Overview of Dental Implant Placement

Dental Implant Surgical Procedure

The procedure to place a dental 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. The surgeon will bring great precision and attention to the details of your case.

Prior to surgery, you may receive antibiotics and for greater comfort, 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 dental 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.

A depiction of the upper jaw with all normal teeth
1. Normal
An example of the upper jaw missing a tooth with the jaw bone unhealed
2. Tooth Loss
A representation of a healed upper jaw bone after loosing a tooth
3. Healed Bone
A representation of the healed jaw bone after placement of the dental implant
4. Implant Placed
A representation of the healed jaw bone after placement of the dental implant
5. Healing
An example of a fully restored tooth using a dental implant
6. Implant Restored

The Dental Implant Surgical Procedure

There are essentially three protocols for implant placement.

Protocol 1: a two-stage approach

The implant is placed within your jawbone and the gum tissue is closed on top of the implant. The dental implant is now “buried” and can now heal in a closed, protected environment. The healing phase ranges between two to six months. It is the period of “osseointegration”. At the end of the healing phase, the implant needs to be “uncovered”: after locally numbing the gum, a small incision is made on top of the implant and a “healing abutment” is connected to the implant. The gum tissue will now heal around the “healing abutment”. A minimum of three weeks later, an impression of the implant is made and a crown is made.

Protocol 2: a one-stage approach

In this case, the implant is placed and a “healing abutment” is directly placed on top of the implant. The implant is already “uncovered”. A healing time of two to four months is needed before the implant can be restored.

Protocol 3: an immediate temporization

In selected cases, we can place the implant and connect during the same appointment a temporary crown on top of the implant. Likewise, for a patient missing all of his/her teeth, we can in certain cases place multiple implants (a minimum of four) and the same day deliver an implant fixed temporary bridge. A well-documented cost-effective protocol that gives an edentulous patient a full set of fixed implant-supported teeth is the “Bar Attachment Denture” concept, where the patient has his/her “Teeth-In-A-Day“.

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What Types of Prosthesis are Available?

Dental implants can be used to anchor fixed or removable teeth (prosthesis)

Fixed prosthesis (the prosthesis can only be removed by a dentist)

  • A single crown is used to replace one missing tooth
  • Multiple single crowns on multiple adjacent implants (number of crowns = number of implants)
  • A fixed bridge, where multiple crowns are connected to implants (number of crowns is greater than the number of implants).

A removable prosthesis (the prosthesis clips on the implants and can be removed by the patient for daily cleaning)

  • Overdenture on individual dental implants
  • Overdenture on implants connected with a bar

The number and positioning of dental implants vary depending upon which type of prosthesis (removable or fixed) is recommended.

Implant dentistry is a prosthetic treatment that includes a surgical component. It is the design of the prosthesis that dictates the placement of the implant(s), not the other way around. Dr. Gallez will discuss with you and your restorative dentist the different prosthetic designs available that will fit your situation as each of them has some pros and cons.

Dr. Gallez, Dr. Sanz Miralles and Dr. Ha perform in-office dental implant surgery in a hospital-style operating suite, thus optimizing the level of sterility. Inpatient hospital implant surgery is for patients who have special medical or anesthetic needs or for those who need extensive bone grafting from the jaw, hip, or tibia

Drs. Gallez, Sanz Miralles and Ha have received extensive training in Dental Implantology. Through continuing education, Drs. Gallez, Sanz Miralles and Ha are abreast of the most current information on implant dentistry, such as TEETH-IN-AN-HOUR™ and 3-D implant treatment planning.

Healing after Dental Implant Surgery

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 be restored immediately after they are placed. The surgeon will advise you on follow-up care and timing. After the initial phase of healing, the surgeon places an abutment (support post) or a healing cap onto the dental implant during a brief follow-up visit. This allows gum tissue to mature and provides access to the implant.

Occasionally, impressions are made at the time the dental implant is placed. This enables the crown to be ready when the dental implants have healed. How long your mouth needs to heal is determined by a variety of factors. Follow-up care (one to four appointments) is usually 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 dental 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.

Dental Implants Presentation

To provide you with a better understanding of dental implants, we have provided the following multimedia presentation. Many common questions pertaining to dental implants are discussed.

Dental Implants Presentation

When are dental implants placed?

Implants are often placed several months after extraction. At times, an implant may be placed immediately after extraction of a tooth. This may involve a little more risk, but 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 is not the best treatment.

If your tooth has been missing for some time, the adjacent support 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 third of your jaw’s thickness 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 dental implants do I need?

Most frequently, one dental implant per missing tooth is placed. 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.