Overview of Implant Placement – What to Expect

Dental implant placement is a team effort between an oral and maxillofacial surgeon and a restorative dentist. Dr. Stopperich or Dr. Koutras performs the actual implant surgery, initial tooth extractions, and bone grafting if necessary. The restorative dentist (your dentist) fits and makes the permanent prosthesis. Your dentist will also make any temporary prosthesis needed during the implant process.

The Surgical Procedure

The procedure to place an implant takes 30 to 60 minutes for one implant and approx 1 to 2 hours for multiple implants. The number of appointments and time required vary from patient to patient. The surgeon will bring great precision and attention to the details of your case.

For greater comfort, intravenous sedation or nitrous oxide (laughing gas) may be provided. These options are discussed with you at your consultation appointment. A local anesthetic will be administered to numb the area where the implant will be placed.

When you are comfortable, the surgeon makes a small incision in the gum tissue to reveal the bone, creates space using special instruments, and gently inserts the titanium implant. The top of this implant is often visible through the gum. Sometimes it is better in the early stages of healing to have the implant covered by the gum tissue.

The Healing Phase

Now the healing begins. The length of time varies from person to person, depending upon the quality and quantity of bone. In some cases, implants may be restored immediately after they are placed. The surgeon will advise you on follow-up care and timing. After the initial phase of healing, the surgeon places an abutment (support post) or a healing cap onto the implant during a brief follow-up visit. This allows gum tissue to mature and provides access to the implant.

Occasionally, impressions are made at the time the implant is placed. This enables the crown to be ready when the implants have healed. How long your mouth needs to heal is determined by a variety of factors. Follow-up care (one to four appointments) is usually needed to ensure that your mouth is healing well and to determine when you are ready for the restorative phase of your treatment.

It may be beneficial to perform a soft tissue graft to obtain stronger, more easily cleaned and natural appearing gum tissue in the area around the implant. This process involves moving a small amount of gum tissue from one part of your mouth to the area around the implant. Most often, it is a brief and relatively comfortable procedure.

Whether it’s one tooth or all of your teeth that are being replaced, your dentist will complete the restoration by fitting the replacement tooth (crown) to the dental implant.

When Are Dental Implants Placed?

Implants are often placed several months after extraction. At times, an implant may be placed immediately after extraction of a tooth. This may involve a little more risk, but it simplifies the process — you won’t have to wait for another appointment to place the implant. When infection or other problems with the bone are present, immediate implant placement is not the best treatment.

If your tooth has been missing for some time, the adjacent support bone is likely to grow thinner and shrink. This occurs because the root of the natural tooth has to be present to stimulate the bone. As much as one third of your jaw’s thickness can be lost in the year following tooth extraction. If you are missing enough bone, you may benefit from having additional bone grafted into the area. This ensures the implant will be adequately supported when it is placed in the jaw.

How Many Implants Do I Need?

Most frequently, one implant per missing tooth is placed. Because many of the larger teeth in the back of your jaws have two or three roots, the most common approach is to replace missing back teeth with larger implants. However this is patient specific and this will be determined after a detailed consultation.

After Implant Placement

What can I use for teeth while the dental implants heal?

Many options are available, and they are tailored to your specific requirements. If you need a replacement tooth while the dental implants are healing, temporary removable teeth or a temporary bridge can be made. If all of your teeth are missing, we can usually modify your present complete denture or make you a new temporary denture. If you would prefer non-removable teeth during the healing phase, temporary transitional implants usually can be placed along with the permanent implants, and temporary teeth may be made and inserted the same day. Depending on your particular situation, some implants can be placed and “loaded” immediately. This means a temporary or permanent replacement tooth can be placed on, or shortly after, the day the implant is placed.

What are the potential problems after implant placement?

Although it is natural to be concerned about the pain that may be caused by these procedures, most patients do not experience significant post-operative pain. Pain medication and antibiotics will be prescribed for you to make your recovery as easy as possible. Post-op infections after dental implant treatment is very uncommon. In addition, there is a chance that the nerve in the lower jaw which provides sensation to your lower lip and chin may be affected. If you are missing quite a lot of bone, it might be difficult to place an implant without infringing on the nerve space. Although we take great care to avoid this nerve, in rare situations it may be irritated during the procedure, resulting in tingling, numbness or a complete lack of sensation in your lip, chin or tongue. Usually these altered sensations will resolve within time, but they can be permanent and/or painful. If you notify us of post-operative numbness as soon as possible, it will allow us to manage your care in the most appropriate way.

How long will the dental implants last?

Implants usually last a long time. When patients are missing all of their teeth, long-term studies (more than 30 years) show an 80 to 90% success rate. For patients missing one or several teeth, recent studies show a success rate of greater than 95% which compares favorably with other areas in the body that receive implant replacement (such as hips or knees). However, if one of your dental implants either doesn’t heal properly or loosens after a period of time, you may need to have it removed. After the site heals (or on occasion at the time of removal), another implant usually can be placed.

When are the replacement teeth attached to the dental implant?

The replacement teeth are usually attached to the implant when adequate healing has occurred and your jaw bone is firmly fused to the implant. Depending on a variety of factors, it may be possible to begin this phase of your treatment immediately or shortly after implant placement. We will review the most appropriate treatment sequence and timing for your particular situation.

The dental work required to complete your treatment is complex. Most of the work involves actually making the new teeth before they are placed. Your appointments are considered more comfortable and more pleasant than previous methods of tooth replacement. Frequently, this process can be performed without local anesthesia.

