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Dental implants

Implants definitely are becoming a larger part of my practice. Several factors are driving the demand for implants. And some factors are important to consider.

  • Implant after previous extraction: In some cases, the patient had a tooth removed years ago and has been living with a space in his or her mouth. Now, the patient has decided that s/he wants that space filled.
  • An alternative to root canal: If I believe a tooth will survive for more than two or three years after restoration, I recommend an implant.
  • implants
    Dental implants
  • Multi-part process: The process of placing a dental implant usually entails the following steps:
    • Taking an impression of the tooth before extraction
    • Surgery to extract tooth and place the implant screw
    • Waiting a few months for the bone to integrate with the implant screw
    • Placement of the post and a temporary crown
    • Placement of a permanent crown.

    In some cases, a bone substitute implant is necessary before the implant screw is put in place. That way, there’s a stronger base for the new tooth. Whether bone implant is or isn’t necessary, I don’t recommend having an implant and post put in the same day.

  • Same-day implants are very risky—Some dentists advertise that they can do “same-day” implants (the implication is start-to-finish, including the crown). Unfortunately, while that sounds good, putting in the implant screw, the post and the crown all at once leads to a higher failure rate than does a conservative implant procedure.

    A solid foundation is essential—Bone must grow and integrate with the implant screw, in order for the implant to be stable. I prefer to place the screw and stitch gum over it. Reason: It takes 4 to 5 months for bone to integrate with the implant (sometimes longer for upper implants). Then, I put in the post and cement the temporary crown to the post.

    In the meantime, a permanent crown is created in the lab. After the screw is integrated into the bone, and the foundation for the post and crown is strong, I place the permanent crown.

    Sometimes, patients come in for implants, but they don’t have sufficient supporting bone. In that case, I can do another type of implant known as a “mini-implant” procedure. This may be particularly helpful to patients who have ill-fitting dentures.