Chapter 3
Welcome to the third chapter on dental implant procedure. Here we will talk all about the dental implant procedure. We are sure that after learning everything there is to know about dental implants and the types of dental implants you’ll be able to take a good decision about your dental health. So let’s take a step forward. What do you need to know about the dental implant procedure?
A dental implant procedure always starts with preparation for surgery. From a medical visit to x-rays to planning the procedure. This will always be an important stage in which to talk about medical history, plans, goals, and fears. During the first surgery, dental implants will be implanted, and then the gum will be closed again. Then begins a healing period. It takes from 4 to 6 months for the gum to heal. The next step is a second procedure in which the abutment is added and the dental prosthesis is then installed.
The overall procedure lasts from 6 to 9 months if we count recovery time. This also depends on the type of implant chosen and the patient. However, there’s also a same-day dental implants option and quicker options taking from 1 to 3 days.
What are the dental implant procedure steps?
If you have already read the articles on types of dental implants, you will know that there are different types of implants, especially when it comes to procedures. In this article, we will mainly talk about the more classic procedure of dental implants. However, we will add paragraphs explaining if there are exceptions or differences in procedure. For example, slightly different procedures as the type of implant require several steps.
The dental implant procedure steps are:
- Preparation for surgery
- Placing the implant
- Healing time after the first procedure
- Dental implant abutment procedure
- The prosthesis installment
Let’s check them one by one!
Preparation for surgery
The first part of the preparatory process for the dental implant procedure can take some time and some important decisions on your part. You will first have to choose who will perform the entire dental implant surgery. You will need a dentist who specializes in oral surgery. After deciding the dental specialists to trust, it will be necessary to analyze the area to be treated and create a treatment plan. This is the time for a dental exam and the planning stage. You will need to look at your current situation but also your medical history. It’s important to always have an overview of the patient’s medical history, present, and past.
You will certainly need panoramic x-rays of the area to examine carefully the bone, nerves, and sinuses. In addition, the gums should be analyzed to find out their condition and the dents to ensure that there are no problems with tooth decay or infections. This type of problem will need to be resolved before the dental implant procedure begins.
In addition, we need to note that if there is not enough amount of jawbone, a dental bone graft or a sinus lift may be necessary for extra bone density. Obviously, the surgeon will evaluate this option and include it in the treatment plan.
The dental extraction may be performed during this day if you wish and if you’re in need of tooth extraction.
Placing the implant
When the day of the dental implant procedure arrives, you can feel anxious and worried about the dental implant process. It’s time to insert the artificial tooth root. So let’s talk about what’s going on so you can know what’s going on and find some peace of mind.
The dental and oral surgeon will start measuring and marking the distance between the top and bottom teeth and jaw naturally present in case of a denture implant. The distance between the top and bottom jaw should be the same after the procedure too. This ensures a natural feeling, the same facial structure, and a good chewing capability.
The procedure begins with the injection of local anesthesia. If you have severe anxiety and want a quieter procedure, a sedative can be given to help you out. You will not feel any pain, but you will hear the annoying noises typical of a dental office. While the anesthesia takes effect, your dentist will tell you about the procedure and the various steps, the expected duration of the surgery, and advice on how to behave after the procedure.
The procedure then begins. In this part, we will talk about the endosseous implant procedure also known as the endosteal implants procedure (you can learn about this type in Chapter 2).
The surgeon opens the gum to reveal the bone. They will then open a hole in the bone to create enough space to insert the metal screw (usually titanium post), the dental implant, or artificial tooth root. Once the opening is complete, the metal post is inserted. Finally, the gum is closed with stitches to protect the area. In fact, it will be important not to let food and bacteria come into contact with the bone and the implant, avoiding infections.
The operation ends like this. You will be free to go home having to avoid food and drinks for a few hours.
Healing time after the first procedure
Once the first part of the dental implant procedure, it’s time for you to take care of your implant. It’s time for healing. This can take from four to six months usually and some proper care to keep your dental health on point.
During this time, the osseointegration process takes place. What’s osseointegration?
