02 Sep 2020
6 min read
By Dr. Marco Benigni
Specialist Oral Surgeon
Dental implant procedures can vary greatly from one patient to another.
A simple implant procedure starts with the placing of the implant.
The healing of the bone around the implant can then take a few months of healing.
It’s like creating a fracture in the bone that has to heal so that needs time.
The new bone that is growing on the surface of the implant will need to calcify and get strong enough to support the load of the mastication – when we eat, there’s a heavy load on the implants and on the teeth in general.
So after the implant placement, we usually have to wait maybe three or four months until we can have a crown on the implant.
So that’s one of the most simple cases we have.
Depending on the problem, obviously the first thing to do is the extraction.
The tooth has to be extracted and that can be for many reasons. It can be a large cavity, it can be an infection or it can be a gum problem.
Then sometimes it's possible to place an implant in the same appointment as the extraction and in some cases – that are usually aesthetic cases – it's also possible to place a temporary fixed crown on the implant.
An example of a case that’s more difficult would be a patient who comes in after an accident and the central incisor is fractured and needs to be extracted.
In more complex cases such as this we need a CT scan.
So after the assessment and the planning, which is the most important part of the treatment, we may be able to do the extraction of the tooth, the implant placement and fix the temporary crown in the same appointment. (The temporary crown is like the definitive crown. It’s just the materials that are different.)
But if there's an infection or if the bone is not good enough and we see that before we start – obviously with the CT scan and the assessment – the implant cannot be placed.
That’s because, if there's an active infection and pus, we don't really want to place an implant. Where there is a large amount of bacteria, the implant would be contaminated.
So what we do is just the extraction, then wait usually two to three months, reassess and then place the implant.
Then, as in the first example, we wait for another three months and then place the crown on top of the implant.
Another example of a case would be where the extraction has been done and there is not enough bone in the area.
Let’s look at two possible scenarios.
i) There is not enough bone to perform the bone graft and the implant placement in the same appointment. So we perform just the bone graft, then wait a few months, then place the implant, wait another few months and then place the crown.
ii) It all depends on the anatomy but, if there is enough bone, we can perform the bone graft and the implant placement in the same appointment. Then a few months later, we can place the crown. That would usually save a good six months.
There are also some big cases where it’s possible to treat all the mouth or a single arch – extractions, implant placement and full, temporary bridges in just one day.
As we said at the beginning, implants cases vary hugely and can be completely different depending on the patient, which is why it’s so important to come and see a specialist.
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