Single-tooth implant procedures can be used in people who are missing one or more teeth. An implant is surgically placed in an opening that your dentist makes in the jawbone. After the implant integrates (attaches) to your bone, it acts as a new “root” for the crown that will replace your missing tooth.
A crown (cap), which is made to look like a natural tooth, is attached to the implant and fills the space left in the mouth by the missing tooth.
For this procedure to work, there must be enough bone in the jaw. The bone has to be strong enough to hold and support the implant. If there is not enough bone, it may need to be added with a procedure called bone augmentation or bone grafting. In addition, natural teeth and supporting tissues near where the implant will be placed must be in good health.
How Do Implants Work?
An implant-restored tooth consists of several parts.
- The implant, which is made of titanium, is placed in the upper or lower jawbone.
- The abutment can be made of titanium, gold or porcelain. It is attached to the implant with a screw. This part connects the implant to the crown. It is shaped like a natural tooth that has been cut down to receive a crown.
- The restoration (the part that looks like a tooth) is a crown. It usually is made of porcelain fused to a metal alloy (PFM). It also can be all metal or all porcelain. The crown is screwed or cemented onto the abutment. If the crown is screwed to the abutment, the screw hole will be covered with restorative material such as tooth-colored filling material (composite).
The Implant Process
The time frame for completing the implant and crown depends on many factors. When the traditional method of placing an implant is used, the shortest time frame for a complete implant is about five months in the lower jaw and six months in the upper jaw. This includes surgeries and placing the permanent crown. However, the process can last a year or more, particularly if bone needs to be built up first.
In another technique, implants and healing caps are placed at the same time. If the dentist is using mini implants, he or she will place them as well as the crown, bridge or denture at the same visit.
In the traditional method, two procedures are required, with three to six months between them. During the first procedure, a small incision is made in the gum where the implant will be placed. A hole is drilled in the bone, the implant is placed into the hole in the bone, and the incision is stitched closed.
At the end of the healing period, a second procedure takes place. It involves making a new incision to expose the implant. A collar, called a healing cap, is screwed onto the top of the implant. It helps the surrounding gum tissue to heal. After a few weeks, the healing cap is removed. The abutment is screwed into the implant and used to support the crown.
A one-stage procedure is now used sometimes for implants. In this procedure, your dentist can place the implants, abutments and a temporary crown or bridge all in one visit.
Initial Consultation
Before any work is done, you will visit either a specialist called a prosthodontist or a general dentist who has had advanced training in the placement and restoration of implants.
Your dentist will do a comprehensive examination. During the exam, he or she will review your medical and dental history, take X-rays, and create impressions of your teeth and gums so that models can be made. In some cases, the dentist also may order a computed tomography (CT) scan of your mouth. This scan will help your dentist determine how much jawbone is available to hold the implants in place. It also will show the location of structures such as nerves and sinuses (located above your upper teeth) so they can be avoided during surgery.
If the X-rays show that your jaw does not have enough bone to hold an implant, the dentist can discuss options for building up the bone. These may include bone grafting or bone distraction. Grafting involves taking bone from another source and adding it to your jaw. A graft could be your own bone, from your mouth, chin or hip.
Processed cadaver, cow or pig bone also can be used. Another option is a synthetic material such as hydroxyapatite or calcium phosphate. Bone distraction is a surgical procedure at the site where more bone is needed. It causes the body to grow more bone by slowly pulling apart the existing bone using pins and screws.
If you need one of these procedures, it will take about 4 to 12 months for the bone to be ready for the implant.
What Can You Expect From Your Implant?
Single-tooth implants will work and look like your natural teeth. However, for some patients, it will be difficult to make the implant look exactly like your natural teeth. In some cases, your implant will not be placed straight, but will be inserted on an angle in the bone because of the amount of bone that you have and the amount of bone that is needed to place the implant properly.
A crown can be made wider to close a space. Studies so far have shown that these implants can last as long as 25 years.
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