stages involved
There are a number of phases in implant dentistry. Not all patients require all phases to be done and, because implant technology is constantly improving, as time goes by the number of phases required is rapidly reducing. If the implants are long and solid at the time of placement and other factors are favourable, we can even take teeth out, place implants and place a provisional restoration all on the same day. The following are the general phases involved.
phase 1 –planning
Using a radioopaque replica of the anticipated tooth position, a template is made and this is worn while appropriate Xrays are taken. The proposed site can be visualised and the appropriate implant position, length and diameter determined.
phase 2 – site improvement
If there is insufficient bone or soft tissue for an implant, and there is no suitable alternative site, the site can be improved by a number of techniques such as ridge augmentation, guided tissue augmentation with or without membranes, bone onlay grafts, sinus grafts and connective tissue grafts. These are usually complex procedures which are normally referred to a periodontist or oral surgeon. Sometimes after the site has been prepared, a new set of Xrays is taken to check the site is now acceptable.
phase 3 –surgery
Using very accurate surgical techniques, an incision is made in the gum tissues and implants are carefully placed into precisely defined areas in the jawbone. The gum tissues are then closed and the healing phase begins. Implants may be able to be used immediately or it may take anywhere up to a year to ensure a strong base. This extremely variable time frame is dependent on many factors including: the amount and strength of the bone, the number, length and diameter of the implants, the bite, the number of teeth the implants are to support and whether they can be joined to other implants.
The discomfort level is generally not as severe as having a tooth extracted. The surgery is usually performed under local anaesthesia, with sedation if required, using a fully sterile technique. Appropriate medications are provided to take home and instructions are given to minimise any swelling.
phase 4 – the provisional restoration
After the surgery, provisional acrylic bridgework or dentures are modified to accommodate the exposed implant or healing tissues. Even if not necessary, it is often a wise strategy to make a provisional crown or bridge on new implants. This is because not all implants work (although the success rate is very high) and it is better to learn an implant has failed before incurring the expense of the definitive restoration.
phase 5 – the definitive restoration
Creating and fixing the new tooth or teeth to the implant structure completes this process.