Your restorative treatment begins with specialized impressions that allow us to produce a replica of your mouth and implants. We will also make “bite” records so that we see the relationship of your upper and lower jaws. With this information, we will make the abutments (support posts) that attach your replacement teeth to your implants. Various types of abutments exist. In all cases, custom abutments must be made of gold or a tooth-colored ceramic material. As you can imagine, these custom made abutments add to the cost and treatment time involved. Which abutment to use is a decision that often cannot be made until after healing is complete and impressions have been made.

The number of appointments and the amount of time required for each appointment is different for each patient. No two cases are exactly the same and regardless of the number of teeth replaced, the work must be completed with great precision and attention to detail. If you are having only a few teeth replaced, as few as three short appointments may be required. Between appointments, we will need time to complete the necessary lab work to make your replacement teeth. It is most beneficial that you keep all of your scheduled appointments.

If your final restoration is a removable denture, you will need to come to as many as five office appointments (although it may be fewer) over the following several months. During these appointments, we will perform a series of impressions, bites, and adjustments in order to make your new teeth, as well as the custom support bars, snaps, magnets, or clips that will secure your teeth to the implants. During this period, every effort will be made to ensure you have comfortable, temporary replacement teeth.

In general, once your dental implants are placed, you can expect your tooth replacement treatment to be completed anywhere from 1 to 12 months. For these reasons, it is difficult for us to tell you exactly how much the restorative phase of your treatment will cost, although you should receive a reasonable estimate from our office. It also is difficult to give you a specific timeframe for completion of your treatment until after the implants are ready for restoration.

How do I clean my new teeth?

As with natural teeth, it is important that you clean implant-supported restorations regularly with toothbrushes, floss, and any other recommended aids. You should also visit your dentist several times each year for hygiene and maintenance. As with regular dentures and other tooth replacements, your implants and their associated components are subject to wear and tear and eventually will need repair, including clip replacement, relines, screw tightening, and other adjustments.

Will one doctor do everything?

Usually, a dental surgeon places the implant(s) and performs other necessary surgical procedures — your general dentist provides the temporary and permanent replacement teeth. Both doctors are involved in planning your dental treatment. Also, depending upon a variety of factors, different dental specialists may help with your dental care.

How much does all of this cost?

Before treatment begins, every effort will be made to give you an accurate estimate of all the expenses involved in placing the implants and making your replacement teeth. In many cases, there is an initial charge for the diagnostic work-up, including study models, x-rays, and the fabrication of a surgical template to ensure the best possible result. In addition you will be charged for the abutment or support post(s), plus the crown, dentures, or anything else that will be placed over the implants, including temporary restorations. Periodic maintenance such as hygiene visits, tissue conditioners, denture relines, and other repairs will also incur additional charges.

When different doctors are involved in your treatment, you will be charged separately for their services. We will try to assist you in estimating what your actual payments will be after we evaluate your insurance coverage or other third party payments. Also, you should consider your personal financial investment in each treatment option as some insurance companies provide limited or no coverage.

Each patient is unique and it is not possible for us to discuss every option and every contingency for treatment outcome. We are here to help you understand the general treatment options available to you. If your specific treatment options are not clear, please contact us. We will be happy to answer any questions you have about your dental care.

Cost of Dental Implants

Dental implants have been available for several decades. However, for most patients, they are still a relatively new concept. When considering the cost of dental implants and comparing quotes, there are several important points that should be kept in mind.

Longevity

When comparing the cost of dental implants to other tooth replacement methods such as dentures and bridges, it is important to take into consideration the longevity offered by dental implants that is not always afforded by other, more traditional methods.

While dentures and bridges are initially less expensive, their affordability can be short-lived. Because these older methods require repair and replacement every 5 to 10 years, they are often more expensive over time. By contrast, dental implants, when properly placed and cared for, can last a lifetime.

Jaw Bone Health

Over time, when a tooth is missing, the jaw bone deteriorates. So while a denture or bridge may seem to function similarly to a tooth, underneath the surface damage is being done to the jaw bone and ultimately to the structure of the face. This can result in the distortion of the shape of a person’s face, leading to additional cosmetic costs down the road.

On the other hand, dental implants are made of titanium, which actually integrates with the jaw bone, strengthening it and stimulating bone growth. This preserves the natural strength and quality of the mouth, lessening problems in the future.

Quality of Life

Dental implants can be seen as a long-term investment not only in terms of money, but also in terms of quality of life. A dental implant is the closest thing to a natural tooth. In addition to allowing the patient to eat the same healthy foods he or she has always enjoyed, it also eliminates the day-to-day hassles and possible embarrassment that are frequently caused by dentures.

Comparing Dental Implant Quotes

There are several steps (and often multiple professionals) involved in the placement of a dental implant. When comparing quotes, it’s important to factor in the cost of each of these steps:

• Exams/office visits
• Tooth/root extraction
• Bone grafting
• Placement of the titanium root (the “dental implant”)
• Placement of the crown
• X-rays, pre-/post-operative care

Financing for Dental Implants

First, check with your dental insurance carrier to see what portion, if any, of dental implants they cover.

Insurance can be very confusing for most patients. Our practice implant treatment coordinator, Jen, will verify your insurance coverage for all related procedures and provide an estimate of any out-of-pocket expense based on your insurance. If needed she will also provide information regarding health care companies that offer no-interest and low-interest loans for medical procedures including dental implants.

Dental implants are an investment in your health as well as your appearance. A full set of teeth makes eating a pleasure again, making it easier to eat a balanced, healthy diet. A full set of teeth also preserves the contours of the face, keeping you from looking old before your time.

Schedule Your Consultation

The only way to receive an accurate price quote is to call us and come in for a consultation and we can give you a specific price for your case. Please call us at McMurray Office Phone Number 724-942-4800 to schedule your consultation.