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Overview
Dental implant surgery is a procedure that replaces tooth roots with metal, screwlike posts and replaces damaged or missing teeth with artificial teeth that look and function much like real ones. Dental implant surgery can offer a welcome alternative to dentures or bridgework that doesn't fit well and can offer an option when a lack of natural teeth roots don't allow building denture or bridgework tooth replacements.
How dental implant surgery is performed depends on the type of implant and the condition of your jawbone. Dental implant surgery may involve several procedures. The major benefit of implants is solid support for your new teeth — a process that requires the bone to heal tightly around the implant. Because this bone healing requires time, the process can take many months.
In general, dental implants may be right for you if you:
Don't smoke tobacco
Risks
Like any surgery, dental implant surgery poses some health risks. Problems are rare, though, and when they do occur they're usually minor and easily treated. Risks include:
How you prepare
The planning process for dental implants may involve a variety of specialists, including a doctor who specializes in conditions of the mouth, jaw and face (oral and maxillofacial surgeon), a dentist specializing in treating structures that support the teeth, such as gums and bones (periodontist), a dentist who designs and fits artificial teeth (prosthodontist), or occasionally an ear, nose and throat (ENT) specialist.
Because dental implants require one or more surgical procedures, you must have a thorough evaluation to prepare for the process, including a:
To control pain, anesthesia options during surgery include local anesthesia, sedation or general anesthesia. Talk to your dental specialist about which option is best for you. Your dental care team will instruct you about eating and drinking before surgery, depending on what type of anesthesia you have. If you're having sedation or general anesthesia, plan to have someone take you home after surgery and expect to rest for the remainder of the day.
What you can expect
Dental implant surgery is usually an outpatient surgery performed in stages, with healing time between procedures. The process of placing a dental implant involves multiple steps, including:
The entire process can take many months from start to finish. Much of that time is devoted to healing and waiting for the growth of new bone in your jaw. Depending on your situation, the specific procedure done or the materials used, certain steps can sometimes be combined.
When bone grafting is required
If your jawbone isn't thick enough or is too soft, you may need bone grafting before you can have dental implant surgery. That's because the powerful chewing action of your mouth exerts great pressure on your bone, and if it can't support the implant, the surgery likely would fail. A bone graft can create a more solid base for the implant.
There are several bone graft materials that can be used to rebuild a jawbone. Options may include a natural bone graft, such as from another location in your body, or a synthetic bone graft, such as bone-substitute material that can provide support structures for new bone growth. Talk to your doctor about options that will work best for you.
It may take several months for the transplanted bone to grow enough new bone to support a dental implant. In some cases, you may need only minor bone grafting, which can be done at the same time as the implant surgery. The condition of your jawbone determines how you proceed.
Placing the dental implant
During surgery to place the dental implant, your oral surgeon makes a cut to open your gum and expose the bone. Holes are drilled into the bone where the dental implant metal post will be placed. Since the post will serve as the tooth root, it's implanted deep into the bone.
At this point, you'll still have a gap where your tooth is missing. A type of partial, temporary denture can be placed for appearance, if needed. You can remove this denture for cleaning and while you sleep.
Waiting for bone growth
Once the metal implant post is placed in your jawbone, osseointegration begins. During this process, the jawbone grows into and unites with the surface of the dental implant. This process, which can take several months, helps provide a solid base for your new artificial tooth — just as roots do for your natural teeth.
Placing the abutment
When osseointegration is complete, you may need additional surgery to place the abutment — the piece where the crown will eventually attach. This minor surgery is typically done with local anesthesia in an outpatient setting.
To place the abutment:
In some cases, the abutment is attached to the dental implant metal post when the post is implanted. That means you won't need an extra surgical step. Because the abutment juts past the gumline, however, it's visible when you open your mouth — and it will be that way until your dentist completes the tooth prosthesis. Some people don't like that appearance and prefer to have the abutment placed in a separate procedure.
After the abutment is placed, your gums must heal for about two weeks before the artificial tooth can be attached.
Choosing your new artificial teeth
Once your gums heal, you'll have more impressions made of your mouth and remaining teeth. These impressions are used to make the crown — your realistic-looking artificial tooth. The crown can't be placed until your jawbone is strong enough to support use of the new tooth.
You and your dental specialist can choose artificial teeth that are removable, fixed or a combination of both:
After the procedure
Whether you have dental implant surgery in one stage or multiple stages, you may experience some of the typical discomforts associated with any type of dental surgery, such as:
You may need pain medications or antibiotics after dental implant surgery. If swelling, discomfort or any other problem gets worse in the days after surgery, contact your oral surgeon.
After each stage of surgery, you may need to eat soft foods while the surgical site heals. Typically, your surgeon will use stitches that dissolve on their own. If your stitches aren't self-dissolving, your doctor removes them.
Results
Most dental implants are successful. Sometimes, however, the bone fails to fuse sufficiently to the metal implant. Smoking, for example, may contribute to implant failure and complications.
If the bone fails to fuse sufficiently, the implant is removed, the bone is cleaned up, and you can try the procedure again in about three months.
You can help your dental work — and remaining natural teeth — last longer if you:
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