Deciding whether to get dental implant surgery is a big decision. It is an investment not only in your smile but in your self-confidence and comfort. Before making a decision on the procedure or on your dentist, you should be informed. We put together this guide to help you understand every step of the process!
Table of Contents:
- What Are Dental Implants?
- Advantages of Implants
- Implant Procedure Overview
- Guided Dental Implant Surgeries
- Questions to Ask Your Dental Implant Dentist
Dental implants are man-made substitutions for the root structure of the teeth. The root structure is secured into the bone, allowing the tooth or teeth to look and feel more natural. The jaw bone will naturally grow around the implant allowing it to be even more secure within the mouth. With a dental implant, you have the freedom to eat any foods you please because the structure is fixed, unlike a traditional denture.
There are three parts involved in a complete dental implant procedure:
- Crown or prosthesis
Implant: The implant is the underlying manmade root structure. This is traditionally made out of titanium for strength and longevity of the implant. There are a wide variety of different dental implants, and not all are created equal. At Stanley Dentistry we use BioHorizons dental implants because they have the best-proven strength and success.
Abutment: The abutment is a piece that screws into the implant and provides a surface above the gum line to support the tooth (crown).
Crown/Prosthesis: The prosthesis or crown refers to the tooth-like structure that the implant supports. The prosthesis can be a single tooth or a full bridge.
Whether you are missing one tooth or multiple, there are many advantages to choosing dental implants over dentures or partials.
1. Maintains Jawbone Structure
After teeth have been lost or removed, the underlying bone in the jaw can deteriorate over time. Natural teeth embedded in the jawbone stimulate the bone though chewing and biting. Without the tooth root structure, the jawbone can lose its strength, break down, or resorb since the body no longer “needs” it.
Because dental implants are secured in the jawbone they stimulate the bone in the same way a traditional tooth would. Dental implants are the only solution for lost teeth that helps preserve the jawbone. Overtime, without the natural teeth, your smile may begin to have a sunken in look.
2. Restore Your Natural Smile
With dental implants, you essentially get your natural smile back. You can eat, drink, smile, and laugh just as you normally would. You won’t have to worry about taking something out to eat or your teeth not being secure. Dental Implants will allow you to maintain your natural face shape and protect your healthy teeth. Often, a tooth-supported partial puts a strain on healthy teeth and can grind away at the surrounding teeth. The healthy teeth are used to secure and support the partial and can be damaged over time.
3. Avoid Problems with Traditional Dentures
Many denture wearers experience problems with excessive salivation, gagging, loss of taste sensation, or poor fit. Traditional dentures cover the roof of the mouth to maintain a more secure hold in the mouth, but that also means some loss of taste. Most of your taste buds are located on your tongue, but a few are located on the roof of your mouth. Excessive salivation can be a problem, especially in new denture wearers. The brain senses that there is something foreign in your mouth and can register this as food. A message is then sent to the salivary glands to produce more saliva to break down and digest the food. Excessive gagging can be a side effect of the excessive salivation or a natural reaction to the new appliance in your mouth. Dental implants look and feel like natural teeth, allowing you to avoid any discomfort caused by traditional dentures.
The first step in any dental implant procedure is the initial consultation. The dental office should provide a free consultation to discuss your options and give you more information on costs and their process. Be aware that your best option for your procedure may not be the cheapest option. If the dentist does not perform fully-guided surgeries the chances of your implant failing or hitting a nerve or sinus is much higher. This means that you may need to have your implant fully replaced in just a few years.
Next, your dentist should take a 3D scan of your mouth and skull. With the 3D scan, they can plot out your dental implant procedure, noting the placement of blood vessels, nerves, and sinuses. Then, depending on the office you visit, your dentist should create a full guide of the implant surgery to ensure precise placement the day of the surgery.
With the advancements in technology and surgical methods, most dental implant surgeries can be completed in one day. Some exceptions may occur depending on your underlying bone structure. Your dentist will be able to tell you if your procedure can be completed after evaluating your case.
Day of Surgery
Depending on the number of implants being placed your surgery could last a few hours or just under an hour. The first step in any dental implant procedure is sedation. Be sure to ask your dentist about their sedation options and if they have the means to use IV sedation at their office.
First, if present, the damaged tooth or teeth will be removed from the mouth. After any necessary teeth have been extracted, your dentist will access the jawbone. Using the guide, the jawbone will be prepped for optimal implant placement.
Once the jawbone is prepped, the first pilot hole is drilled. The pilot drill is the initial drill used in placing the implant. The pilot hole serves as a guide for subsequent drills used later in the implant procedure. Your dentist should use a guide that has been created specifically for your procedure to obtain the precise position and orientation of your implant.
