Overview of Dental Implant Placement & Evaluation
Do you need Dental Implants?
The standard of care for tooth replacement, whether for a single tooth or multiple teeth, is dental implants. Dental implants are artificial roots that can support natural looking replacement teeth or stabilize removable dentures. Dental implants are intimately connected with the gum tissues and underlying bone in the mouth. Since periodontists are the dental experts who specialize in precisely these areas, they are the ideal members of your dental implant team. Not only do periodontists have experience working with other dental professionals, they also have the special knowledge, training and facilities that you need to have teeth that look and feel just like your own. Dental implants can be utilized to:
- Replace a tooth that was lost due to an accident, decay, fracture, or infection
- Replace a tooth that is congenitally missing (never formed)
- Replace one or more teeth without affecting bordering teeth
- Replace dentures or missing teeth that are an embarrassment when laughing or smiling
- Overcome issues of eating in public or being socially or physically active due to problems associated with dentures or missing teeth
- Provide support for a denture, making it more secure and comfortable
- Avoid the embarrassment of removing a denture at night
Evaluation for Dental Implants
Upon arrival at our office, you will be asked to complete or provide:
- A medical/dental history form
- A list of medications you are currently taking (Prescription, Over-the-Counter, Supplements)
- X-rays from your Dentist
- HIPAA form (Patient Privacy Act)
- Patients less than 18 years of age must be accompanied by a parent or guardian
Dr. Eskow will discuss the reasons you are seeking implant dentistry. He will then perform a clinical examination, which includes oral cancer screening and an evaluation of the tissue and bone in the area where teeth are missing or are about to be lost. Because of Dr. Eskow’s expertise in Oral Medicine, an emphasis is placed on evaluating medical conditions that influence implant success. Furthermore, discussion with your dentist and other diagnostic tests may be necessary before the final treatment can be decided.
The ideal candidate for a dental implant is in good general and oral health. Adequate bone in the jaw is needed to support the implant, and the best candidates have healthy gum tissues that are free of periodontal disease. If there is insufficient bone for implant placement, there are techniques available to predictably rebuild the bone, allowing for implant placement.
During the evaluation, factors that might interfere with a successful result will be discussed. These include dental disease, diabetes, osteoporosis, medications and smoking.
This process includes studies that determine the feasibility of implant placement and if there is a need for additional procedures to compensate for insufficient bone in order to achieve proper esthetics and function. Therefore, a CAT or Cone Beam scan may be necessary to assess the quality and quantity of bone available. Dr. Eskow’s office is equipped with the necessary software to analyze a CAT or Cone Beam scan and plan the optimal surgical placement of an implant. In addition, the restorative dentist may create a prototype of the final tooth form. When all this information has been gathered and analyzed, the details of the treatment course will be discussed.
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. 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 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.
2. Tooth Loss
3. Healed Bone
4. Implant Placed
6. Implant Restored
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 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 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 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 (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 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.
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 Implants Do I Need?
Most frequently, one 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.