Dental Implants

What Is It?

Dental implants are titanium posts that are surgically placed into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts, called abutments are then attached to the implants. The abutments allow a dentist to attach teeth to the implants.

The concept of titanium implants integrating to bone was discovered by a Swedish scientist and orthopedic surgeon, Dr. Per-Ingvar Branemark. This discovery was made over 35 years ago. Implants have now been in clinical use for many years, restoring millions of individuals to healthy function and esthetics.

To provide you with a better understanding of dental implants, we have provided the following multimedia presentation. Many common questions pertaining to dental implants are discussed.

Implants have the following benefits:

  1. Increased strength and retention of artificial, or prosthetic teeth
  2. Maintenance and preservation of jawbone structure
  3. Helps supports facial soft tissues and contour
  4. Prevents shifting of teeth adjacent to and opposing missing teeth
  5. Improves stability and retention of dentures
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What to Expect

Implant surgery involves a small incision in the gum. This allows the surgeon to access the underlying bone structure.

A bone preparation, called an osteotomy, is prepared. In many cases, if bone augmentation is necessary, it can be performed at the same time, utilizing either . A cover screw is placed on the implant.

In some cases, particularly if bone augmentation is required, the implant is maintained below the gumline for 4 to 6 months to provide it with additional protection; in this instance, a minor procedure is performed to expose the implant, with attachment of a longer cover screw, in preparation for tooth restoration. In other cases, a second exposure procedure is not necessary.

Routine implant surgery can often be performed under local anesthesia, with adjunctive conscious sedation techniques, such as nitrous oxide (“laughing gas”) or oral sedation used in combination. Intravenous deep sedation and general anesthesia are always available for patients who prefer to be asleep during their procedures.

Recovery from implant surgery is generally minor. There is usually a small amount of swelling in the gums and/or cheek areas, that begins to resolve approximately 3 days following surgery. Self-dissolving sutures are used. Temporary dentures, orthodontic retainers, or Essix retainers can usually be adjusted and worn throughout the healing process.

It is essential to maintain a soft, non-chewing diet for 2 weeks following implant surgery. The implants are left to integrate, or bond, to the jawbone for a period of 4 months prior to tooth restoration. Most patients experience minimal disruption in their daily life following implant surgery.

Frequently Asked Questions

Long-term survival of dental implants depends on several factors, but one of the most important ones is ensuring that implants have a good volume of supporting bone and gum tissue to maintain health. In some cases, a tooth can be extracted and “immediate implant placement” can be offered with a high degree of predictable success, while in other cases a staged approach that may require bone grafting is preferred. Dr. Freilich will analyze your case in great detail, discuss your treatment options with you, and provide you with an explanation of the advantages and disadvantages of the various surgical possibilities that we can offer you.

The surgical placement and restoration of dental implants demands extensive training and knowledge to provide you with your best possible outcome. Dental Implant placement is a team effort between an oral and maxillofacial surgeon and a restorative dentist. While Dr. Freilich performs the actual implant surgery, initial tooth extractions, and bone grafting if necessary, your dentist fits and makes the permanent prosthesis (tooth replacement). Your dentist will also make any temporary prosthesis needed during the implant process.

The type of prosthesis that is best for your case depends on several factors:

  1. The number of missing teeth that need to be replaced
  2. The strength of your bite
  3. The length of time you have been missing teeth
  4. Whether you are a candidate for bone graft surgery, if required
  5. Esthetic requirements of your treatment

If you are missing a single tooth, a dental crown is attached to your implant. If you are missing several teeth, multiple implants can be used to either support individual tooth crowns, or to support fixed bridges. Patients who are missing all of their teeth in one or both of their jaws have the option of having implants placed to retain or support removable dentures, fixed bridgework, or a hybrid prosthesis that is not removable by the patient, but can be removed by the dentist as necessary.

Our office provides digital impressions (intraoral scans) with the Trios scanning system. In some cases this eliminates the need for your dentist to take a conventional impression of your mouth in order to make the crown for your implant! Some types of implant treatments do, however, still require conventional impressions, depending upon how many implants are being restored.

At your implant consultation, Dr. Freilich will thoroughly review your medical history with you, and perform a detailed clinical and x-ray examination of your mouth, structure of your jawbone and the condition of your natural teeth. Depending on the length of time your teeth have been missing, and the cause of your tooth loss, you will be informed as to whether bone replacement (“bone grafting”) will optimize your chance for long-term success of your treatment, and what the various options are for replacing missing bone. We treat many young patients who are missing teeth due to congenital absence (cleft lip and palate, oligodontia, ectodermal dysplasia), trauma, or pathologic lesions such as cysts and tumors. In growing children, implant surgery must always be delayed until the growth of the child is complete. Some medical conditions and medications may increase your risk of implant surgery not being successful. If this is the case, your surgeon will discuss this with you, as well as any alternative treatment options that are available. It is our responsibility to ensure that our recommendations are in your best interest.
Dental implants require the same care as natural teeth. Your regular dentist will discuss techniques for cleaning your prosthetic teeth at home once your treatment has been completed. Your implants will require professional cleaning by a qualified dentist and/or hygienist 1-2 times per year. The bite on the implant should be re-evaluated annually, as adjustments may be required to modify heavy bite forces. Implants should be evaluated radiographically (x-rays) periodically to ensure that they are maintaining their bone support.

Patient Instructions

Following oral surgery for placement of dental implants, do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There can be a metal healing abutment protruding through the gingival (gum) tissue. For more instructions including managing pain, please see our full dental implant patient instructions here.
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