Dental Implants
Dental implants can be thought of as artificial roots onto which teeth or prosthetic connectors can be placed. Placement and restoration of dental implants is now a fairly routine procedure, but all phases of dental implantology require experience, skill and exacting techniques. Generally speaking, the implant surgery is done by a periodontist or oral surgeon and the restorations (placing the teeth or attachments on the implants) are done by your regular dentist, although some dentists do both phases.
This page will show the actual procedure used to place and restore an implant used to replace a congenitally missing tooth in a teen-age girl.
Implant restoration: Dr. Norman Ball
Photography: Dr. Howard Hunt
Crown fabricated by Weber Dental Laboratory
The patient's lower right lateral incisor never developed.
Small incisions are made to expose the bone into which
the implant will be placed.
The pilot drill is used to establish the location
of the implant. It must be parallel to the adjacent teeth, and angled
slightly to the inside of the lower jaw.
A parallel pin is used to confirm the placement of
the pilot hole.
A round bur is used to enlarge the opening of the
pilot hole.
An intermediate spade drill is used to enlarge the
pilot hole slightly.
Another parallel pin is used to confirm that the angle
and location of the implant is still correct.
The final spade drill is used to enlarge and shape
the site to exactly fit the implant.
An implant body try-in is used to again confirm
that the site has been prepared correctly.
The implant site is irrigated with sterile saline.
The implant is carried to the site.
The implant is placed flush with the surrounding bone.
There is a healing screw in place on the implant, which
will be buried under the gum tissue for between 3 and 9 months to allow
the bone to bond to the implant.
The gum tissue is sutured over the implant.
X-ray shows the implant in place.
The patient wears an artificial tooth attached to her
orthodontic retainer during the healing period.
In this case, three months later, the healing is complete.
Small incisions are again made to expose the implant,
which is now firmly bonded to the bone.
The healing screw is removed.
A temporary gingival cuff, which will protrude
through the gum tissue will be placed into the implant.
The gum tissue is sutured around the temporary gingival
cuff.
After 3-4 weeks of healing, the gingival cuff can be
simply unscrewed from the implant by the patient's regular dentist.
An impression post is screwed into the implant
using a small screwdriver. The post is used to locate the implant in the
impression that the restoring dentist will make.
An impression is taken of the impression post and the
surrounding teeth. The impression will be used to make a model that will
be used by the dental laboratory to make the replacement tooth.
The final restoration in place.