How are dental implants placed?

The order of placement of dental implant components – How are dental implants placed?

The placement of dental implants today is a routine procedure with over 96% success. Nevertheless, it is useful for patients to get acquainted with the process, in order to be able to better organize their time, finances and to enter the surgery without stress. We would like to stress here that the process of placing implants can start only when it is shown that there is enough jaw bone tissue and that other conditions have been met, which you can read about in detail on the page Are you a candidate for dental implants?

Even in the case of complete toothlessness, this procedure is done quickly, in two stages, with a three-month interim in which the patient wears a temporary denture or temporary plastic bridge fixture, so that you can continue your lifestyle as normally as possible.

Implant placement, temporary denture

After making a detailed treatment plan, the patient will receive the necessary medication as the preparation for the implant surgery, so that the process of placing the titanium screws can start the next day. Before the surgery, the patient signs a consent agreement for the implant procedure. If a tooth extraction is required, it will be done on the first day, and the installation of screws will begin two or three days later, after the wound has been left to properly heal. In certain cases, it is possible to pull the teeth out if required, and immediately continue with the implant placement, while in other instances it is recommended to wait, even up to a few months, depending on what the 3D CBCT indicates, which will be discussed with the patient at the first examination.

After this, the temporary tooth denture is made, which takes about five days to complete. As soon as the patient receives the screws, fine adjustments are made to make it settle as comfortably as possible. Practice has shown that this first stage of dental implant procedure may take between 7 and 14 days. The implant placement surgery lasts as little as half an hour if a single titanium implant is being placed, or up to a couple of hours if multiple screws have to be installed. The number of dental implants required for a full jaw function is four to eight per jaw.

In the following period of the next four months, the patient has routine checkups, in order to allow the screws and the bones to bond. If the implants used are the ones that can receive immediate load (Nobel Parallel CC and Implant Direct Legacy), then the patient can get a temporary bridge which is screwed in and immobile, which is much more comfortable than the temporary denture. The temporary denture and teeth extraction are included in the cost, while there is an extra charge for the temporary bridge.

Making and placing dental crowns

The second stage of the implant procedure involves making the crowns and placing them on the implants. It is very important, prior to its construction, to define the crown’s colour, shape and length, where the patient is presented with images of different types and colours of crowns made for other patients to help them decide. The making of the crown itself starts by opening dental implants and taking tooth impressions.

It takes to between 7 and 14 days make a dental crown. Two to three trials are done in the period of 7 to 10 days, when final corrections are made regarding the colour and shape of the crown. Then, the final tightening of the abutment onto the implant is done, and the cementing of the future dental crown, which marks the end of the whole procedure. The cementing of all crowns is the process which takes one session to perform, and the moment of cementing the last crown means that the patient is 100% rehabilitated. Alternatively, instead of cementing, it is possible to attach the crowns using screws, which you can read about in section Types of dental crowns.

After the placement

After the first few months it will become clear whether the implants have bonded well with the jawbone, which is true for almost all cases, since in our clinic we do not commit to placing implants before we are convinced that they will integrate well with the bone. Implant integration becomes significantly easier if the patient takes up a healthier lifestyle, including quitting smoking and dealing with other health issues like cholesterol levels, since these are some of the many factors that affect how well the blood vessels concentrate around the screw. After a successful placement and implant integration, the patient must take good care of hygiene around the implant, which is discussed further here.

FAQ

• 1. What are the basic health requirements to get dental implants?
  If you are a healthy person without major systemic or chronic illnesses and if the x-ray (CBCT) shows that you have enough bone tissue, you may freely choose to have dental implants placed.
• 2. Can I get implants if I am a smoker?
  Yes, you can. Smokers are regularly treated with implants with great success. However, there is a somewhat higher risk of implant rejection.
• 3. Is there an age limit for placing implants?
  No, there is no age limit for placing implants. The most important issue is the general health of a patient and absence of serious illnesses and other risk factors which, unfortunately, naturally occur in elderly patients.
• 4. Can an implant be rejected by the body?
  Dental implant rejection, or failure to integrate into the bone, is a very rare occurrence. It happens in about 1% of cases, and if it indeed happens, we can easily place a new implant where the rejected one was, which is done as soon as possible after a rejection occurs. All major implant manufacturers issue lifelong warranties on their implants, which means that the replacement is free of charge, along with being fast and simple.
• 5. What is the life span of dental implants?
  After placing a dental implant and its integration into the jawbone, it should last you a lifetime. However, just like with natural teeth which should ideally have no expiration date, there may occur certain issues with implants. We cannot stress enough how important the hygiene around dental implants is, along with regular checkups. If this is done properly, there is no reason why an implant should not be stable in the jaw and last for a lifetime. Of course, the patient’s general health is another major factor. For example, at times it may happen that in case of an acute illness both natural and artificial teeth deteriorate. An interesting fact is that the first Nobel Biocare implants placed on a patient in 1965 lasted until the patient died a few years ago.
• 6. Is the procedure of placing an implant painful?
  No. The placement procedure is always performed under a local anesthetic, much like when treating a natural tooth.
• 7. What kind of anesthetic is used in the procedure?
  The dental implant surgery is performed with local anesthesia, using special surgical anesthetics with an extended effect. For more complicated surgical procedures of placing dental screws, sedation is advised, either orally applied via tablets or intravenously in the presence of an anesthesiologist. The dental implant surgery itself is performed in a special operating room with maximum sterile environment.
• 8. How long does the placement procedure last?
  The procedure of placing a dental implant lasts 15-20 minutes per dental implant and up to two hours for placing eight implants in one jaw. This period includes administration of anesthetic, placement and stitching.
• 9. Are there any special rules to go by after placing an implant?
  After placing a dental implant, the musts and must nots are the same as with any surgical procedure: eat soft and pureed food, use cold wet cloth for cooling, avoid physical straining and hot beverages. Patients mostly complain about the stitches, because they irritate the surrounding tissue. Stitches must be there and, for our part, we will ensure that the threads are as short as possible, but if they are too short, they may fall out.
• 10. How many implants do I need?
  The answer to that question depends directly on how many teeth need to be replaced. For example, if three teeth are missing, then two dental implants need to be placed, later to be topped with three crowns.
• 11. How long do I have to wait for dental crowns once the implants are placed?
  After placing a dental implant, you have to wait at least 3 months to place crowns in lower jaw, or 4 months for the upper jaw. This waiting period is necessary to let the implant integrate into the bone.
• 12. How long does the fabrication of crowns take?
  The process of fabricating a crown takes 3 days for a single crown and up to three weeks for all crowns in both jaws.
• 13. How are a crown and an implant bonded?
  First, an abutment is screwed in the dental implant, and then the dental crown is cemented onto the screwed-in abutment. Also, there is an option to fabricate a crown using the CEREC CAM/CAD machine. This type of crown is itself a screw-on, so it can be later taken off without damaging it, whereas a cemented crown has to be cut into in order to take off.
• 14. Do I get a warranty on the implants?
  Indeed! The manufacturers issue special warranties for their implants, and some of them, like Nobel Biocare, will give you a worldwide warranty, which means that if you have any problems with implants, an authorized local dentist will receive you free of charge anywhere in the world. This does not mean that problems with implants are expected, aside from minor ones dealt with in the first months after the procedure, with significant issues present in less than 3% of cases (these are mostly implant rejection cases, having nothing to do with either defective material or errors made by specialists). All patients having any problems in the functionality of their implants are immediately checked into our clinic to perform corrections free of charge, and, if need be, a free replacement of the implants.