When you are missing a tooth (or a few) or you have one requiring extraction, your dentist will often recommend putting a dental implant in its place. Why? Besides the fact that it looks better, leaving an open spot in your mouth often results in the other teeth shifting in to fill the space. This misaligns your bite and your smile. The implant consists of a titanium post, surgically installed into the jawbone, under the gum line. This allows a natural-looking replacement tooth to be mounted. It is a permanent solution, and can even be used to hold a dental bridge.
When you decide to go for an implant, you probably have a lot of questions. How intense is the surgery? What is the recovery time? How many visits to my dentist or oral surgeon will be required? In this article, we will attempt to answer these questions, so you have a good idea about what to expect when getting a dental implant.
First Things First
When considering implants, you will need to visit a prosthodontist or dentist with specialized training in implant placement. You will receive x-rays and a review of your medical and dental history. Impressions are often taken during this visit, so that accurate models of the area can be made. Sometimes your specialist will order a computed tomography, or CT scan of your mouth and jaw, allowing him or her to evaluate the supporting bone structure, as well as the location of your nerves and sinuses (if your implant is going in the upper jaw).
Before you can undergo the implant surgery, your gums need to be healthy, and you must have adequate bone structure in the area to hold the implant. If your bone isn’t strong or healthy enough due to age, infection, or other factors, bone grafts or bone distraction might be required. Bone grafting involves removing bone from another source (either your own, or from a cow or pig) and adding it to your jaw structure. Synthetic materials such as hydroxyapatite or calcium phosphate are sometimes used, but natural bone is preferable.
Bone distraction is the process of using pins or screws to gently pull apart existing bone structure, allowing the body to grow more bone and strengthen the area on its own. Preparatory bone work could add several months or up to a year to the process of receiving your implant.
In the upper jaw, inadequate bone height or sinuses that encroach on the area may require a sinus lift. This is not especially common. Your specialist will consult with you about the location of your sinuses and any necessary procedures.
Beginning the Process
The traditional implant process will generally take from about 5 months to a year to complete, depending on whether any bone grafts or sinus work are needed. Barring that preparatory work, you will begin with two procedures, three to six months apart. The first one involves making a small incision where the implant – a titanium rod – will be positioned. Your surgeon will drill a small hole in the bone, place the implant, and then close the incision. The implant will not be seen, as it is below the gum line.
Preparing for Replacement
Over the next few months, you’ll be allowed to heal. When you’re ready, you will most likely need what is called a healing cap. This second procedure involves another incision that allows your surgeon to screw a small collar, or healing cap, into the top of the implant. This healing cap is instrumental in the healing of the surrounding gum tissue. In a few more weeks, the cap will be removed, and the abutment will be permanently screwed or cemented onto the implant. The abutment is above the gum line, shaped like a tooth that has been ground down to receive a crown. It may be made of titanium, gold, or porcelain. In some cases, you may be able to skip the healing cap, receiving your abutment and even a temporary crown as part of your second procedure.
Getting Back to Normal
Once your abutment is placed, your dentist can install a temporary crown. This will allow you to resume normal chewing while your permanent crown is being made and healing is completed. The temporary crown is made of a softer material with a purpose. It helps cushion your jawbone against chewing pressure, allowing it to strengthen gradually around the new implant. Generally, you’ll be ready for your permanent crown in about four to six weeks.
Your permanent crown is created from a model of your own teeth and gum tissue, ensuring a perfect fit and normal chewing. Once completed, your crown may be either cemented or screwed onto the abutment. The advantage of cement is that there is no screw inside the crown that could give it a dark appearance. However, crowns that are screwed in place are fairly simple to remove if it becomes necessary for your dentist to reach the implant or the surrounding gum tissue.
After Care
Fortunately, the placement of your temporary and permanent crowns are not generally too traumatic to your surrounding tissues. Throughout the other procedures and the time between them, most of the healing has already taken place. At this point, you should be pretty much ready resume just as before. As far as the implant itself goes, it shouldn’t require any special care. It’s a permanent structure rooted in your jaw, just as your natural tooth was. Good oral hygiene and regular dental cleanings will be required, just like you’ve always done.
Potential Complications
Of course, any surgical procedure presents certain risks. With dental implants, aside from the normal risks of the surgery, there is a small possibility of implant failure. This failure could involve infection, but it is rare. Other failures might include improper bite alignment. If you’re prone to grinding your teeth or clenching your jaw, this can put excess pressure on your implant and cause breakage or bone loss.
Other rare but possible complications involve nerve or sinus damage. Nerve damage can cause tingling or numbness in the chin, lower lip, or jaw. Usually, this heals and subsides over time. Sinus damage in your upper jaw can result in infection. However, your specialist will use your x-rays and CT scans to help ensure these complications can be avoided.
Moving On
When you have x-rays done, you’ll be able to see your implant, abutment, and crown. Your dentist will evaluate these x-rays at your regular appointments to make sure everything still looks good. Your implant will look and function just like a natural tooth. Most often, there won’t be much if any outward difference between your implant and the rest of your teeth. And according to ongoing study, you can expect your implant to last up to 25 years.