Overview of Implant Placement

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. Drs. Pollack, Odrich and Sarmiento will bring great precision and attention to the details of your case.

Prior to surgery, you may receive antibiotics and for those who request it, oral sedatives, 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, though oftentimes a small cap, called a healing abutment, is placed to protrude through the gum slightly.

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 even be restored immediately after they are placed. The doctors and staff will advise you on follow-up care and timing. After the initial phase of healing, the doctor will confirm successful “osseointegration” of the implant(s) during a brief follow-up visit, and place a healing cap if not done at the initial placement. This healing abutment allows gum tissue to mature and provides access to the implant for your restorative dentist to prepare the replacement tooth/teeth.

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 is 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. Oftentimes, an implant may be placed immediately after extraction of a tooth. This may not always be advisable, but, when it is, 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 may not be the best option, though research has not shown a significant difference in success or healing outcome. Some circumstances require bone grafting, and possibly guided bone regeneration membranes to optimize both the short-term success of the implant and the long-term result for best performance.

If your tooth has been missing for some time, the local tooth-supporting 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 half of the local bony ridge volume 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, sufficient numbers of implants are placed to enable fixed bridge restoration of multiple missing teeth, though one implant for each tooth is not necessary. 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.