An implant is surgically placed in an opening that is made by your dentist in the jawbone. After the implant integrates (attaches) to your bone, it acts as a new “root” for the crown that will be replacing your missing tooth. A crown (cap), which is made to look like a natural tooth, is attached to the implant and fills the space left in the mouth by the missing tooth. For this procedure to work, there must be enough bone in the jaw, and the bone has to be strong enough to hold and support the implant. If there is not enough bone, bone may need to be added with a procedure called bone augmentation. In addition, natural teeth and supporting tissues near where the implant will be placed must be in good health.
- The implant, which is made of titanium, is placed in the upper or lower jawbone.
- The abutment can be made of titanium, gold or porcelain. It is attached to the implant with a screw. This part connects the implant to the crown.
- The restoration (the part that looks like a tooth) is a crown, usually made of porcelain fused to a metal alloy (PFM), but also could be an all-metal or all-porcelain crown. The crown is attached either to the abutment or directly to the implant. It can be screwed or cemented onto the abutment. If the crown is screwed to the abutment, the screw hole will be covered with restorative material such as tooth-colored filling material (composite).
The time frame for completing the implant and crown depends on many factors.
- Implant-supported crowns are a naturally better solution.
- Looks, feels and performs similar to your natural tooth.
- Does not compromise your adjacent teeth to support a bridge.
- Preserves surrounding bone (replaces tooth root).
- Prevents bone collapse and jaw line recession.
- Oral care same as a natural tooth.
- Restores a more secure biting ability than a removable denture.
- Restores self-confidence and appearance.
Before any work is done, you will visit our Implantologist who has had advanced training in the placement and restoration of implants will do a comprehensive examination. During the exam, he or she will review your medical and dental history, take X-rays, and create impressions of your teeth and gums so that models can be made. In some cases, the dentist also may order a computerized tomography (CT) scan of your mouth. This scan will help your dentist determine how much jawbone is available to hold the implants in place, and will show the location of structures such as nerves and sinuses (located above your upper teeth) so they can be avoided during surgery. If the X-rays show that your jaw does not have enough bone to hold an implant, the dentist can discuss options, such as bone grafting and bone distraction, for building up the bone. If you need one of these procedures.
Once you have enough bone to successfully hold an implant, you will schedule the first surgery, which involves placing the implant or implants in your jaw. Our Implantologist usually does this surgery, and stays in close contact with your prosthodontist or general dentist. Although there are several types of implants, the most popular type is root-form implants designed to serve as the root of the tooth. They are placed in the jawbone in the space created by the missing tooth. We wait till the bone and the implants fuse.
Once the implants have become fused with the bone, you can schedule the second appointment. Your dentist will confirm whether the implant is ready by taking an X-ray.
A collar, called a healing abutment (collar), is placed on the head of the implant after it is exposed. This encourages the gums to heal correctly. The collar is a round piece of metal that holds the gums away from the head of the implant. The collar will be in place for 10 to 14 days. If you previously had a removable partial denture, your dentist may adjust it so you can use it during this time.
Healing abutments help the gums to heal properly After the stitches and collar are removed, final impressions are made. These impressions will be used to make models that will look exactly like your mouth. A dental technician will use these models to make the temporary and final crowns.
An abutment and temporary crown are placed on the implant. The abutment is screwed onto the implant and tightened, using special equipment so that it won’t come loose. After the abutment is attached to the implant, the temporary crown is placed on the abutment. In some cases, the temporary crown is attached directly to the implant without an abutment. The abutment then is placed later. In other cases, you may get the abutment and temporary crown immediately after the implants are uncovered during the second surgery, and you won’t need a healing collar. The gums will heal around it and will look like the gums around your natural teeth. The temporary crown is made of softer material than the permanent crown. The softer material helps to cushion and protect the implant from the pressure of chewing, and gives the jawbone the opportunity to gradually get stronger.
While you are wearing your temporary crown, the permanent crown will be made. The crown can be created from a model of your teeth and gums that includes the implant or the abutment. The crown can be either cemented or screwed to the abutment. Crowns held in place by cement may look better because there is no screw hole in the crown to be seen. However, crowns held in place by a screw are easier for your dentist to remove if he or she needs to reach the implant or the tissue around the implant. Sometimes, an abutment can’t be used. In that case, your dentist would attach the crown with a screw.
Rigorous dental hygiene practices consisting of both at-home care as well as visits to your dental clinic are mandatory for optimal oral health. Both your natural teeth as well as implants need to be treated in the same way. Of course regular brushing and flossing are great ways to keep your implants clean and plaque-free.
Post-treatment, the best care plan will be drawn up for you by your periodontist to follow with your help. Remember you follow-up with visits that will help you observe your implant, teeth and gums to ensure they are healthy.