It’s important to note that in the situation where a patient requires a type of graft before receiving an implant (e.g. bone or gum graft) as well as any treatment to make the mouth dentally fit such as a filling or hygiene treatment, this should be carried out in a separate appointment prior to the implant placement.
4 Steps to your dental surgery day
So what does the implant placement appointment involve?
- First, the dentist will assess the previously taken 3D scan to prepare for the procedure and be guided on how to place the implant, the implant should ideally be placed in the middle of the gap which is the most favourable position for stability and healing.
- Once the dentist has checked the 3D and is mentally ready for the procedure a local anesthesia injection is administered near the surgical site, much like what a patient would receive before a filling.
- After a few minutes once the area is numb a small amount of gum is gently peeled away from over the bone to expose it, called a surgical flap. This uncovering of the bone allows the surgeon to visibly see the bone that needs to be prepared to receive the dental implant.
- Once the gum has been raised in the receptor site and the bone is exposed the dentist will use a series of surgical drills of differing sizes, these start from narrower drills and increase in size until the diameter of the implant is reached. For example, if a surgeon chooses an implant that is 4mm in diameter they may use two or three drills to prepare the area in the bone that will receive the implant, the last drill being 4mm so the implant slides into the bone and fits nicely. This is called osteotomy which is a fancy term for drilling a hole in the bone that is the same size as the implant which will follow.
What happens next?
Once the hole has been prepared in the Bone by the dentist the implant is gently screwed into place until it locks into place. The next step after this depends on how sturdy and stable the implant is once placed into the bone, there are two scenarios that the dentist and patient may find themselves in.
- In the first instance, the implant is really stable in the jaw and the dentist can be confident there will be little to no movement by the implant and as a result, it will heal well. In this scenario, the dentist may decide to place something called a healing abutment over the implant which allows the gum to form around the implant and reduces the overall procedure time by weeks as a step is eliminated from the treatment
- In some cases the implant may not be stable enough to place a healing abutment over the tooth, this for example could be in the event of an immediate implant placement where an implant is placed immediately after a tooth is extracted. As the bone can be slightly broken down (understandably as a tooth has just been removed prior to placing the implant) the dentist may need to place the implant slightly deeper in the surgical area and so a cover screw is placed which essentially allows the gum to cover the implant. In this event, an additional appointment is needed to remove the cover screw and place a healing abutment, which allows the gum-shaping process to begin. This treatment route is slightly longer as there is a delay of 2-3 weeks between placing the cover screw over the implant and removing the cover screw to replace it with the healing abutment
- Once the implant has been placed, the gum is replaced and sutured into place and the healing process begins. It takes around 8-10 weeks for the bone to heal around the implant and so this is the period of time between the implant placement appointment and the impression appointment.
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