Overview of Implant Placement

The Surgical Procedure

The procedure to place a dental implant takes 30 to 60 minutes for one implant and two to three hours for multiple implants. The number of appointments and time required varies from patient to patient. The surgeon will bring great precision and attention to the details of your case. This will be explained preoperatively.

At your surgical appointment you may receive antibiotics. Optimal comfort can be provided with a range of anaesthesia services varying from simple local anaesthesia to intravenous sedation or, commonly, general anaesthesia. These options are discussed with you at your consultation appointment. In the case of intravenous sedation or general anaesthesia, local anaesthesia is still administered intraoperatively to provide initial postoperative comfort.

After appropriate anaesthesia, your surgeon will make a small incision in the gum to reveal the underlying bone. Special instruments are used to create space for the implant and the titanium implant is then gently inserted. The top of the implant is often visible through the gum. Sometimes it is better in the early stages of healing to have the implant buried under the gum tissue temporarily.

The Healing Phase

Healing time varies from person to person depending on bone quality and the nature of the treatment. In some cases implants may be restored immediately after they are placed. Most commonly there is a waiting period of three months prior to restoration of the implant. Patients requiring simultaneous grafting of the bone or patients with poor bone quality may require extended healing time.

Most commonly, a healing abutment or healing cap is placed at the time of surgery. These are visible during the healing phase and look like small buttons protruding through the gum tissue. Occasionally, the implants will be submerged under the gum tissue to optimize the potential for healing. In these cases a second stage procedure is required to attach the healing abutment. This can be done at three to six months postoperatively.

Follow up care is needed to ensure that your mouth is healing well and to determine when you are ready for the restorative phase of your treatment.

Sometimes it is beneficial to perform soft tissue grafting in the gum tissue around the implants. This can help obtain stronger, more durable and more easily cleaned and natural appearing gum tissue in the area around the implant. If you are a candidate for this ancillary procedure, your surgeon will explain this to you.

Ultimately, at completion of healing, you will be referred back to your dentist for restoration of the implant(s).

What is the Timing of Dental Implant Placement?

Implants are often placed several months after tooth extraction. At times, an implant may be placed immediately at the time of tooth extraction. The advantage to this approach is the reduced number of appointments and healing time before placement of the prosthesis. Your surgeon will tell you if you are a candidate for this treatment approach. If infection is present or there are other problems with the surrounding bone, immediate implant placement is not indicated.

If your tooth has been missing for some time, the adjacent bone is likely to grow thin and shrink. This atrophy process occurs when the bone loses the natural stimulation that comes from chewing on your teeth. Patients missing large amounts of bone may benefit from bone grafting as a preparatory procedure prior to implant placement. This optimizes adequate support for the implant.

How Many Implants Do I Need?

Generally, one implant per missing tooth is recommended. The large molar teeth in the back of the jaws have two or three roots per tooth. Missing back teeth may be restored with larger single implants. Multiple missing teeth may be restored with implant-supported bridges. This can allow for a reduced number of implants compared to the number of missing teeth.