Dental Implants: Consultation, Procedure, Recovery and Aftercare

Article: http://www.yourdentistryguide.com/implants/

Authored By: Allison DiMatteo

Reviewed By: W. Peter Nordland, DMD

Dental implants are artificial tooth roots used to support a restoration for a missing tooth or teeth, helping to stop or prevent jaw bone loss. The dental implant procedure is categorized as a form of prosthetic (artificial replacement) dentistry, but also is considered a form of cosmetic dentistry.

People who have lost teeth might feel too self-conscious to smile or talk. Additionally, biting irregularities caused by tooth loss can have a negative effect on eating habits, leading to secondary health problems like malnutrition.

By replacing missing tooth roots, dental implants provide people with the strength and stability required to eat all the foods they love, without struggling to chew. Additionally, dental implants stimulate and maintain jaw bone, preventing bone loss and helping to maintain facial features.

Tooth Loss

Tooth Loss

Teeth are lost because of:

Congenital defects

Dental Implants: Consultation, Placement, and Recovery

To determine if implants are right for you, a consultation with your dentist, oral surgeon, and/or periodontist or prosthodontist is needed. During this appointment, your dental professional will thoroughly examine your teeth and gums and evaluate bone density and quantity. This may involve X-rays and computer tomography scans (CT scans) to ensure there is sufficient bone structure for placing the implant(s), and to determine exactly where the implant should be placed.

Based on the condition of your oral tissues, oral hygiene and personal habits, and commitment to follow aftercare instructions, your dentist will advise you of the most appropriate dental implant treatment plan. Some patients with insufficient bone or gum tissue require bone or soft tissue grafts and/or the use of small diameter implants (also called mini implants).

Depending on your situation, your dental professional will advise you of how long the entire treatment process will take, how many appointments will be necessary and what you can expect after each procedure. During the consultation, options for local anesthesia (to numb the affected and surrounding areas) and sedation dentistry, if necessary, also will be discussed.

The Dental Implant Placement Procedure

Today's dental implant restorations are virtually indistinguishable from other teeth. This appearance is aided in part by the structural and functional connection between the dental implant and the living bone. Implants are typically placed in a single sitting but require a period of osseointegration.

Osseointegration is the process by which the dental implant anchors to the jaw bone. Osseointegrated implants are the most commonly used and successful type of dental implant. An osseointegrated implant takes anywhere from three to six months to anchor and heal, at which point your dentist can complete the procedure by placing a crown restoration. If osseointegration does not occur, the implant will fail.

Dental implantation, which is performed to replace missing teeth, can be done any time after adolescence or when bone growth is complete. Certain medical conditions, such as active diabetes, cancer or periodontal disease, may require additional treatment before the implant procedure can be performed.

Detailed procedural steps are as follows:

Preparing the Jaw for Implantation: A dental implant restoration is commonly composed of a titanium material screw and a crown. A small-diameter hole (pilot hole) is drilled at edentulous (where there is no tooth) jaw sites in order to guide the titanium screw that holds a dental implant in place. To avoid damaging vital jaw and face structures like the inferior alveolar nerve in the mandible (lower jaw), a dentist must use great skill and expertise when boring the pilot hole and sizing the jaw bone. In many instances dentists use surgical guides created based on the CT scans when placing the dental implants.

Placement of the Implant: After the initial pilot hole has been drilled into the appropriate jaw site, it is slowly widened to allow placement of the implant screw. Once in place, surrounding gum tissue is secured over the implant and a protective cover screw is placed on top to allow the site to heal and osseointegration to occur. After up to six months of healing, your dentist will uncover the implant and attach an abutment (which holds the crown or tooth-like replacement) to the implant. In some cases, the abutment may be attached during the initial procedure. When the abutment is in place, your dentist then will create a temporary crown. The temporary crown serves as a template around which the gum grows and shapes itself in a natural way. The process is completed when the temporary crown is replaced with a permanent crown.

Dental Implants Recovery

Dental implant recovery depends on a number of factors, one of which includes the various procedures required to complete your treatment. However, it is generally recognized that once an implant has been placed, maintaining diligent oral hygiene habits is required to ensure proper fusing of the implant and bone structure. If cared for properly, an implant restoration can remain in place for more than 40 years.

After the initial surgical procedure, discomfort should be minimal. Swelling of your gums and face may occur, as well as minor bleeding and bruising of the implant site. Prescription pain medications may be prescribed by your dentist to relieve any pain or discomfort you feel after the procedure.

Healing from the surgical procedure to place the dental implant(s) takes up to six months, while the fitting and seating of the crown(s) can take up to two months. Again, this timeframe depends on individual cases and treatments. Follow-up appointments with your treatment coordinators are essential for monitoring your progress.

Implant Surgery Follow-up and Aftercare

For five to seven days after surgery, your diet should be restricted to soft foods. If stitches are present, they may need to be removed by your dentist; however, self-dissolving stitches that do not require removal are typically used.

If provisional restorations were placed along with the dental implant, it will be important to clean them as you would your natural teeth to ensure the best possible healing and fusing of the implant.

