Dental Implant Procedure

If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.

What are the advantages of a single-tooth implant over a bridge?

A dental implant procedure provides several advantages over other tooth replacement options. In addition to looking and functioning like a natural tooth, a dental implant replaces a single tooth without sacrificing the health of neighboring teeth. The other common treatment for the loss of a single tooth, a tooth-supported fixed bridge, requires that adjacent teeth to be grounded down to support the cemented bridge.

Because a dental implant will replace your tooth root, the bone is better preserved. With a bridge, some of the bone that previously surrounded the tooth begins to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.

In the long term, a single implant can be more aesthetic and easier to keep clean than a bridge. Gums can recede around a bridge, leaving a visible defect when the metal base or collar of the bridge becomes exposed. Resorbed bone beneath the bridge can lead to an unattractive smile. The cement holding the bridge in place can also wash out, allowing bacteria to decay the teeth that anchor the bridge.

How will the implant be placed?

First, the implant, which looks like a screw or cylinder, is placed into your jaw. Over the next two to six months, the implant and the bone are allowed to bond together to form an anchor for your artificial tooth. During this time, a temporary tooth replacement option can be worn over the implant site.

Often, a second step of the procedure is necessary to uncover the implant and attach an extension. This temporary healing cap completes the foundation on which your new tooth will be placed. Your gums will be allowed to heal for a couple of weeks following this procedure.

There are some implant systems (one-stage) that do not require this second step. These systems use an implant which already has the extension piece attached. Your periodontist will advise you on which system is best for you.

Finally, a replacement tooth (crown) will be created for you by your dentist and attached to small metal post (abutment). After a short time, you will experience restored confidence in your smile and your ability to chew and speak. Dental implants are so natural-looking and feeling, you may forget you ever lost a tooth.

Every case is different, and some of these steps can be combined when conditions permit. Your dental professional will work with you to determine the best implant procedure.

Practice Example

The patient previously had root fracture and infection which was treated with a root canal therapy. The CBCT scans showed a infection and bone loss in the root area. The implant planning was prepared (in blue) prior to surgery.

The CBCT scans allowed the accurate planning and placement of implant with the permanent crown mounted on the implant. The implant was placed immediately after removing the infected tooth and bone graft. A membrane were placed to gain bone to support the implant and gum.

Single Canine Tooth Missing

Diagnosis: left canine tooth missing

History: Patient had five temporary dentures made in the past years to replace her one single missing tooth before implant surgery.

1. Implant and Titanium abutment were placed.
2. Patient received a temporary Veneer on the same day right after her implant was placed.
3. Patient received the permanent Crown which replaced the temporary Veneer.  Patient requested the Crown to be whiter than her current teeth to allow teeth whitening.

If you are missing several teeth, implant-supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

What are the advantages of implant-supported bridges over fixed bridges or removable partial dentures?

Dental implants provide several advantages over other teeth replacement options. In addition to looking and functioning like natural teeth, implant-supported bridges replace teeth without support from adjacent natural teeth. Other common treatments for the loss of several teeth, such as fixed bridges or removable partial dentures, are dependent on support from adjacent teeth.

In addition, because implant-supported bridges will replace some of your tooth roots, your bone is better preserved. With a fixed bridge or removable partial denture, the bone that previously surrounded the tooth root may begin to resorb (deteriorate). Dental implants integrate with your jawbone, to help keep the bone healthy and intact.

In the long term, implants are esthetic, functional and comfortable. Gums and bone can recede around a fixed bridge or removable partial denture, leaving a visible defect. Resorbed bone beneath bridges or removable partial dentures can lead to a collapsed, unattractive smile. The cement holding bridges in place can wash out, allowing bacteria to decay teeth that anchor the bridge. In addition, removable partial dentures can move around in the mouth and reduce your ability to eat certain foods.

How will the implants be placed?

First, implants, which looks like screws or cylinders, are placed into your jaw. Over the next two to six months, the implants and the bone are allowed to bond together to form anchors. During this time, a temporary teeth replacement option can be worn over the implant sites.

Abutments attached to implants form a foundation for new teeth. Often, a second step of the procedure is necessary to uncover the implants and attach extensions. These temporary healing caps complete the foundation on which your new teeth will be placed. Your gums will be allowed to heal for a couple of weeks following this procedure.

There are some implant systems (one-stage) that do not require this second step. These systems use an implant which already has the extension piece attached. Your periodontist will advise you on which system is best for you.

