Frequently asked questions about the treatment phases:
After placement, the implant is buried in the bone with the gum closed back over the top. Thus the temporary denture or bridge in place before the implants were placed can remain until the day of completing the treatment with the definitive crown or bridge.
- Diagnosis and treatment planning.
- Initial treatment to stabilise the mouth and eradicate infection-if necessary.
- Construction of provisional dentures or bridge to be used whilst the implant integrates within the bone.
- Placement of implants and fitting of temporary restoration.
- Removal of sutures one week later and review
- Healing period for 6 weeks
- Uncovering of implant if buried or testing if already uncovered. At this stage it is known if the bone has grown onto the implant.
- Impressions two weeks later.
- Fitting of crown/bridge/denture after two weeks of manufacture at laboratory.
- Reviewing and monitoring.
From original loss of tooth to final cementation of crown on top of implant usually takes about three months. This period can increase if bone augmentation is needed, or decrease slightly if the bone strength is very high and the crown can then be cemented almost immediately.
Normal oral hygiene procedures such as brushing and flossing are essential to maintain a healthy attachment between the gum, the implant and the bone. The method of cleaning implants is very similar to that of teeth but the standard for implants must be impeccable if they are to last as long as possible.
Your dentist and hygienist will monitor your progress and advise accordingly.
Once the bone has integrated around the implant and the situation is stable and healthy, it is the quality of home and professional care which determines how long the implants will last. Just as teeth can develop gum disease or periodontitis, implants can develop a similar condition known as periimplantitis which results in inflammation of the gum around the implant and eventually, if untreated, will result in bone being lost around the implant and ultimately loosening and then loss of the implant.
To prevent problems and to ensure that the implants last indefinitely, good home cleaning should be practised every day, and regular visits to the dentist and hygienist maintained. This way, plaque will not be allowed to accumulate on the surface of the implant (which causes gum disease) and any warning signs will be detected early and are usually reversible.
It will probably be necessary to replace the crown or bridge on the implant after a long period in function as these structures, just like teeth, can experience wear and fracture etc.
There are many documented cases of implants in function for over thirty years.
Dental implants placed next to natural teeth gives the best result in terms of aesthetics. The single-tooth implant between two natural teeth is an almost perfect dental restoration; the appearance is almost undetectable and the success rates are close to 100%. With careful planning the risk of damage to adjacent teeth is small and if a tooth is inadvertently damaged by the placement of a nearby implant, any resulting problems can generally be resolved by root canal treatment in which the nerve of the natural tooth is removed and the nerve chamber sealed.
In the upper jaw or Maxilla, there is very little to avoid except the sinuses. These are air-filled chambers above the back teeth and sometimes their floor needs to be lifted to create more bone for implant placement.
In the lower jaw there are a few structures of importance which are to be avoided during surgery. The most important of these is the inferior dental nerve which supplies sensation to the teeth and lower lip. If this nerve is damaged during the procedure, then the lip may experience temporary numbness similar to after having a dental injection. In severe cases this numbness can be permanent-a rare but important complication.
If it is discovered that the bone has not integrated with the implant there are usually no symptoms at all. We will only discover the problem at the uncovering and testing stage six weeks after placement. The implant will be covered by gum instead of bone and simply lifts out of the socket with no pain or discomfort.
If the implant has not been successful, which happens in only 1-2% of cases, then there are three options;
a. Allow the area to heal and then place another implant after six weeks.
b. Remove the implant and place a slightly larger one straight away.
c. Elect to restore the space without using dental implants.
Options a and b, above, improve the chances of success still further and are usually successful in achieving an osseointegrated, functional implant. I a very small number of cases, multiple or cluster failures occur and there is usually a medical reason for this. Such cases include previous treatment with radiotherapy or rare bone diseases.
Insurance plans are available to covert the cost of placing a second implant is covered.
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