Next, the Osteotomy drill is used to widen the pilot hole to prep for the implant placement.
Finally, the implant is placed into the hole created by the pilot and osteotomy drills. Your dentist should use a guide to ensure optimal placement and positioning of your implant.
From there your dentist will place a cap on the implant. This will be used while your dentist prepares the prosthesis or should you require healing time before the final prosthesis is placed. Even if your final prosthesis is not placed the day of surgery, you will be given a temporary to give you a natural smile until the crown can be placed.
A fully-guided dental implant surgery starts with a 3D x-ray of your mouth and skull. This allows us to plan the optimal placement of the tooth - taking the blood vessels, sinuses, and bone structure into consideration to reduce pain and improve success and longevity.
After the surgery is planned virtually, an exact model of your mouth is made and guides are created to direct the placement of each element of the implant (3 guided layers). The guides are used during the surgery to ensure we achieve the correct angle, size, and depth of the implant. This keeps your dental implant surgeon from hitting a blood vessel or sinus which often means pain and discomfort for you after surgery. Many dentists will offer partially-guided surgeries where they may plan the placement within your mouth, but do not have a guide to planning the depth of the implant placement. That becomes a problem when a millimeter difference means the implant invades the sinuses.
Placing an implant without a guide is much like hanging a painting without a measuring tape or level. You may place it close to the center of the wall but it will often be just slightly off. When it comes to dental implants, even a slight inaccuracy can seriously impact the success of the implant.
With a fully-guided surgery, you know your dental implant is placed in the optimal location to achieve a better success rate. Your surgery can also be smoother and quicker. Because we virtually practice your entire surgery and plan out every aspect, what at another office can be a 12-hour procedure, can be done in 3 hours at Stanley Dentistry.
Will a fully-guided surgery cost me more?
The guide for the fully-guided surgery costs $250 from the manufacturer – here at Stanley Dentistry, we don't up-charge our patients for the guide. The guide costs us $250 and that is what we bill your insurance. We want to make fully-guided surgeries the easy choice for our patients. The guides help us know that we performed the best surgery possible and help you have a long-lasting dental implant. We've reconstructed many dental implants over the years that could have lasted much longer if the original implant was placed using a full guide. Our top priority is giving you an implant that will last, not just for 3 years, but for the rest of your life.
While lots of dentists in the Triangle area offer dental implants, you won't get the same quality and success rates everywhere. There are a few key questions you need to ask that could be the difference in your dental implant lasting 5 years or the rest of your life.
Do you handle the entire dental implant process?
Your general dentist may not be able to handle the entire process in-house. In some cases, you will have an oral surgeon, general dentist, periodontist, and an anesthesiologist who work collaboratively on your dental implant surgery. While each of these doctors is specialized in their field, it also involves many more moving parts and coordination when it comes to your surgery. Doctors are not project managers by trade so this presents more opportunities for the ball to get dropped. Also, for you it could mean more confusion on who to follow up with should you have any complications with your surgery.
At Stanley Dentistry, we handle the dental implant surgery, any gum or bone grafting, and crown placement under one roof. This allows us to fully manage the process, making scheduling and coordination easier on you. We also employ a licensed nurse anesthetist to monitor you throughout the surgery and make sure you are in good hands.
Are your dental implant surgeries fully-guided?
Surprisingly, not all dental implant placements are performed the same way. Some dentists will perform the surgery without a guide while others will do a partially-guided surgery and only a few do fully-guided surgeries. A fully-guided dental implant surgery ensures the optimal placement of the dental implant for the best success, but only 3% of dentists do fully guided surgeries.
There are three types of guides:
- Pilot hole
- Pilot hole + Osteotomy
- Pilot hole + Osteotomy + Implant placement
A dentist will say that they do guided dental implant surgery even if they only use one of the three types of guides. This is why it is important to ask if they do fully-guided surgeries.
What type of prosthetics do you use?
With an All-on-4 or Teeth Xpress procedure, some doctors will convert your existing denture into a fixed prosthesis. We don’t recommend this method because most dentures are made of acrylic. Acrylic is naturally a more porous material and usually needs to be replaced after 5 to 7 years since you can no longer remove the denture to clean it. Acrylic prosthesis often absorbs the smells of foods and beverages and can start to smell after a while.
It is best if your dentist creates a custom crown or prosthesis that has the exact size holes to affix to your dental implant abutments. This will allow for the most secure fit and improve the longevity of your dental implant. The new prosthesis should be made out more durable, less porous material that can last a lifetime with proper care.