If you’re considering getting a dental implant for the first time, there are probably many questions running through your mind. What are dental implants? How are implants placed? How long does it take? Does it hurt? This is a quick review of the overall surgical procedure that most implant dentists follow to place dental implants.

What is a dental implant?
A dental implant is a prosthetic replacement for a missing tooth. Natural teeth consist of the crown and the root. The crown is the visible section that is covered with white enamel. Supporting the crown is the tooth root which extends into the jawbone. The root is the part of the tooth that is effectively replaced by an implant.

There are commonly three parts to what is described as an implant – the implant device itself (which is inserted directly into the bone); the abutment – the piece that connects the implant device to the third part – the overlying crown or denture.

Today’s implants are predominantly made of titanium, a metal that is bio-compatible and offers strength and durability as well as a unique property of fusing directly to bone – the process known as osseointegration. Other materials, such as zirconium, might be used to make implants in the future. But for now, these materials have not been perfected for general use.

What can you expect with dental implant surgery?

• Dental implant surgery is usually an outpatient surgical procedure performed in stages:
• Your damaged tooth is removed.
• Your jawbone is prepared for surgery. In some instances, bone grafting may be necessary.
• After the jawbone has healed, your implant dentist will place the dental implant metal post in your jawbone.
• A healing period follows that could last a few weeks to several months. This varies for each patient.
• The implant abutment (an extension to the metal post) is placed by the implant dentist.
• After the soft gum tissue heals, your implant dentist will make molds of your teeth and jawbone to prepare the crown – the artificial tooth – to connect to the abutment.

Bone grafting
If your jawbone isn’t thick enough or considered too soft to support the implant or withstand chewing forces, a bone graft can create a more solid, reliable base for the implant. A bone graft involved removing a piece of bone from another part of your jaw or your body and transplanted to your jawbone. Artificial bone that is commercially available is another option to discuss with your implant dentist. The bone grafting procedure may take up to several months to grow enough bone to support a dental implant.

Placing the dental implant
During the surgical procedure, your implant dentist will make an incision to your gum to expose the bone. Holes are drilled into your bone where the dental implant metal post will be placed. Since the post will serve as the tooth’s root, it is implanted deeply into the bone. At this point, you’ll have a gap where your tooth is missing. A temporary denture can be placed that can be removed for cleaning and for safety while you sleep.

Waiting for the bone to merge with the implant
During the process of osseointegration, the jawbone tissue will grow into the metal implant post. This process can take several months to provide the secure attachment that will provide a solid base for the new artificial tooth.

Placing the abutment
When the bone and implant have securely integrated, additional surgery is required to place the abutment to the implant post. This minor outpatient surgery is typically done with local anesthesia. This involves your implant dentist reopening your gum to expose the dental implant and then attaching the abutment. The gum tissue is then closed around, but not over, the abutment. In some cases, the abutment is attached to the dental implant metal post when the post is implanted to avoid a second surgical step. With this option, the abutment is exposed and visible during the healing process.

Placing the artificial tooth (implant crown)
There is a healing period of about 1-2 weeks before the crown is placed on the abutment. Once the gums have healed, your dentist will make impressions of your mouth and teeth to create a natural-looking artificial tooth. Once your jawbone has healed sufficiently to support the use of the new tooth, the crown will be placed on the abutment.

Your new dental implant
Once your implant is placed and healing has occurred, you should experience normal chewing and speaking capabilities. After each surgical stage, soft foods may be necessary to resist pressure being placed on the healing tissue and implant device. Some swelling and discomfort may be expected after your implant procedure is complete. For optimal healing success, it’s important to schedule follow-up visits to your dentist as well as follow recommended oral hygiene once your new implant is in place.