What are the normal
stages involved in having an implant?
Stage 1 - Diagnosis, treatment plans and consent
During the first stage of care a full diagnosis is made and
a provisional treatment plan formulated. The patient is then
informed of their suitability for implant therapy, alternative
treatment options and advantages and possible complications
of each option. In my opinion only at this stage is it possible
for a patient to consent to implant treatment. Implant therapy
is an elective procedure and should be patient driven.
Stage 2 - Stabilisation of disease
During stage 2 the affected tooth or teeth is removed and
an appropriate provisional denture or bridge is placed. It is
at this stage when other general dental health requirements
if required are also stabilised.
Stage 3 - Planning
and implant placement
The implant is placed into the jaw using a minor surgical
technique. This is normally carried out under sedation using
a drug called Midazolam. This drug is a sedative not a general
anaesthetic and is considered a very safe drug when used within
a dental environment. It is usually administered by a second
practitioner and has the advantage of making the procedure as
comfortable as possible leaving the patient with few recollections
of the treatment. Some patient occasionally prefers not to have
sedation however in my experience especially with multiple implant
placement sedation is preferable.
Stage 4 - Abutment
connection
This procedure is a limited surgical procedure to locate
the top of the implant and allow connection of the abutment
to the implant. The abutment is the second implant section,
which attaches to the implant top with a screw and holds the
implant crown or bridge. This stage is carried out 4-6 months
after implant placement. It is at this stage when the implants
integration (bonding to bone) is confirmed.
Stage
5 - Provisional crown and bridge construction
Following confirmation of the success of the implants integration
the provisional or temporary crown and bridge can be constructed.
This stage is carried out 2-6 weeks after stage 4.
Stage 6 - Final construction
The final crown or bridge is made. This stage is carried
out after 4-12 weeks following the provisional stage.
Stage 7- Maintenance
This stage involves clinical monitoring and patient home care
advice to ensure that the implants are maintained to a high
standard.
Does it hurt?
It is very uncommon for patients to experience any discomfort
during implant placement. Most patients experience a small amount
of discomfort following placement which is easily controlled
with over the counter drugs.
Will my face swell after treatment?
Most patients experience mild swelling over the implant area
for one to three days. If a graft is placed or multiple implants
are placed the swelling may be more pronounced however it will
reduce after three days.
When can I return to work?
In most cases patients can return to work the following
day. In the case where grafts have been placed or where heavy
physical work is carried out 3 days should be allowed.
How long will implants last?
In my experience this will depend upon the quality and quantity
of bone available at the time of implant placement, the bodies’
response to treatment and the level of maintenance carried out
by the patient. Once integrated an implant should last 15 years
and hopefully if bone levels remain constant a lifetime.
Will my implants require maintenance?
Yes from both the patient and our team. Dental implants
can require maintenance and repair of their above gum components
similar to crown and bridgework.
Can I have my implants straight away?
There are two distinct concepts when considering this question:
- Immediate placement
The tooth is removed and the implant immediately placed.
This forms the new artificial root.
- Immediate restoration
The implant is placed and the tooth is restored at the
same time. This provides a new tooth on top of the artificial
root.
It is possible to have a tooth extracted and an implant
immediately placed and restored. This option has a number
of advantages for the patient including speed of treatment
and avoiding the need for temporary dentures or bridges. The
major disadvantage especially with single teeth is the reduced
success rate and difficulty in controlling the gum level.
I rarely carry out immediate placement and restoration of
single teeth for the above reasons and prefer to use a delayed
approach, which provides me with greater success and control
of the final cosmetics.
I do however carry out immediate placement where it is clinically
indicated leaving the restorative phase for the normal time.
The exception to the rule is where patients have or are about
to loose all their lower teeth. Research shows that this is
of benefit for the patient and the integration compared to
a delayed approach.
This is possible due to the ability to link the lower implants
together and the limited visibility of the necks of the lower
teeth.
The options available to each patient will be discussed at
the time of their initial consultation.
How long will I be in surgery
when I have my implant?
Implant placement will take from 3/4 hour for a single
tooth to three hours for a very complicated large case. Sedation
therapy will reduce the patient’s perception of time to
10-20 minutes.
Can I have sedation during
implant placement?
I recommend sedation for all cases unless the patient
requests otherwise. Sedation is not a general anaesthetic and
is a safe, predictable method of ensuring a patients comfort
during placement.
Is age a restriction to
implant care?
In my opinion a patient is never too old to benefit
from implant care as long as their general health is good enough
to undergo the procedures involved in implant dentistry. A patient
can however be too young. I would not recommend that a female
patient undergo implant care before the age of 18 and a male
20. This is because if an implant is placed before growth is
complete there is a possibility that the jaw will grow leaving
the implant in a non-ideal position.
What medical conditions exclude
patients from implant care within our clinic?
- Chemotherapy within the past 6 months
- Radiotherapy to the oralfacial area – Hospital referral
required
- Alcoholism
- Mental illness - uncontrolled
- Serious illness within the past 3 months
- General health of a level where minor surgery is not conducive
to the patient’s well being.
- Uncontrolled diabetes
- Steroid therapy - Heavy doses
- Smoking - Onlay and Sinus lift grafts only
What medical conditions
may exclude patients from implant care within our clinic?
Assessment will be required by another health professional
following consultations
- Bleeding disorders
- Warfarin therapy
- Transplant therapy
- Bone disorders including severe osteoporosis
- Steroid therapy - moderate dose
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