Dental Implants: Restoration of a Missing Tooth
October 11, 2017
A Missing Tooth
In dentistry, we use the term prognosis to describe how long a tooth will continue to function properly. That term also encompasses any treatment done on a tooth as a predictor of how long the treatment itself will last and keep the tooth in proper function. Giving a prognosis of a tooth or treatment is a little like predicting the future. We are not giving an exact timeline; we are making an educated guess. We want your teeth and the work we perform on them to last as long as you do!
When a tooth has a hopeless prognosis, the only treatment option is removal of the tooth by extraction. When a tooth or the proposed treatment to save a tooth has a poor long-term prognosis, we will always give you the option to remove the tooth. Once the tooth is removed, you will have several options for replacing it. We believe that your time, effort and money are best invested in something that will last. The treatment option with the highest success rate for replacing a missing tooth is a dental implant.
Anatomy of a Dental Implant
One of the reasons a dental implant has such a high success rate is that its anatomy mimics a natural tooth more closely than any other treatment option available in dentistry. This configuration allows a dental implant to stand alone; it does not anchor or rest on any other teeth the way a bridge or a removable partial does.
A dental implant consists of three parts:
1 Implant body – The implant body is the root replacement. It is made from titanium, like implants and prostheses used in other parts of the body. This titanium root form comes in many different sizes, and using our 3D image of your jawbones, we will select the proper size for your specific missing tooth. In some cases, the implant can be placed at the time of extraction, called an immediate implant. In other situations, it is necessary to allow the jawbone to heal for several months between the extraction and the placement of the dental implant. Once the implant has been placed into the jawbone, it must heal for several months, allowing the bone to grow into the threads of the implant form, which is a process called osseointegration. After a minimum of 3 months of healing, we assess the level of osseointegration of the implant to ensure that the implant is stable and ready to withstand chewing forces.
2 Abutment – The abutment is the connector between the implant root and the dental crown. An abutment can be made from several different materials, as needed for appearance. The abutment is affixed to the implant root with a small screw, and it protrudes from the gums, providing the core structure for a crown.
3 Abutment-supported crown – An abutment-supported crown is very similar to a traditional dental crown. It covers the entire abutment form to the gumline and restores the natural anatomy of the tooth, enabling you to return to normal function in this area.
What Is the Process for Replacing a Missing Tooth with a Dental Implant?
At this visit, images are taken of the proposed implant site, including photographs, dental x-rays, an intraoral scan and a 3D CBCT image. Dr. Chowning determine which size dental implant will best restore your missing tooth and discuss the details of the upcoming surgical visit.
Visit 2: Surgical Placement of the Implant
During the surgical visit, you have the option to be sedated, and if you desire this, please discuss it with Dr. Chowning BEFORE this visit. You can also elect to have the procedure done with local anesthetic only, meaning you are awake throughout. Implant placement is a relatively quick procedure and usually causes less discomfort than a tooth extraction so many people choose to remain awake for this visit. You should feel only vibration as the site in the bone is being prepared and the implant placed. You will be given very strict post-operative instructions regarding your stitches, care of the surgical site, and oral hygiene to follow.
Visit 3: Post-operative evaluation
Between one and two weeks later, you will return for the post-operative evaluation of the surgical site. This is typically a very quick visit, and most, if not all, post-operative pain or discomfort has subsided by this time.
Visit 4: Uncovering and Testing Implant
At four months post-op, the implant will be exposed to the mouth (if it is not already) by removing the gum tissue over it with a dental laser. If the implant shows the correct amount of stability, we can proceed with visit 5.
Visit 5: Scanning for Abutment and Crown
This visit may be done in combination with visit 4 if the implant has osseointegrated. Using our 3D CEREC scanner, we take an image of the implant site and the surround teeth. The abutment and crown are designed and fabricated using our CEREC software and milling system. A healing cap may be placed to maintain the position of the gum tissue while the abutment and crown are being made.
Visit 6: Final Placement of Abutment and Crown
When the abutment and crown are completed, the healing cap is removed from the implant, and the abutment and crown are placed. The abutment is attached to the implant via a small screw, which is torqued to the appropriate tightness. Dental x-rays confirm the fit of the crown. Once the crown meets our standards and feels perfect to you, it will be cemented and cleaned.
Do You Have a Missing Tooth that You Would Like Restored with a Dental Implant?
Call our office at 940-382-1750 to set up a consultation with Dr. Chowning. He will discuss your treatment options in detail and help you choose what is right for you.