Dental implants are a great solution to replace missing or extracted teeth. They are better than other alternatives like bridges because no additional teeth need to be altered to replace the new tooth. Dental implants are made from Titanium and resemble a screw.
The entire implant process is performed over the course of a few months. The first part of the process is to determine whether there is adequate bone present in the site. If no further bone is needed (please see Ridge Augmentation and Sinus Lift descriptions), the implant is placed into the jaw bone. Oftentimes, an incision is made in the gum so that the implant can be placed and then the gums are sutured.
The implant must be allowed about 3-6 months to heal, and during this time the jaw bone will form around the implant in a process called osseointegration. During this healing time you may be able to have temporary crowns installed so that you can eat and speak normally and maintain a proper aesthetic appearance for your smile, however, this depends on several factors and is not always possible.
After the implant has healed it is time to place an abutment on the implant. The abutment serves as the base for your new tooth and is a post that is placed into the hollow opening of the implant. One this is placed, an impression of the abutment is taken and is used to create your permanent restoration. Some offices have an onsite lab to create the crown, but others will have to send it to an outside lab. Once the restoration is completed you can return to the office to attach the restoration permanently.
When you lose teeth, and do not replace them, the jawbone deteriorates where the tooth socket once was. This makes it difficult, and in some instances impossible to get dental implants or dentures later on. There is a procedure called ridge augmentation to restore the bone structure that is needed for restorative procedures such as dental implants. This procedure involves lifting the gum from the ridge to expose the deficient area of the bone. After creating access to a blood supply for healing, a bone graft is placed in the deficient ridge, covered with a protective collagen layer and stitches are placed. The ridge augmentation needs 4-6 months to for healing of the bone graft and at that time it will be determined if there is adequate bone present for implants.
Loss of posterior teeth may result in excessive forces placed on your remaining teeth. Fortunately, the use of dental implants and crowns allow you to replace these missing teeth. However, the position of the sinus in the upper posterior areas may be too low for proper placement of dental implants.
A simple procedure allows the sinus floor to be repositioned, creating enough space to properly place an implant. Various grafting materials are used to encourage your bone to grow more quickly into the area, helping to stabilize the dental implant. Replace with your own bone in this area the grafting material as it grows into the area.
Under certain conditions, an even simpler procedure can be utilized. When possible, the bone remaining under the sinus floor is gently “pushed up”, thus lifting the floor of the “dropped” sinus. Bone replacement materials are then placed beneath this lifted bone. Once again the bone materials are replaced as your body grow new bone into this area.
Sinus augmentation procedures are highly predictable, with studies reporting over 95% success. Following sufficient healing of a sinus augmentation (6-10 months), implants are placed in a predictable and successful manner. It is important to realize that if the sinus augmentation procedure does not result in enough bone for implant placement, additional bone may be regenerated through a second sinus augmentation procedure at the time of implant placement.
Extraction Site Preservation
When removing a tooth it is important to consider what will be done with the empty space after that tooth is removed. If a tooth is removed and nothing is done with the extraction site, the jaw bone will degenerate and change shape during healing and can cause your teeth to shift. This can create problems in your bite and affect your ability to speak and chew. Extraction site preservation is when a bone graft is placed at the time of tooth removal. The graft acts as a scaffold for your own bone to regenerate and holds the space for a dental implant.