Implants & Surgical

Dental Implants

Dental implant surgery is a procedure that replaces tooth roots with metal, screwlike posts and replaces damaged or missing teeth with artificial teeth that look and function much like real ones. Dental implant surgery can offer a welcome alternative to dentures or bridgework that doesn't fit well and can offer an option when a lack of natural teeth roots don't allow building denture or bridgework tooth replacements.

How dental implant surgery is performed depends on the type of implant and the condition of your jawbone. Dental implant surgery may involve several procedures. The major benefit of implants is solid

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support for your new teeth — a process that requires the bone to heal tightly around the implant. Because this bone healing requires time, the process can take many months.

 

Dental implants are surgically placed in your jawbone, where they serve as the roots of missing teeth. Because the titanium in the implants fuses with your jawbone, the implants won't slip, make noise or cause bone damage the way fixed bridgework or dentures might. And the materials can't decay like your own teeth that support regular bridgework can.

In general, dental implants may be right for you if you:​

  • Have one or more missing teeth

  • Have a jawbone that's reached full growth

  • Have adequate bone to secure the implants or are able to have a bone graft

  • Have healthy oral tissues

  • Don't have health conditions that will affect bone healing

  • Are unable or unwilling to wear dentures

  • Want to improve your speech

  • Are willing to commit several months to the process

  • Don't smoke tobacco

Bone Grafting

Patients who have experienced bone loss might require a bone graft to help support existing teeth or an upcoming restoration. Events such as aging, missing teeth, genetic or development defects, untreated periodontal disease, and trauma to the jaw can lead to bone loss. If you need a tooth extraction and are considering a dental implant, your dental professional might recommend bone grafting. In fact, it is estimated that half of implant placement procedures require bone grafts.

What Are the Steps of a Dental Bone Graft Procedure?

Before your dental bone graft procedure, you will meet with a periodontist or oral surgeon to discuss the treatment plan and determine the bone grafting material to be used. Your bone grafting procedure will depend on the purpose of treatment, but you can usually expect these steps:
 

  • Step 1: Anesthesia. Your dental professional will use a local anesthetic to numb the surgical site. You also might need IV sedation if they source the tissue from your own body or if you experience dental anxiety.

  • Step 2: Extraction and/or bone sourcing. If you are using an autograph, the dental professional will start by sourcing the bone from the chosen location. Similarly, if you need a tooth removed, the surgeon will perform the tooth extraction at this time. Combining tooth extraction with bone grafting encourages faster healing.

  • Step 3: Graft insertion. Next, the dental professional will thoroughly clean the area. If you do not have an extraction, the dental professional will make an incision in the gum tissue to expose the bone. Then, he or she will attach the bone graft material to the exposed bone.

  • Step 4: Stitching. Once the graft material is in place, the area is sutured closed. The dental professional may use pins, plates, wires, cables, or even a titanium screw to hold the tissue together. If you source the bone from your body, the surgeon will also stitch that area together.

  • Step 5: Recovery. In most cases, you can plan to return home the same day as your procedure, but you might need a driver if you received sedation or general anesthesia. You will need four to six months — and sometimes longer — to completely heal and be ready for your dental implant. Your dental professional will provide instructions to care for the area, and you should follow these closely to prevent failure or complications.
     

Other Types of Dental Procedures to Support Bone Growth

Bone grafting is just one type of bone augmentation procedure, and others may be needed to build bone in your mouth and support dental implants. These other procedures include:
 

  • Sinus lift or subantral graft. This procedure raises the sinus floor to increase the bone's height in your upper jaw above the premolar and molar teeth to support the placement of dental implants.

  • Ridge expansion. This surgical procedure divides the jawbone into an inner and outer section to insert bone graft material, create new bone, and widen the jaw to support dental implants.

  • Distraction osteogenesis. This procedure makes a shorter bone into a longer bone by cutting it into two pieces, slowly pulling the two pieces apart and encouraging new bone to form and fill the space.

  • Alveolar ridge preservation or socket preservation. This surgical procedure reduces bone loss after tooth extraction by placing a bone substitute in the socket and covering it with a barrier membrane directly after removal.
     

Like dental bone grafts, most other bone augmentation procedures only sound like a complex or invasive procedure. In reality, your dental professional can quickly perform most surgeries needed to support bone growth and development. In four to six months, you can have the healthy bone structure required to support dental implants and be one step closer to a dazzling smile.

Tooth Extraction

In many cases,  you can repair teeth that are broken or damaged by decay with a filling, crown, or other dental treatment. Sometimes, though, the damage is too severe to repair, you may need an extraction.

Here are some other reasons tooth extraction might be necessary:
 

  • Decay or infection has reached deep into the tooth

  • Trauma or injury

  • There isn’t enough room for all the teeth in your mouth

  • Baby teeth don't fall out in time for the permanent teeth to come in

  • Orthodontic treatment might require tooth extraction to create room for the teeth as they move into place

  • Wisdom teeth, also called third molars, are often extracted either before or after they come in
     

Before removing a tooth, we will thoroughly review your medical and dental history and take the appropriate X-rays. X-rays reveal the length, shape, and position of the tooth and surrounding bone. From this information, we can determine the best way to remove the tooth or whether to refer you to an oral surgeon.

Before removal during a simple extraction, we will numb the area around your tooth using local anesthetic. However, during a more complicated removal, called a surgical extraction, an oral surgeon might administer intravenous (IV) anesthesia, which can range from conscious sedation to general anesthesia, which will put you to sleep. If this is the case, arrange for someone to drive you home after the procedure and stay with you until the effects wear off.
 

There are two types of extractions you might have:

  1. A simple extraction is the removal of a tooth that is visible in your mouth. It’s common for a general dentist to perform simple extractions. During a simple extraction, your dentist will numb the tooth and gum tissue and loosen the tooth with an instrument called an elevator before removing it with dental forceps.
     

  2. A surgical extraction is a more complex procedure used for a tooth that may have broken off at the gum line or has not come into the mouth yet. Oral surgeons usually perform surgical extractions; however, general dentists can perform them as well. During a surgical extraction, the doctor will make a small incision (cut) into your gum and remove the underlying tooth.
     

The most important thing to keep up with after a tooth extraction, is keeping the area clean and preventing infection. Immediately following the procedure, your dentist might ask you to bite down gently on a piece of dry, sterile gauze, which you should keep in place for up to 30 to 45 minutes to limit bleeding, while clotting takes place.  We will provide you with detailed aftercare instructions, but for 24 hours following your extraction, you shouldn't smoke, rinse your mouth vigorously, or clean the teeth next to the extraction site.

You can expect a certain amount of pain and discomfort following an extraction. In some cases, we will recommend a pain killer or prescribe one for you. It might help to apply an ice pack to your cheek to reduce swelling. You should also limit strenuous activity, as well as avoid hot liquids and not drink through a straw. Under normal circumstances, discomfort should lessen within three days to two weeks.