June 30th, 2017 - Daniel Radu, DMD
I intend for this to be something more than a simple blog entry – look at it as more of a ‘Wikipedia’ entry, a go-to page for anyone looking for information on dental implants. Some of it may be more detail than you are looking for, but some of you may prefer that detail.
I’ll cover implants, who places them, the procedure itself, bone grafts, and more.
If you’re reading this, you may just be curious, or are looking to learn some things on the subject, so as to be more knowledgeable when making decisions with your dentist. Either way, you’ve come to the right spot!
Dental implants are often a misunderstood and confusing topic for many people. There are several components to an implant, several procedures that may or may not be associated with getting one, and oftentimes people are surprised at the timeframe related to process.
Let’s clear some things up.
What is a Dental Implant?
Quite simply, a dental implant is a replacement for a tooth in the mouth. But to be more precise, and to clear up an often confusing part of my discussion with patients, the dental implant does not actually give you a ‘tooth’ in the sense that you may think.
The actual ‘implant’ is only the portion within the bone, underneath the gum. A crown is what you will actually be chewing with, and seeing outside the gum. Another component, called the abutment, is a middle portion, connecting the implant to the crown. The implant crown is generally placed at a later date, once the implant within the bone has healed and integrated fully. More on that further down.
Who Places Dental Implants?
Obviously, a dentist. But a discussion that sometimes arises with patients (and also within the dentist community), is whether a specialist should place them, or a general dentist.
General dentists can certainly be more than well-equipped to place implants. This is especially the case nowadays, with the development of certain technologies. It is the planning of the implant that is the most important aspect of the procedure, and new technologies have made planning straightforward. The next section discusses this aspect.
Furthermore, it is the general dentist who will be placing the future crown on the implant. This means that the general dentist is well-aware of how an implant’s angulation will affect the future crown. The placement of the implant leads directly to how a crown can be put on the implant. Without the input of the general dentist, the surgeon may not have a good guide in where the implant is best-suited.
Technologies
A cone-beam computerized tomography (CBCT) x-ray is essential for implant placement. This x-ray provides the dentist a 3-D view of the bone in the area for the implant. It is possible to visualize, in incredible detail, exactly how much bone exists both horizontally and vertically, which is the most important aspect in regards to placing implants.
With this x-ray, it is possible to digitally plan exactly where the implant will be placed. To further this, if the dentist has a 3-D scan of your teeth and gums, they are able to combine the two computer files, and then create a surgical guide that rests on your teeth, for use during the surgery. This guide is printed in 3D, and allows for a simple, fast, and accurate placement of the implant during surgery.
Two implants, planned digitally. The red line indicates the nerve of the jaw, something that must absolutely be avoided.
A surgical guide, used to guide the drill during surgery. This allows the dentist to follow the planned placement of the implant as close as possible. This digital rendering is printed from a 3D Printer in our office.
Surgical guides are indispensable for a seamless implant placement. They reduce the possibility of angulating an implant outside the area of bone or hitting a nerve, and can reduce the trauma of the surgery. Also, they reduce the time of the procedure in the chair.
Don’t get me wrong, implants were placed for decades without the use of these fancy tools, and they were successful. But to minimize any risk, improve healing time, and plan for the future restoration (crown) to be in the correct position, a guide is an amazing tool.
Visualizing the nerve, bone, angle of placement, future crown placement, with 3-D scan of teeth aligned onto 3-D bone x-ray.
Our office 3D Printer for printing surgical guides.
Does Getting a Dental Implant Hurt?
In short – no. But to expand on that, there really is no reason to hurt during any dental treatment these days. If you hurt, tell the dentist, and he or she should numb you more! Implants have become a much more common procedure these days, and can be placed in a very atraumatic, straightforward way.
In the days following the appointment, you may experience some discomfort in the area, as you would with any type of surgery. In general, we recommend patients to simply take 800mg of ibuprofen a few times a day, for 2-3 days, and that covers any discomfort that may occur. Antibiotics and stronger pain medications may be prescribed, depending on the situation.
In general, our patients are almost always pleasantly surprised at how straightforward and simple the procedure is, as well as the healing time.
Summary
In our office, we look to stay ahead of the curve in terms of technology, and for that reason, we purchased a 3D scanner and 3D printer a year ago, all to better our patients’ experiences. We did not increase our fees for implants, because it is simply peace of mind for us to perform all the background work to ensure your implant procedure is done as perfectly as possible. In fact, the technology makes our job easier.
Next time: Bone grafts, sinus lifts, and why they may be necessary!