Placing a Dental Implant

September 22, 2020
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Posted By: Nola Dentures and General Dentistry

    Dental implants have been true game changers in dentistry.  Before implants became mainstream treatment, often times dentists would try to save every single tooth with all techniques available.  Multiple different gum and root canal treatments would be done with the hopes of holding on to a tooth for as long as possible.  With the advent of dental implants though, I am able to help my patients restore their smile and chewing with artificial teeth that feel like regular teeth.  When my patient and I have decided to restore an area with an implant, the three parts of the implant process are planning for the implant, surgically placing the implant, and then finally restoring the implant.

    The goal for an implant is for it to stay in the same spot, and implant are difficult to fix if they are placed in the wrong spot or have issues in the future.  I will first do an exam to make sure that my patient is healthy enough to have an implant placed.  Certain medications such as ones to treat osteoporosis as well as medical conditions such as poorly controlled diabetes make implant placement more difficult.  Second I will take a 3D x-ray to ensure enough bone is present in the area and take models of the mouth to make sure that a tooth can fit there.  I scan the models into my computer with a digital 3D scanner and using special software I can merge both the 3D x-ray with the models so that I can see where the teeth, gums, and bone are.  By knowing these three things, I can place the implant digitally to make sure that it is the proper place and create a custom surgical guide.  By using a surgical guide, much of the guesswork of where an implant should be placed in removed, and my patient gets a better end product.  I print out the guide using a special 3D printer with dental resin specially made to place implants.

    The next step is the day of implant placement.  I will numb the mouth and place the guide to make sure that it fits well and that everything looks correct.  After the mouth and gums in the area where I am going to place the implant are numb, then I will make a small incision along the gums so that I can see the bone.  From here, I use special tool that help me prepare the bone to the correct space so that I can place the implant in the right spot.  I then gently place the implant in the bone, place sutures over the gums to cover and protect the implant, and take another 3D x-ray afterwards to confirm that it is in the correct place.  I will have my patient come back in a week to remove the suture and make sure that the area is healing well.  After the implant is placed, it takes between three to six months for the bone to heal around it and for the implant to integrate.  After it has had sufficient time to integrate, I will again numb the mouth and make a small incision and place a healing abutment on top of the implant.  This is to help the gums form properly around the implant so that we can place a crown.  The gums take about another one to two weeks to heal well around this healing abutment.

    After the gums have formed properly, I take an impression of the implant and teeth in the area again using specialty parts.  The parts are needed so that my lab technicians who fabricates the prosthesis can easily see how the crown on top of the implant needs to fit with the teeth next to it as well as the teeth that chew with it.  The two ways to fabricate an implant crown is to either make it cement retained or screw retained.  I prefer screw retained as there are fewer chances for complications and it is easier to retrieve if necessary, but I do cement retained ones when it is in an esthetic zone like the front of the mouth.  After the implant crown is made, I try it in and make sure that the way it fits against the adjacent teeth and the way that the opposite bites into it are both correct.  After both are correct, we will connect the implant crown to the implant and the entire process is done.  The implant can now be chewed on like a regular tooth.

While the implant process does take some time and seems complicated, most of my patients are amazed about how quickly it goes and how good the teeth feel afterwards.  Implants are a wonderful way to replace missing teeth and make things the mouth feel whole again.  If you feel like you need an implant, please call us at 504-392-5104.  

 

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