A natural tooth consists of a root and a crown. If you compare natural teeth to implant-supported replacement teeth, you’ll see they have the same basic parts. Both have a crown (the visible part used to chew food). Both have a root that holds the tooth securely under the gum and is anchored into the jaw. The difference is that the implant is made of titanium – the same time-tested material used by surgeons for artificial joints. When you lose a tooth, you lose both the root and the crown. To replace the tooth, the surgeon first replaces the root with a small dental implant.
Time is allowed for bone to heal and grow around the dental implant. The bone bonds with the titanium, creating a strong foundation for artificial teeth. A support post (abutment) is then placed on the implant and a new replacement tooth (crown) is placed on top of the abutment. In many cases a temporary replacement tooth can be attached to the implant immediately after it is placed. If all of your teeth are missing, a variety of treatment options are available to support the replacement teeth.
The Surgical Procedure
The procedure to place an implant takes 30 to 60 minutes for one implant and only 2 to 3 hours for multiple implants. The number of appointments and time required, vary from patient to patient. The surgeon will bring great precision and attention to the details of your case.
Prior to surgery, you may receive antibiotics and for greater comfort, intravenous sedation or nitrous oxide (laughing gas). These options are discussed with you at your consultation appointment. A local anesthetic will be administered to numb the area where the implant will be placed.
When you are comfortable, the surgeon makes a small incision in the gum tissue to reveal the bone, creates space using special instruments, and gently inserts the titanium implant. The top of this implant is often visible through the gum. Sometimes it is better in the early stages of healing to have the implant covered by the gum tissue.
The Healing Phase
Now the healing begins. The length of time varies from person to person, depending upon the quality and quantity of bone. In some cases, implants may be restored immediately after they are placed. The surgeon will advise you on follow-up care and timing. After the initial phase of healing, the surgeon places an abutment (support post) or a healing cap onto the implant during a brief follow-up visit. This allows gum tissue to mature and provides access to the implant.
Occasionally, impressions are made at the time the implant is placed. This enables the crown to be ready when the implants have healed. How long your mouth needs to heal is determined by a variety of factors. Follow-up care (one to four appointments) is usually needed to ensure that your mouth is healing well and to determine when you are ready for the restorative phase of your treatment.
It may be beneficial to perform a soft tissue graft to obtain stronger, more easily cleaned and natural appearing gum tissue in the area around the implant. This process involves moving a small amount of gum tissue from one part of your mouth to the area around the implant. Most often, it is a brief and relatively comfortable procedure.
Whether it’s one tooth or all of your teeth that are being replaced, your dentist will complete the restoration by fitting the replacement tooth (crown) to the dental implant.
When Are Dental Implants Placed?
Implants are often placed several months after extraction. At times, an implant may be placed immediately after extraction of a tooth. This may involve a little more risk, but it simplifies the process—you won’t have to wait for another appointment to place the implant. When infection or other problems with the bone are present, immediate implant placement is not the best treatment.
If your tooth has been missing for some time, the adjacent support bone is likely to grow thinner and shrink. This occurs because the root of the natural tooth has to be present to stimulate the bone. As much as one third of your jaw’s thickness can be lost in the year following tooth extraction. If you are missing enough bone, you may benefit from having additional bone grafted into the area. This ensures the implant will be adequately supported when it is placed in the jaw.
How Many Implants Do I Need??
Most frequently, one implant per missing tooth is placed. Because many of the larger teeth in the back of your jaws have two or three roots, the most common approach is to replace missing back teeth with larger implants.