Helaine Smith DMD

In my last post about dental implants, I discussed the difference in training between general dentists and periodontists as well as how to choose the right dentist to perform your implant surgery.

In this post I”ll discuss the dental implant procedure and what you can expect when you have an implant placed.

Typically, your dentist will suggest the implant procedure if you’re missing a tooth or teeth. Dentists can also use implants to support dentures (also called “mini dental implants” or “implant-supported dentures”).

The first step is to ensure that you are a candidate for the procedure. If, for example, you’ve been missing a tooth or teeth for years, the bone below the gum may have receded too much.

(Advanced procedures now include bone grafting. Most general dentists can perform basic bone grafting procedures but as with anything, you’ll want to ask how often your dentist performs this type of procedure, how often his/her skills are updated through continuing education, etc.

Next, your dentist (or periodontist) will do a CT scan of the head and face in order to determine proper placement of the implant.

CT scanning instruments are quite expensive, so most general dentists don’t have the ability to do scans in office. Instead, you’ll be referred out.

Here at my office we use XPresscan, a company located right in our neighhborhood.

From this scan, the dentist or periodontist can locate nerves and arteries, the shape of the jaw and gums, placement of teeth and any potential issues or challenges.

Placing the implant itself is fairly straight-forward. The periodontist places a hollow titanium post into the gum.

Nobel Biocare Dental Implants

After the post is placed into the jaw bone, the dentist places a healing cap into the top of the post, which is an open hole, while the gum tissue heals and the bone begins to adhere to the implant. This process can take 3 to 6 months.

Once the healing process is complete, the periodontist then removes the cover of the implant and puts in the abutment using a special torque wrench. This process actually requires skill as it takes some real torque to ensure the abutment is screwed into the pin and won’t come loose.

After watching Dr. Favaloro do this, I’ve realized that most general dentists don’t know how to apply torque properly. The first time I saw him place an abutment, I was shocked at the amount of force it takes to torque it down. This is where the periodontist’s training really comes into play!

Once your abutment is placed, your dentist then makes the new crown which covers the abutment.

The beauty of a dental implant is that it doesn’t shift over time (the way a crown and bridge will) as it’s placed directly into your bone. (The crown that covers the abutment will need to replaced in about 20 years, however.)

For implant-supported dentures, the periodontist places “mini” implants into the bone and the dentures are then “snapped” into them. Implant-supported dentures give you the support and confidence you’ve always wanted as they don’t move around like ordinary dentures.

The following Today Show clip shows a facial and jaw scan — as well as the denture that gets “snapped” in once the implants have been placed.

Do you have questions about dental implants? Feel free to leave them in the comments section and either I or Dr. Favaloro will answer them.