Finally, replacement teeth, or bridges, will be created for you by your dentist and attached to small metal posts, called abutments. After a short time, you will experience restored confidence in your smile and your ability to chew and speak.

Every case is different, and some of these steps can be combined when conditions permit. Your dental professional will work with you to determine the best treatment plan.

Practice Example

Diagnosis: Multiple Extraction

Six months after implant surgery, the healing caps were removed, the titanium abutments were placed and impression was taken for final crowns.

If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

What are the advantages of implant-supported full bridges and implant-supported dentures over conventional dentures?

Dental implants provide several advantages over other teeth replacement options. In addition to looking and functioning like natural teeth, implant-supported full bridges or dentures are designed to be long lasting. Implant-supported full bridges and dentures are also more comfortable and stable than conventional dentures, allowing you to retain a more natural biting and chewing capacity.

In addition, because implant-supported full bridges and dentures will replace some of your tooth roots, your bone is better preserved. With conventional dentures, the bone that previously surrounded the tooth roots begins to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.

In the long term, implants can be more aesthetic and easier to maintain than conventional dentures. The loss of bone that accompanies conventional dentures leads to recession of the jawbone and a collapsed, unattractive smile. Conventional dentures make it difficult to eat certain foods.

How will the implants be placed?

Implants are placed in the jaw as anchors for artificial teeth (Full Bridge or Implant supported Denture).

First, implants, which looks like screws or cylinders, are placed into your jaw. Then, over the next two to six months, the implants and the bone are allowed to bond together to form anchors for your artificial teeth. During this time, a temporary teeth replacement option can be worn over the implant sites.

Often, a second step of the implant procedure is necessary to uncover the implants and attach extensions. These temporary healing caps, along with various connecting devices that allow multiple crowns to attach to the implants, complete the foundation on which your new teeth will be placed. Your gums will be allowed to heal for a couple of weeks following this procedure.

New teeth will snap on and off. There are some round ball anchors. There are some implant systems (one-stage) that do not require this second step. These systems use an implant which already has the extension piece attached. Your periodontist will advise you on which system is best for you.

Depending upon the number of implants placed, the connecting device that will hold your new teeth can be tightened down on the implant, or it may be a clipped to a bar or a round ball anchor to which a denture snaps on and off.

Finally, full bridges or full dentures will be created for you and attached to small metal posts (abutments). After a short time, you will experience restored confidence in your smile and your ability to chew and speak.

Every case is different, and some of these steps can be combined when conditions permit. Your dental professional will work with you to determine the best implant procedure.

Practice Example

Diagnosis: Patient has been missing all upper teeth for more than twenty years; during this time he had several dentures made but they had been very loose. Patient came to Dr. Nguyen to have a more secure upper denture.

The problem: The patient has limited bone & lip support and he didn’t want any bone graft done.

The solution: The best option was to place four Implants with ball attachments and a full denture with retentive housings embedded in the denture.

A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. If you’ve lost bone in that area due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants.

Sinus lift surgery can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. Several techniques can be used to raise the sinus and allow for new bone to form. In one common technique, an incision is made to expose the bone. Then a small circle is cut into the bone. This bony piece is lifted into the sinus cavity, much like a trap door, and the space underneath is filled with bone graft material. Your periodontist can explain your options for graft materials, which can regenerate lost bone and tissue.

Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. After the implants are placed, an additional healing period is required. In some cases, the implant can be placed at the same time the sinus is augmented.

Undergoing sinus lift surgery has been shown to greatly increase your chances for successful implants that can last for years to come. Many patients experience minimal discomfort during this procedure.

Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. This defect may have been caused by periodontal disease, wearing dentures, developmental defects, injury or trauma. Not only does this deformity cause problems in placing the implant, it can also cause an unattractive indentation in the jaw line near the missing teeth that may be difficult to clean and maintain.

To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Your periodontist can tell you about your options for graft materials, which can help to regenerate lost bone and tissue.

Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. In some cases, the implant can be placed at the same time the ridge is modified.

Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come. Ridge modification can enhance your restorative success both aesthetically and functionally.

Practice Example

Diagnosis: Patient had a tooth with root fracture and severe infection.

The socket is very large and deep at 18mm and 12mm. There are 1.5 cubic centimeters of Allograft bone and a collagen membrane were placed to augment this large defect.

Three months after the bone was healed the implant was placed.