Dental implant surgery replaces the root area of the tooth with metal, screw-like posts. These posts are installed into the jawbone, where they provide a strong base for an artificial tooth, known as a crown. This surgery can be performed in several steps depending upon the kind of implant you’re getting and the health of your jawbone.
Dental Implant Surgery
Dental implants are artificial teeth that are implanted into the mouth and jaw. Dentists often install implants when people lose their aging, adult teeth. Most dental implants look, feel, and act like natural teeth, and they are the closest thing you can get to authentic, healthy teeth. Not only do dental implants help preserve the look of your smile, but they also maintain the overall structure of the mouth. They can help keep the other teeth from moving out of position in unnatural or painful ways.
A dental implant is made of a metal post topped by an artificial tooth, known as a crown. This implant is installed into the jawbone to provide a sturdy structure that helps maintain the position of the remaining teeth and helps keep natural chewing and biting intact.
Dental implant surgery replaces the root area of the tooth with metal, screw-like posts. Your dentist will install them into your jawbone, where they provide a strong base for an artificial tooth or crown. The artificial teeth look and act just like real ones, making this type of surgery a great alternative to wearing dentures or having ill-fitting bridgework done.
There are many reasons to have dental implants. You may have one or more missing teeth. Maybe you're unable to wear dentures or have a speech impediment that could be improved by adding one or more dental implants to your gumline.
Like with any medical procedure, there are risks involved with dental implant surgery. While issues or complications are rare, there is still a risk of infection at the implant site, leading to other problems later on. Additionally, your jawbone will need to be strong enough to undergo the procedure.
Another possible complication from dental implant surgery can be damage to the surrounding teeth or nerves and a failing or wobbly implant. Discuss the risks of dental implants with your dentist or oral surgeon. They should be able to address your concerns ahead of the procedure.
Dental implant surgery can be performed in several steps, depending on the kind of implant you're getting and the health of your jawbone. The process requires the jawbone to heal tightly around the dental implant area (called osseointegration), absorbing it into the gumline as if it were a natural tooth. The implants are surgically placed within the jawbone and serve as the "root" of the artificial tooth. Titanium is often used for this procedure because it fuses the implant with the jawbone, remains firmly in place, and won't decay like some bridgework.
Because dental implants require several surgical procedures, your dentist or oral surgeon will conduct a full and thorough evaluation, including X-rays and teeth models, to ensure the dental implants will closely match your natural teeth.
Next, your dentist will review the condition of your jawbone concerning how many teeth you plan on having replaced with implants. This planning process could involve several types of dental specialists, including a maxillofacial surgeon or a periodontist.
Your dentist will also want to know about any medical conditions you have, as well as any medications you are taking, including over-the-counter medicines. Do you have any heart conditions or orthopedic implants? If so, your dental specialist might prescribe antibiotics before the surgery to help prevent infection.
Your doctor should know and discuss your surgical anesthesia options and which might be best for you during the procedure. Your surgical team also might provide a list of dos and don'ts that you should adhere to leading up to the surgery.
If you haven't already, arrange for a friend or family member to drive you to and from the surgery because you'll be in no condition to drive yourself after the procedure. Expect to be in "full rest" mode for the rest of the day following the surgery.
During the Surgery
Dental implant surgery is often done in several stages, requiring the jawbone to heal entirely around the implant before proceeding. Here is the typical order of procedures:
- Remove the damaged tooth if it hasn't already come out in some other way.
- Prep the jawbone for surgery, which might include some measure of bone grafting.
- Once the jawbone heals, insert the implant into the gumline.
- Give the jaw time to heal again. Then, the surgeon will place the abutment (the piece that screws into the implant) and attach the artificial tooth on top, completing the full implant.
This process could take up to several months to allow your jaw time to heal and to prepare for the final installation of the implant. Without a strong jawbone in place, the implant won't take, so it's essential to be patient during the healing process. Let's next take a more in-depth look at some of the steps in this process.
The current jawbone site for your implant might not be thick enough, or it could be too soft. Because your jaw creates so much pressure while chewing, the bone needs to be extra strong to handle chewing and protect the dental implant.
Depending on the structure of your jawbone, you might need to add a little extra bone to give the implant site a more solid foundation. An oral surgeon adds this bone through a process called bone grafting, where a small bit of bone or other material is transplanted to help solidify the implant base within the jawbone. If bone grafting is needed, the healing process can take at least four to six months before installing an implant.
While the implant heals, you'll wear a temporary denture to keep the appearance of an entire tooth. The denture will be removable and should be kept clean at all times.
During this time, osseointegration will be occurring. Osseointegration is when the bone begins growing into and uniting with the surface of the implant, making it a part of the natural gumline. The process can take anywhere from three to nine months and will operate the way the roots of a natural tooth normally would.
When the healing and osseointegration processes are complete, your dentist will install the abutment. The installation is a minor outpatient procedure using local anesthesia.
The oral surgeon will reopen your gums so that the dental implant is exposed. They will then screw the abutment into the dental implant. The gum tissue is then closed back around the abutment and left to heal for one to two weeks. Later, the artificial tooth will be attached to the abutment.
Once your gums have healed, your dentist will make more impressions of your mouth and the remaining teeth. These impressions are used to make the artificial tooth or crown for your dental implant. There are two main types of artificial teeth you'll be able to choose from — a removable implant prosthesis or a fixed implant prosthesis.
Going the removable route is similar to a removable denture. It's mounted on a metal frame that snaps securely onto the implant abutment. This artificial tooth is an excellent choice because it can be removed for cleaning or replacement, especially when several teeth have been removed and required dental implant replacements. It's also a more secure and affordable option.
If you choose to get a fixed implant, the artificial tooth is very challenging to remove. It's either permanently screwed onto the abutment or cemented down. If you have several teeth that require implants and money isn't a concern, you can have all of them replaced in this manner – with each crown attached to its separate dental implant.
Discomfort is natural and expected after dental implant surgery. Here's what you can expect:
- Swelling of the face and gums
- Bruising of the gums or skin
- Pain at the site of your implant surgery
- Minor bleeding
If any of these symptoms worsen several days after the surgery, contact your dentist or oral surgeon immediately. It might indicate implant issues that need to be addressed by a professional.
To help you heal post-surgery, your dentist or oral surgeon might advise eating soft foods, applying ice packs to relieve the swelling, and patience while the surgical site heals.
While most dental implants are routine procedures and most dental implant surgeries are successful, there may be complications, including bone fusing to the implant. You can prevent this fusing by doing the following things:
- Practice proper oral hygiene by brushing twice a day and cleaning between your teeth with interdental brushes or water flossers at least once a day
- Attend regular dental office visits and examinations to stay on top of your oral health
- Avoid using tobacco products
- Avoid bad oral habits, such as chewing on ice or hard candies
If you think you might be a candidate for dental implants, talk to your dentist or oral surgeon about dental implant surgery. Take care of your teeth, and you can take on anything.
This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.