Dental implants are given to restore the form, function and the esthetic of the mouth. Now the question arises how dental implants are placed? What is the procedure of placing the dental implants? In dentistry when we talk about the dental implants, we normally talk about the ENDOSSEOUS IMPLANTS i.e. root form implants. In this dental implant procedure, the hole is formed in the bone to place the dental implant and is left in there to integrate with in the bone and this integration process is called as osseointegration.
Now we will talk about the procedure of dental implants i.e. how the dental implants are placed in the oral cavity. Dental Implant surgery can be performed under local anaesthesia. It requires more time than other dental surgical procedures, so conscious sedation can be another option. Placing a dental implant is less painful and traumatic than extracting a tooth but patients expect it to be more traumatic. Educating the patient and counseling will help in reducing the anxiety of the patient during the dental implant placement procedure.
Let us discuss the procedure of dental implant like what all steps are done while putting the dental implant in the oral cavity. There are different steps which are:
Dental Implant Case Selection - Before doing the actual dental implant procedure, selection of the case is done. It is a very important step. The success of the dental implant depends not only on the proper procedure but also on the proper selection of the case. The dentist has to decide whether the particular patient is a good candidate for dental implant procedure or not. For this detailed history is taken. The patient who has uncontrolled diabetes, who are on immunosuppressive drugs, like for the treatment of cancer or who has untreated periodontal conditions are poor patients for dental implants. The patients who smoke tobacco, are likely to have 5 times more dental implant failure rate. So for the success of dental implant case selection is the important step. After the case selection the actual procedure for dental implant starts.
Surgical Access for Dental Implant - First of all, the part of the dental implant which has to be put in the bone and which acts as the root is placed. This part of the dental implant can be placed in the bone either immediately after the extraction of the tooth or it is placed afterwards. If it is placed afterwards then incision has to be given. The incision chosen should allow retraction of soft tissue for dental implant placement and should preserve attached tissue esthetics and quantity.
Dental Implant Placement - After giving the incision the dental implant is placed. For this the recipient site is prepared. It requires atraumatic preparation of the recipient site. The site is prepared with a series of gradually enlarged burs. A pin is placed in the preparation to check alignment and angulation for dental implant. After a desired depth and diameter is achieved, the dental implant is placed. The diameter of the hole in which the dental implant has to be placed should be equal to the diameter of the dental implant which has to be placed. If any bone defects are present then during the procedure of dental implant placement, demineralized bone grafting material is placed. After this suturing is done and patient is sent to home. It takes around 2 to 3 months for the dental implant to osseointegrated. Patient is recalled after regular intervals for the assessment of dental implant proceure done. During this time the dental implants fully adheres with the bone and the demineralized bone grafting material is replaced by the bone.
Post Operative Evaluation of Dental Implant - After the placement of the part of dental implant in the bone, radiograph is taken to evaluate the position of the dental implant. The dentist sees the placement and the angulation of the dental implant and call the patient at regular interval to assess the condition till the placed dental implant is properly osseointegrated.
Abutment Attachment to Dental Implant - When the dentist finds out that the dental implant is osseointegrated and it is ready for the dental crown then the dentist gives the abutment over the dental implant. Normally this procedure is done after 2 to 3 months of placement of dental implant. In this procedure, first the dental implant is surgically uncovered. For this, a incision is given to expose the dental implant under local anaesthesiat. After it is exposed the abutment is attached to the implant. Abutment is attached with the help of small screw. Now the dental implant looks like a reduced tooth.
Placement of the Dental Crown over Dental Implant - Finally dentist takes the impression of this for the dental crown. It is the standard impression. It is the same type the way dentist takes when he has to give the dental crown on the natural tooth. It is sent to the lab. When the crown is ready it is cemented on the tooth with dental implant procedure. It is not always that crowns are put on the dental implants. Some times full or partial dentures are made on the dental implants depending upon the case.