Dental Implants - Process

Normally, an implant consists of three parts: the implant body which is anchored in the bone (in the form of a screw or cylinder), the implant framework (abutment or implant post) situated atop the tooth which functions as the connection between the implant body and the dental replacement, and a top-layer super-construction in the form of a fixed or removable dental replacement. After the completion of treatment, only the super-construction is outwardly visible.⁶

Implant installation is normally conducted using local anaethesia; more comprehensive measures may employ general anaethesia.
After opening the mucous membrane in the affected area, a small hole is drilled into the bone with two different drills, thereby preparing an implantation bed. The holes drilled for screw-shaped implant bodies feature threaded walls so that the implant stays firmly anchored in the bone later on. The aforementioned boring template is usually employed during this process, allowing millimeter precision in the placement of the implant. Thereafter, the implant is installed and the cut is closed. In some cases, an interim dental prosthesis is also installed. Normally, the anaesthetic permits these steps to be experienced free of pain. According to patient reports, having a tooth pulled is considerably more unpleasant than having an implant installed.

Recovery time follows soon after the installation of the implant. During this time, the cut made in the bone heals around the implant: the body builds new blood vessels and, later on, scar tissue. In addition, osteoblasts (bone-building cells) build new tissue which later hardens into bone. The trabeculae contained therein build connections to the implant and outward hence during so-called osseointegration, with the result that the small amount of space between the implant and implant bed is filled and the implant gains substantial stability within the bone.⁷

The length of recovery normally lasts 4-6 months for the upper jaw, and 3-5 months for the lower jaw.⁸

During the second session, the implant is exposed via a second micro-opening into the mucous membrane under local anaesthetic. Subsequently, a "recovery crown" or a scalloped tooth shaper made of titanium is screwed onto the implant. During the immediately following second stage of recovery, the mucous membrane forms around this structure and anneals.
In principle there is also the possibility of avoiding a second incision into the mucous membrane. This would then be called a single-phase implant: the implant body projects so far over the mucous membrane that the dental replacement can be prepared directly after the first recovery period and later attached to the implant post.⁹

After the hypothetical second healing phase (1-2 weeks) has run its course, an impression of your dental structure is made. The dental technician will use this impression to prepare your dental replacement. As soon as this is ready, the scalloped tooth shaper will be swapped with the existing implant post in a follow-up session and the pre-constructed dental replacement will be affixed using screws or cement.¹⁰

Potential dental replacements are determined by the nature of the problem. One possible solution for single missing teeth, larger gaps, or shortened rows of teeth would be crowns. Individual implants would not be advisable in the case of multiple missing teeth in a row; it would be preferable to connect crowns together. For mouths that are nearly or completely toothless, the use of implant-supported bridges or removable prostheses should be considered.¹¹

You should determine which dental replacements are appropriate for your situation during a planning session with your dentist.