DETAILS OF THE PROCEDURE

What happens during the dental implant procedure, and how is it performed?
A typical implant consists of a titanium screw, with a roughened surface. This surface is treated either by plasma spraying, etching or sandblasting to increase the integration potential of the implant. At edentulous (without teeth) jaw sites, a pilot hole is bored into the recipient bone, taking care to avoid vital structures (in particular the inferior alveolar nerve within the mandible).

This pilot hole is then expanded by using progressively wider drills. Care is taken not to damage the osteoblast cells by overheating. A cooling saline spray keeps the temperature of the bone to below 117 degrees Fahrenheit (approx) or 47 degrees Celsius. The implant screw can be self-tapping, and is screwed into place at a precise torque so as not to overload the surrounding bone. Once in the bone, a cover screw is placed and the operation site is allowed to heal for a few months for integration to occur.

After some months the implant is uncovered and a healing abutment and temporary crown is placed onto the implant. This encourages the gum to grow in the right scalloped shape to approximate a natural tooth’s gums and allows assessment of the final aesthetics of the restored tooth. Once this has occurred a permanent crown will be constructed and placed on the implant.

What type of anesthesia will be used?
A dental implant is surgically placed under local anesthesia causing the procedure to be generally not at all painful.

How long after a dental implant is placed can it be used to anchor my new teeth?
In earlier days, the waiting time was three months in the lower jaw and six months in the upper jaw before beginning to construct the new dental prosthesis that is supported by the implants.

In recent years, an increasingly common strategy to preserve bone and reduce treatment times includes the placement of a dental implant into a recent extraction site. In addition, immediate loading is becoming more common as success rates for this procedure are now acceptable. This can cut months off the treatment time and in some cases a prosthetic tooth can be attached to the implants at the same time as the surgery to place the dental implants.

What precautions will I need to take after the procedure?
Dental implants are not susceptible to dental caries but they can develop a periodontal condition called peri-implantitis where correct oral hygiene routines have not been followed. Risk of failure is increased in smokers. For this reason implants are frequently placed only after a patient has stopped smoking as the treatment is very expensive.

What are the risks/complications associated with dental implants?
Although there are not many things that can go wrong with dental implants, some of the problems could be:
• Failure to integrate into the bone resulting into the falling out of the implant.
• A fracture or breaking of the implant.
• Problems with the connection between the implant and the prosthesis.
• An infection or an inflammatory condition in the soft tissue and sometimes in the bone as a result of the implant placement.
• Damage to the nerves in the lower jaw and to the maxillary sinus or the nasal cavity.
All of these complications are rare and can usually be easily corrected.

Does it hurt after the dental implants have been placed?
Some discomfort may occur once the effect of the anesthesia wears off about three or four hours after the procedure. Most patients do not have significant problems although the level of discomfort varies from patient to patient. Some patients do have varying degrees of pain or discomfort which may last for several days. Swelling and black and bluing may also develop.

What should I watch out for?
You should call upon your dentist when there is prolonged pain as this is not a good sign with dental implants. Having prolonged pain does not always mean failure but the cause of the pain should be determined as soon as possible.
The implant may have to be removed if an infection develops or if the implant is not properly integrating into the adjacent bone.

What happens if my dental implants are rejected?
In occasional cases when the dental implants fail or are rejected, they can be replaced with another implant, usually of a slightly larger size. The rate of failure is only about 1-5%. This might be somewhat higher in smokers and people with compromised immune systems. The key element to determining implant success is proper diagnosis and treatment planning.