Dental Implants

Titanium posts are placed in the bone to serve as the replacement for the root portion of a missing natural tooth. In addition to holding crowns, implants can be used to support partial dentures and "overlay" dentures, where the appliance is supported by implants but removable.

Implant Treatment Outline

Implant placement is surprisingly easy, and generally there is little more than "aspirin pain" post-operatively. This is because the bone that receives the implant has no nerve endings, and the only minor discomfort is the small incision in the gum. The implants are checked regularly after placement to follow healing. It takes 3-6 months for the implants to integrate (bond) with the jawbone, at which time the post is placed. The last phase is placement of the final crown or appliance.

There are several approaches that may be used in implant placement, depending on the patient's particular needs. Generally, an implant restoration consists of three phases: (1) placement of the implant itself, (2) following implant healing, insertion of a post or other fixture that emerges through the gum, and (3) seating the final crown or prosthesis. Below is an example of a typical treatment sequence for a common restoration, the single tooth replacement.

Phase 1 (Surgeon)

  • Appointment 1 - Examination and Treatment Planning
  • Appointment 2 - Placement of Implant
Phase 1 Placement

Missing tooth to be replaced

Phase 1 Examination

Hole prepared to receive implant

Phase 1 Seated

Implant Seated and gum closed

  • Appointment 3 (10 - 14 days) Sutures removed
  • Appointment 4 (4 weeks) Site examined to assure proper healing
  • Appointment 5 (3 - 6 months) Implant exposed, if submerged at the insertion appointment
Phase 1 Access

Access hole in gum to expose implant

  • Appointment 6 (1 - 3 weeks after exposure) Study models taken that record exact location of implant

When the study models are poured they produce an exact replica of the patient's jaws, with the implant simulation in place.

Using the models, the dentist orders the exact size of post or fixture that will be attached to the implant and used to hold the restoration (such as a crown). The surgeon or the restorative dentist may perform this step.

Phase Two (Restorative Dentist)

The restorative dentist can use the study models, with the post attached to the simulated implant, to analyze the case before the patient is seen. The post may be contoured to the desired shape on the models, so only minimal refinements are needed when seated in the mouth.

  • Appointment 7 Post seated permanently in the implant, and shape refined.  A temporary crown is placed on post (Final impressions for the crown may be taken at this appointment)
Phase 2 Implant Shaped

Post seated in implant

Phase 2 Implant Seated

Post shaped to receive crown

  • Appointment 8 (if needed) Final impression for crown taken and sent to lab

Phase Three (Restorative Dentist)

  • Appointment 9 Final crown seated and occlusion (bite) refined
Phase 3

Phase 3 Completed

There can be a number of variations in treatment. Under ideal circumstances it may be possible to place the implant without reflecting the gum, using a small punch hole for access to the jaw. In these cases a healing cap may be placed at the surgical appointment, negating the need for the secondary implant exposure surgery (Appointment 5). Conversely, surgery may reveal less bone than expected, and implant placement may be delayed while more bone is generated.

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