Failure to floss and brush is a leading cause of implant failure, and infection can occur if the implant and surrounding areas are not cleaned properly. Smoking also is attributed to high failure rates with dental implants and should be avoided following implant procedures.mini-tooth


Corrective Jaw Surgery

Corrective Jaw Surgery

Corrective jaw, or orthognathic, surgery is performed by Oral and Maxillofacial Surgeons to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth, which, in turn, can improve chewing, speaking and breathing. While the patient's appearance may be dramatically enhanced as a result of their surgery, orthognathic surgery is performed to correct functional problems.

Following are some of the conditions that may indicate the need for corrective jaw surgery:

  • difficulty chewing, or biting food
  • difficulty swallowing
  • chronic jaw or jaw joint (TMJ) pain headache
  • excessive wear of the teeth
  • open bite (space between the upper and lower teeth when the mouth is closed)
  • unbalanced facial appearance from the front, or side
  • facial injury or birth defects
  • receding chin
  • protruding jaw
  • inability to make the lips meet without straining
  • chronic mouth breathing and dry mouth
sleep apnea (breathing problems when sleeping, including snoring)

Who Needs Corrective Jaw Surgery?

People who may benefit from corrective jaw surgery include those with an improper bite resulting from misaligned teeth and/or jaws. In some cases, the upper and lower jaws may grow at different rates. Injuries and birth defects may also affect jaw alignment. While orthodontics can usually correct bite, or "occlusion," problems when only the teeth are misaligned, corrective jaw surgery may be necessary to correct misalignment of the jaws

Evaluating Your Need for Corrective Jaw Surgery

Your dentist, orthodontist and Oral and Maxillofacial Surgeon will work together to determine whether you are a candidate for corrective jaw, or orthognathic, surgery. The Oral and Maxillofacial Surgeon determines which corrective jaw surgical procedure is appropriate and performs the actual surgery. It is important to understand that your treatment, which will probably include orthodontics before and after surgery, may take several years to complete. Your Oral and Maxillofacial Surgeon and orthodontist understand that this is a long-term commitment for you and your family.They will try to realistically estimate the time required for your treatment.

Corrective jaw surgery may reposition all or part of the upper jaw, lower jaw and chin. When you are fully informed about your case and your treatment options, you and your dental team will determine the course of treatment that is best for you.

Correction of Common Dentofacial Deformities

dental-1dental-2dental-3dental-4

Correcting an Open Bite: Some of the bone in the upper tooth-bearing portion of the jaw is removed. The upper jaw is then secured in position with plates and screws.

Dental 1-bDental 2-bDental 3-bDental 4-b

Correcting a Protruding Lower Jaw: The bone in the rear portion of the jaw is separated from the front portion and modified so that the tooth-bearing portion of the lower jaw can be moved back for proper alignment.

 Dental 1-cDental 2-cDental 3-cDental 4-c

Correcting a Receding Lower Jaw or "Weak Chin": The bone in the lower portion of the jaw is separated from its base and modified. The tooth-bearing portion of the lower jaw and a portion of the chin are repositioned forward.

 

What Is Involved in Corrective Jaw Surgery?

Before your surgery, orthodontic braces move the teeth into a new position. Because your teeth are being moved into a position that will fit together after surgery, you may at first think your bite is getting worse rather than better. When your Oral and Maxillofacial Surgeon repositions your jaws during surgery, however, your teeth should fit together properly.

As your pre-surgical orthodontic treatment nears completion, additional or updated records, including x-rays, pictures and models of your teeth, may be taken to help guide your surgery.

Depending on the procedure, corrective jaw surgery may be performed under general anesthesia in a hospital, an ambulatory surgical center or in the oral and maxillofacial surgery office. Surgery may take from one to several hours to complete.

Your Oral and Maxillofacial Surgeon will reposition the jawbones in accordance with your specific needs. In some cases, bone may be added, taken away or reshaped. Surgical plates, screws, wires and rubber bands may be used to hold your jaws in their new positions. Incisions are usually made inside the mouth to reduce visible scarring; however, some cases do require small incisions outside of the mouth. When this is necessary, care is taken to minimize their appearance.

After surgery, your surgeon will provide instructions for a modified diet, which may include solids and liquids, as well as a schedule for transitioning to a normal diet. You may also be asked to refrain from using tobacco products and avoid strenuous physical activity.

Pain following corrective jaw surgery is easily controlled with medication and patients are generally able to return to work or school from one to three weeks after surgery, depending on how they are feeling. While the initial healing phase is about six weeks, complete healing of the jaws takes between nine and 12 months.

Enjoy the Benefits

Corrective jaw surgery moves your teeth and jaws into positions that are more balanced, functional and healthy. Although the goal of this surgery is to improve your bite and function, some patients also experience enhancements to their appearance and speech. The results of corrective jaw surgery can have a dramatic and positive effect on many aspects of your life. So make the most of the new you!

The information provided here is not intended as a substitute for professional medical advice, diagnosis, or treatment. It is provided to help you communicate effectively with your oral and maxillofacial surgeon. Always seek the advice of your oral and maxillofacial surgeon regarding an oral health concern.

The American Association of Oral and Maxillofacial Surgeons (AAOMS), the professional organization representing more than 9,000 oral and maxillofacial surgeons in the United States, supports its members' ability to practice their specialty through education, research and advocacy. AAOMS members comply with rigorous continuing education requirements and submit to periodic office examinations, ensuring the public that all office procedures and personnel meet stringent national standards.

© 2006-2012 American Association of Oral and Maxillofacial Surgeons (AAOMS). All rights reserved.


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