The osseointegration process creates a structural and functional connection between the jawbone and the dental implant. Made simple: the bone accepts the implant as part of its own, so the dental implant and the bone merge as one with no rejection. This process is successful if the right material biocompatible to the bone is placed, like titanium and zirconia. These have the highest success rate making them 100% biocompatible.
Dental implant abutment procedure
Once the healing phase is complete, it is time to install abutments. This is the part that connects the implant to the crown, bridge, or denture.
An additional operation will be required to open the gums if a two-step procedure has been used. The second surgery is less invasive than the first and, once again, requires only the use of local anesthesia. It’s just an outpatient procedure.
Once the abutment is applied, the gum will have stitches around but not on the abutment. The dentist will not close the gum on top of the abutment. The gum is closed around it only to avoid gum openings that let bacteria pieces of food pass through.
Sometimes this procedure is performed on the same day as the first, with teeth-in-a-day, for example.
The healing process of dental implant abutment procedures varies, usually taking two to three weeks.
The prosthesis installment
Regardless of the type of dental prosthesis you have chosen, this is the time for the installation procedure. During the healing weeks, you will have temporary prostheses. Temporary prostheses (crowns, bridges, or dentures) are used in the weeks of healing between the abutment and prosthetic installation.
These will be removed, and permanent prostheses will be applied. Once this procedure is completed, you will no longer have to undergo operations or dental visits.
However, we recommend you visit your dentist at least two or three times a year for routine dental cleanings and check-ups.
Placing the implant in a single-stage procedure
The dental procedure in the single case-stage procedure has no differences except in the final phase. So let’s talk about the stitching phase. The suture with stitches – and future re-opening of the gum – is not performed in a single-stage procedure. The gum is left open to avoid a future reopening, avoiding the two steps. Therefore it’s called single-stage.
The decision of whether to close the gum is up to the doctor. The procedure must always be adapted to the patient’s needs. So, based on the situation and the patient, the doctor will decide whether or not to use sutures -.
Placing the implant in an immediate load procedure
In an immediate load implant procedure, there is no waiting between the insertion of the post, the attachment of the abutment, and the attachment of the fake tooth or the denture. To put it simply, it’s a 3-in-1 procedure. In some cases, the fake tooth or denture is inserted on the day of the procedure. In other cases within the following 48 hours. The advantages of this procedure are mainly the speed of the whole procedure. Instead of waiting six to nine months, everything is finished in a couple of days top.
This procedure is usually preferred in case there is a dental extraction on the same day, taking advantage of the fresh extraction socket created by the extraction.
If you are the candidate for a single-stage procedure, your time will be reduced by a couple of weeks
What about an all-on-4 dental implant procedure?
The all-on-4 dental implant procedure is used to apply a full arch denture with only 4 implants, while usually the other implants use six to eight implants.
In the first part of this procedure, any partial or full existing tooth will be removed to create space on both dental arches. The whole gum will be opened to create the space for the four dental implants. Four will be on top, four will be on bottom. The jawbone ridge will be reduced according to the measurements taken previously and the dental implants will be inserted.
Picking a slightly angled direction for the implants it’s essential to allow maximum strength and maximum stability. Also, any other nerve or sinus cavity has to be avoided. After the implants are inserted, the gum will be closed with stitches.
Abutments get installed right away as fake dentures will be implanted on the same day. Why? Well, how can you live comfortably without teeth? So, after stitching the gums and placing the abutment, the temporary denture will be applied and the dentist will make sure the bite is perfect. Any irregular contact point has to be corrected immediately
Once the gum is healed, you will go back for the permanent denture.
This video will help you get an idea on the procedure
Dental implant procedure timeline: how long does a dental implant procedure take?
When you ask yourself about the duration of a dental procedure, you need to be more specific. Do we want to know about the surgery or the whole process which includes all interventions?
Dental implant surgery takes between one hour and two hours. The installation of the abutments takes a maximum of one hour. The application of dental prosthesis takes from 30 minutes to an hour. Obviously, these times vary according to the patient’s situation.
