The first step with dental implant treatment is to have a full mouth assessment. Dental implants need enough jaw for support. They need to be well maintained in a healthy mouth to survive. The planning for dental implants is more important than placing the implants. Care has to be taken that disease processes that could impair the uptake of a dental implant have been resolved. Dental literature suggests that if an implant can survive the first year then it can last in excess of 40 years. There are few things that we can purchase that can last this long, but there is a maintenance requirement and this starts with a disease-free mouth.
The implants are inserted into the jaw generally below the gum level. In some circumstances, the implant comes to gum level but mainly the implant finishes at the jaw level. In single-stage surgery, there will usually be a ‘healing abutment’ placed on top of the implant and the gum will heal around this. In other circumstances, the gum will completely cover the implant (two-stage surgery) while it is healing. This healing process is called osseointegration. These implants are then left for a period of time to osseointegrate prior to teeth being attached. For two- stage surgery the implant/s will require to be uncovered after osseointegration and the gum left to heal usually with a healing abutment but sometimes with a temporary crown to help shape the gum.
In some circumstances, it is possible to load the implants immediately. There are a number of names for this including ‘teeth in an hour’, ‘teeth in a day’ and so on. What this means is that enough planning, enough implants and technical work have been completed, to enable joining implants together to allow immediate function. There are limitations to this approach. There is evidence of increased risk of failure of implants in this situation, but it is useful and can be of help as long as there are sufficient planning and acceptance of the limitations of the technique.
Once osseointegrated, moulds are made of the mouth to allow the manufacture of the tooth/teeth/denture. The decision of what will be made will have been discussed before the implant will have even been placed. With this information, the technicians will begin to fabricate whatever has been planned. Shortly after the planned restoration will be placed to complete your smile.