There are several approaches that may be used in implant placement, depending on the patient’s particular needs. Generally, implant treatment consists of several phases:
- Diagnostics including a clinical exam and CBCT imaging
- Placement of the implant itself (unless bone augmentation is required first)
- Insertion of a post or other fixture that emerges through the gum once the implant has healed (abutment)
- Seating the final crown or prosthesis on the abutment
Below is an example of a typical implant treatment sequence for a common restoration, the single tooth replacement.
Phase One (Diagnosis and Implant Treatment Planning)
- Mounted study models (molds) and any necessary diagnostic wax up. This is usually done by the restoring dentist or prosthodontist
- Clinical exam and CBCT imaging- done by Periodontal Medicine and Surgical Specialists LTD
- Careful planning and coordination between the surgeon (us) and the restorative dentist
- Pre-surgical consultation with patient to review plan and discuss collaborative action plan
Phase Two (Surgeon)
Placement of implant (implant surgery…assuming bone augmentation is not required first)
Appointment 2 (10-14 days)
Appointment 3 (4 weeks)
Site examined to assure proper healing
Appointment 4 (2-4-6-9-12 months)
Implant exposed, if submerged at the insertion appointment. The length of healing prior to implant exposure (i.e. uncovery) and prosthetic phase completion (acquisition of teeth) will depend on several factors. This decision is patient specific and will be discussed during the planning phase between us, your surgeon, and your restorative dentist/prosthodontist. Because every patient’s condition, regional anatomy and clinical situation is different, we will discuss your anticipated timeline during the planning phase of your care.
Phase Three (Restorative Dentist)
The restorative dentist can use the study models, with the abutment attached to the simulated implant, to analyze the case before the patient is seen. The abutment may be contoured to the desired shape on the models, so only minimal refinements are needed when the actual implant is seated in the mouth.
Appointment 1 (4-8-12 weeks after exposure)
Study models taken that record exact location of implant for precise implant planning.
When the study models are poured they produce an exact replica of the patient’s jaws, with the implant simulation in place. Using the models, the dentist orders the exact size of permanent abutment that will be attached to the implant and used to hold the restoration (such as a crown).
Final/permanent abutment seated in the implant, and shape refined
Temporary crown placed on abutment (Final impressions for the crown may be taken at this appointment)
Appointment 3 (if needed)
Final impression for crown taken and sent to lab
Final crown seated and occlusion (bite) refined
There can be a number of variations in treatment. Under ideal circumstances it may be possible to place the implant without requiring a second surgical procedure. In these cases a healing cap/healing abutment may be placed at the surgical appointment, negating the need for the secondary implant exposure surgery (Appointment 5). Conversely, the diagnostic process may reveal that inadequate bone is present and implant placement may be delayed while more bone is generated.