Oral Implants – What’s Involved

A visit by visit explanation………

1. First Consultation: 40 minutes

A careful medical history is taken by Dr Young. There are some medical conditions that may make implant treatment inappropriate so a very rigorous screening approach is employed. Certain medical conditions require Dr Young to liaise with your doctor or medical specialist in order to ensure implant success. Please note that we will always ask for your written permission to liaise with your doctor (or specialist) before writing.

A careful examination of your jaws and mouth including evaluation of gum health, your cosmetic aims and a detailed evaluation of the bone and gum in the areas where you need dental implants. We will usually take some low dose x rays at this stage.

At the end of the consultation, the implantation procedure will be discussed and the likely cosmetic result that can be achieved will be described.

Alternatives to implant treatment will be considered and discussed to make sure you make the right choice for your dental and medical health. We can usually give you a verbal estimate for treatment on the day unless the implant treatment is very complex.

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2. Cone Beam CT Scan

The next stage of treatment is undergoing a cone beam CT scan (CBCT). Three-dimensional imaging is now a critical part of modern diagnostic imaging for implant dentistry and provides a safer and more predictable result for surgery. This technique provides 3 dimensional accurate images but with a much lower dose than medical grade CT scans. It also has a lower cost than the medical grade CT scans. The scan takes place at CT Dent in Altrincham, and we will usually arrange and book your appointment online on your behalf.

4. Implantation Procedure

You will be covered in sterile drapes. All instrumentation used will be sterile and the implant team will wear sterile gowns, gloves and masks. This implant procedure is carried out comfortably under local anaesthetic for most patients as an outpatient procedure. It may take from 30 minutes to over 1 hour.

When the implant is placed in position, sometimes the gum is gently stitched over. On other occasions, the implant is left just visible. However, when your denture or bridge is in place, the implant would be hidden.

Fusion Period This is the time take for the adjacent bone to fuse or bond to the dental implant (osseo-integration). The healing time is usually 8 weeks but in a minority of cases it can take up to 4 months. We use a painless radio-wave technique to test that the implant has healed before fitting teeth on any implant. The device we use (Osstell mentor ™) gives a reading of implant ‘grip’ onto the bone (Implant Stability Quotient or ISQ). An ISQ value of 60% is usually what we like to get before we start to restore an implant.

6. Impression of the Implant

Implant Impression

This is just like having an impression for a normal crown.

8. Fabrication of the Crown by our Dental Technicians

Crown Fabrication 1This takes 2-3 weeks to make. Each crown is custom made for each patient and our technician will work hard to ensure a good cosmetic result.

 

3. Impression Visit (10 minute appointment)

Moulds are taken of your teeth so that a surgical guide or stent can be made.

A surgical guide ensures that the implant is placed in the best possible position to achieve good cosmetics and optimal implant longevity.

Stent

A plastic surgical guide (or stent) isGuide Stabilizes Drill made similar to a denture with metal tubes to ensure accurate implant placement (Left).

This shows how a surgical guide stabilizes the drill to ensure that the implant is placed in the ideal position (Right)

5. Uncovering the Implant (Implant Exposure)

Uncover ImplantWe conduct a minor operation to uncover the implant if the implant has been buried.

7. Visit the Dental Technician for Cosmetic Matching of Your Teeth

For some patients, the best results come from a visit to our dental technician who will be making your crown or bridge. For others (often when replacing back teeth with implants) this visit is not necessary.

9. Fitting of the Crown or Bridge: (30 minute appointment)

Peter will fit the crowns without cement first so that you can see the result. If the fit, shape and colour is natural, the work will be fitted.

If you are not sure we will fit the crown with light cement and you can wear the crowns for a few weeks to see how they look in different lighting.

Post Fitted

Crown Fitted after Post Fitted

Post fitted to implant (Left).

Crown fitted immediately after post fitted (Right).

Minor adjustments of crowns and bridges can be made at the chair side. If a substantial change is needed, the work would be returned to the dental technician for adjustment. Be reassured that we will not fit the work unless you are pleased with how it looks and feels.

We take great pride in knowing that none of the patients we have treated in the last 20 years have been dissatisfied with the cosmetic results achieved. We feel this reflects our dedication and efficiency in our implant work.

10. Post Fitting Review Appointment (20 minutes)

A low dose x-ray is taken 2 weeks after the crowns or bridges are fitted to ensure the crown and implant fit perfectly and to establish bone levels as a reference point.

2 Implants with Crown Fitted

2 implants with crowns fitted.

Excellent bone levels are seen here and this means the implants are very healthy.

Cleaning your Implants
Our hygienist will show you how to clean and look after your implant(s).

Extractions prior to implant treatment 

Some teeth may need to be removed before implant treatment can proceed. If the extractions are straightforward then your dentist can carry out them out. However, there are certain circumstances when the extractions are best carried out by Dr Young and they include: 

  • The presence of long term infection for many months / years
  • Root fractures: there may be little to get hold of with conventional extraction forceps
  • Fusion of the root to the bone (‘ankylosis’)
  • Extremely dense bone

In these circumstances, Dr Young will remove the roots using a very gentle technique developed especially for when implant treatment is planned. This removes the entire tooth and root BUT preserves the bone. This allows the implant procedure to be carried out as soon as possible.  A poor extraction technique (taking away too much bone) will hinder the implantation procedure and may mean a bone patch is need before implants can be inserted – with additional costs.