However, it is necessary to keep in mind the times that elapse between the various procedures. Four to six months pass between the insertion of the implant and that of the abutment. Between the insertion of the abutment to that of the prosthesis for two to three weeks. The procedure can take between five and nine months from start to finish.
With the immediate load procedure, the times are shortened, requiring about two or three days. The same-day implants procedure, as you might imagine, takes only one day, sometimes two.
If you choose the single-step procedure, the time will be reduced by approximately 2 or 3 weeks, as you will not have to undergo an additional procedure for the abutment.
What to expect during a dental implant procedure?
A dental implant procedure can bring fears and insecurities to the patient. Therefore we always try to be transparent in what happens and how a surgical procedure is performed.
However, we always remember that the whole process will take place under local anesthesia, and for this reason, there will be no pain. You will feel slight painless pressure and you will hear all the typical noises of dental offices. Nobody likes them, we know, but at least they don’t hurt.
In the days and weeks following, especially the first procedure, you may have slightly painful sensations and discomfort. You will also need to maintain healthy habits to make sure you do not create problems in the sensitive area after the surgery.
Although for a few weeks you will have to pay attention and have patience, you will have a lifetime with the benefits of a dental implant. You will certainly think back and be sure it was worth it!
FAQ about the dental implant surgery
It’s time for a FAQ, the place we answer quickly to the most requested questions by patients. The FAQs obviously concern dental implant surgery and some details to which we have not yet given an answer in the previous paragraphs. How painful is the surgery? Is the surgery safe? We will give a clear answer to everything. Let’s begin!
Is dental implant surgery safe?
Yes, dental implant surgery is safe, and it has become a routine procedure. However, as in any surgery, there are risks associated with it. Even if they have a low percentage, you should know about them. You will need to follow all doctors’ advice carefully to avoid implant failure and keep good oral health.
You can check Chapter 4 for all the risks associated with this procedure.
Is dental implant surgery dangerous?
No, you don’t need to worry. It’s a safe procedure and it’s routine for an oral surgeon. However, there are some risks associated with this procedure and you should know about them. The risks have a very low percentage and if you carefully follow the dentist’s orders, you will be just fine.
Does dental implant surgery require general anesthesia?
No, dental implant surgery is an outpatient surgery, also known as ambulatory, day, or same-day dental implants surgery. Local anesthesia will be used. This means you will be awake but won’t feel a thing. Your mouth will be completely numb. You will go home right after the procedure but it’s advised to rest if possible.
How painful is a tooth implant after surgery?
The dental implant procedure per se is not painful. Thanks to the use of local anesthesia, you won’t feel a thing. However, some patients feel some pain and discomfort during the first week after each procedure. It’s the normal part of the change period. Usually, it’s nothing an over-the-counter painkiller can’t handle. If you feel any pain that just doesn’t feel right, get in touch with your dentist.
Who performs dental implant surgery?
Dental implant surgery has to be performed by an oral surgeon or a maxillofacial surgeon. Oral or maxillofacial surgeons are dentists or periodontists who have a specialization in surgery. These types of specializations allow the dentist to know the structure of the bone and teeth area and know how to apply implants. This allows you to have successful implants and a safe procedure.
What is a dental implant uncovering procedure?
We have already talked about the dental implant uncovering procedure. The dental implant uncovering procedure involves reopening the gum to insert the abutment. The gum had previously been closed during the first surgery to cover the inserted dental implant and protect it from external agents. The dental implant uncovering procedure is part of the second surgery of a dental implant.
Ebenezer V, Balakrishna
The overall procedure lasts from 6 to 9 months if we count recovery time. This also depends on the type of implant chosen and the patient. However, there’s also a same-day dental implants option and quicker options taking from 1 to 3 days.
Ebenezer V, Balakrishnan K, Asir RV, Sragunar B. Immediate placement of endosseous implants into the extraction sockets. J Pharm Bioallied Sci. 2015;7(Suppl 1):S234-S237. doi:10.4103/0975-7406.155926
