cleaning or while sleeping. In most cases, each dental crown is attached to its own implant abutment. However, because implants are durable, multiple teeth can be attached to a single implant abutment if they are bridged together.
>> See more: Risks And Complications Associated With Dental Implant Failure
After Implant Surgery
Whether you undergo a single-stage or multiple-stage implant surgery, you may experience some typical discomfort similar to any dental surgery, such as:
- Swollen gums and face
- Bruised skin and gum tissue
- Soreness at the implant site
- Minor bleeding
You may need pain medication or antibiotics following the implant surgery. If swelling, discomfort, or any other issues become more severe in the days after the surgery, contact your oral surgeon.
After each surgery, you may need to eat soft foods while the incision site heals. Typically, the surgeon will use self-dissolving sutures. If your sutures are not self-dissolving, the surgeon will remove them.
Conclusion
Most implant surgeries are successful. However, sometimes the bone fails to integrate with the implant. For example, smoking can contribute to implant failure and complications.
You can help the longevity of your chewing function - and preserve your natural teeth - by:
- Maintaining good oral hygiene. Just like natural teeth, keep the implant, artificial tooth, and gum tissue clean. Specialized brushes, such as interdental brushes that slide between the teeth, can help clean the nooks and crannies around the tooth, gum, and metal abutment.
- Regularly visiting your dentist. Schedule dental check-ups to ensure the health and proper functioning of the implant, and follow their instructions for deep cleaning.
- Avoiding harmful habits. Avoid chewing on hard objects, such as ice and hard candies, as they can fracture the dental crown - whether it's on an implant or your natural tooth. Avoid tobacco products that can stain teeth and caffeine-containing products. Seek treatment if you grind your teeth.
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