Dental implant surgery is a procedure that replaces tooth roots with metal, screwlike posts and replaces damaged or missing teeth with artificial teeth that look and function much like real ones. Dental implant surgery can offer a welcome alternative to dentures or bridgework that doesn’t fit well and can offer an option when a lack of natural teeth roots don’t allow building denture or bridgework tooth replacements.
Dental implants procedure
Dental implants are surgically placed in your jawbone, where they serve as the roots of missing teeth. Because the titanium in the implants fuses with your jawbone, the implants won’t slip, make noise or cause bone damage the way fixed bridgework or dentures might. And the materials can’t decay like your own teeth that support regular bridgework can.
In general, dental implants may be right for you if you:
- Have one or more missing teeth
- Have a jawbone that’s reached full growth
- Have adequate bone to secure the implants or are able to have a bone graft
- Have healthy oral tissues
- Don’t have health conditions that will affect bone healing
- Are unable or unwilling to wear dentures
- Want to improve your speech
What you can expect
Dental implant surgery is usually an outpatient surgery performed in stages, with healing time between procedures. The process of placing a dental implant involves multiple steps, including:
- Damaged tooth removal
- Jawbone preparation (grafting), when needed
- Dental implant placement
- Bone growth and healing
- Abutment placement
- Artificial tooth placement
The entire process can take many months from start to finish. Much of that time is devoted to healing and waiting for the growth of new bone in your jaw. Depending on your situation, the specific procedure done or the materials used, certain steps can sometimes be combined.
Placing the dental implant
During surgery to place the dental implant, your oral surgeon makes a cut to open your gum and expose the bone. Holes are drilled into the bone where the dental implant metal post will be placed. Since the post will serve as the tooth root, it’s implanted deep into the bone.
At this point, you’ll 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, osseointegration (oss-ee-oh-in-tuh-GRAY-shun) begins. During this process, the jawbone grows into and unites with the surface of the dental implant. This process, which can take several months, helps provide a solid base for your new artificial tooth — just as roots do for your natural teeth.
Placing the abutment
When osseointegration is complete, you may need additional surgery to place the abutment — the piece where the crown will eventually attach. 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 juts past the gumline, however, it’s visible when you open your mouth — and it will be that way until your dentist completes the tooth prosthesis. 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.
Choosing your new artificial teeth
Once your gums heal, you’ll have more impressions made of your mouth and remaining teeth. These impressions are used to make the crown — your realistic-looking artificial tooth. The crown can’t be placed until your jawbone is strong enough to support use of the new tooth.
You and your dental specialist can choose artificial teeth that are removable, fixed or a combination of both:
- Removable. 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.
- Fixed. 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, each crown is attached to its own dental implant. However, because implants are exceptionally strong, several teeth can be replaced by one implant if they’re bridged together.
Types of Dental Implants
There are three common types of dental implants that you can choose from Endosteal, subperiosteal, and zygomatic.
Endosteal is the safest and most common, followed by subperiosteal, and then zygomatic being the last and most complex. It is rarely used.
Endosteal implants are the most common type of dental implant. They are suited for most patients but, they require a good, healthy jawbone for the post to fuse to.
They are placeholder posts that are shaped like screws. They put into the jaw that the false teeth are fitted onto.
Once the procedure is done it takes a little time to heal. It requires the time to fuse together and create a stronghold. Once it’s healed the false teeth can be placed onto the post to fit in with the surrounding teeth.
If you don’t like the idea of something being placed into your jawbone, you might like the idea of the second most common implant a little more.
Another type of dental implant is Subperiosteal Implants. This is the main alternative to Endosteal Implants.
Instead of being fixed into the jawbone, subperiosteal implants rests on top of the bone but still under the gum.
A metal frame is placed under the gum with a post attached to it. The gum then heals around the frame to hold it in place. The false teeth are secured to the poles that come from the gum.
This procedure is only used if the patient doesn’t have enough jawbone for an implant to be placed or if the person in question just doesn’t want to go through with intensive oral surgery to add bone to the area.
If this applies to you, maybe this next implant will suit you better.
Zygomatic implants are the least common type of dental implant available to you. It is the most complicated procedure and should only be done if you don’t have enough jawbone for the Endosteal implant.
The implant is placed in the patient’s cheekbone rather than the jawbone.
If complications arise and your jaw cannot support implants and a Zygomatic implant is absolutely out of the question, your dentist may suggest other alternatives.
Your dentist will restore the bone in your jaw if, in the case, it can not support implants.
It’s possible to use bone additives to fortify the bone. I know that sounds like something out of Star Trek, but it can actually work.
This procedure involves adding bone below the sinus if the bone there has managed to deteriorate due to missing upper back teeth.
It is possible that your jaw is simply not wide enough for implants. In this case, your dentist can graft material to be added to a space created along the top of your jaw.
Any three of these techniques can work to make space for implants, however, if your dentist deems these a bad idea not all is lost. There are still a few more techniques your dentist may suggest.
Again, like right out of Star Trek, technology has evolved enough for your dentist to be able to see a 3D model of your jaw.
By studying this software, your dentist can plan the best course of an implant procedure for you. This cuts down on money, and recovery time.
Immediate load Dental Implants
This type of dental implant is much like adding a spare tire on to your car except with teeth.
It allows for the temporary placement of a temporary tooth, the same day as your implant placement.
This might be the option for you if you have enough bone and have an implant secure enough to support the placement and pressure of the temporary tooth.
Mini Dental Implants
These are toothpick sized implants that are extremely narrow. Their primary use is to stabilize a lower denture.
They are less innovative than the others, but still a perfectly acceptable option for you to look into.
This is used as an alternative for placing a full set of top or bottom replacement teeth.
Four dental implants are placed in the available bone, this does away with the need of bone grafting. A temporary set of replacement teeth can be placed the same day.
The downside is you will have to follow a special diet while the tissue is still healing and the implants bond with the bone.
After a short 6 months, a permanent set of replacement teeth are placed and you can finally resume your normal diet.
Most dental implants are successful. Sometimes, however, the bone fails to fuse sufficiently to the metal implant. Smoking, for example, may contribute to implant failure and complications.
If the bone fails to fuse sufficiently, the implant is removed, the bone is cleaned up, and you can try the procedure again in about three months.
You can help your dental work — and remaining natural teeth — last longer if you:
- 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.