Best Dental Implant Surgery Procedure; Indication, Contraindication and Complication

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A dental implant is one of the treatments to replace missing teeth. Their use in the treatment of complete and partial edentulism has become an integral treatment modality in dentistry. A dental implant is a structure made of alloplastic materials implanted into the oral tissues beneath the mucosa through the bone to provide a new natural like tooth in function and appearance.

Why Dental implant surgery procedure is needed?

Dental surgery is a procedure in which implants are placed within the jaw bone in place of missing teeth. Implant made of titanium metal has a special ability to fuse with bone which is called osseointegration.By this process the implant within bone is like a root of teeth and supports the crown portion. Also it will last long and will not be mobile as of natural teeth.

When it is done?

  1. Missing one or more teeth
  2. If unable to wear denture
  3. Absence of any bone disease
  4. Absence of any metabolic disease like diabetes mellitus.
  5. When a patient is not satisfied with the existing denture
  6. unstable and non retentive conventional complete dental prosthesis.
  7.  To preserve existing removable partial prostheses.

When you cannot opt for this treatment:

It is absolutely prevented in:

  1. Acute illness
  2. The magnitude of defect or anomaly
  3. Uncontrolled metabolic disease
  4. Bone or soft tissue pathology/infection

You might not able to be undergo this treatment in following conditions:

  1. Diabetes
  2. Osteoporosis
  3. Parafunctional habits
  4. HIV/ AID
  5. Bisphosphonate usage
  6. Chemotherapy
  7. Irradiation of head and neck
  8. Behavioral, neurogenic, psychosocial, psychiatric disorders

Preparation of Implant Surgery:

The prosthesis should be designed first, similar to the architect designing a building before making the foundation. Only after the prosthesis is created can the abutments, implant bodies, and available bone requirements be determined to support the specifically predetermined restoration.

The patient is medically evaluated for cardiovascular diseases (hypertension, congestive heart failure, subacute bacterial endocarditis, etc.), endocrine disorders (diabetes mellitus, thyroid disorders, etc.), pregnancy, blood disorders, and bone diseases, etc.

Comprehensive and accurate radiographic assessment provides all necessary surgical and prosthetic information required for the success of the venture. Various types of imaging modalities are used for dental implant imaging.

dental-implant-surgery-procedure

How it is done?

Dental implant placement is done in multiple phases. Since it requires some healing time so we have to do it in multiple appointsment. Altogether there are steps in dental implant placement.

Extract the Tooth

The tooth should be removed atraumatically, taking care to preserve as much of the buccal plate and surrounding bone as possible if any present.

Graft the Socket (if needed)

Sometime, size of jaw bone may not be adequate to support the implant and chewing forces. In this case the jaw bone or socket should be grafted with bone material so that it forms strong base for implant. Also there are various materials for grafting purpose which will be selected by doctor accordingly.

Allow the Grafted Extraction Site to Heal

 It takes approximately four months for the extraction site to heal and the graft to mature. During this time, the graft serves as an extracellular scaffold that allows the patient’s native bone cells to replace the grafting material with live bone, creating an ideal site for implant placement.

Place the Implant via Flapless Surgery

Flapless implant placement is an excellent option for many of these cases because it is minimally invasive, reduces disruption to the blood supply, and facilitates a smooth healing process. It is process of drilling the implant inside the bone. The deep seated metal post will serve as root of the natural tooth. Still there will be gap but there will be space for the removable denture that is being used.

Deliver Healing Abutment

After placing the implant post, the metal and the bone will fuse together called osseointegration. This may take some time, several months. After osseointergration is completed, a minro surgery is done to place healing abautment. The gum tissue is opened by surgery, placed abutments on the implant post and then the gum is closed. The abutment will be seen from outside just at the gum. There are some procedure where the abutments are completely covered.

After the abutment is placed, your gums must heal for about two weeks before the artificial tooth can be attached.

Take Final Impression

About after 3 months, the healing abutment is removed which reveals a healthy and esthetic soft tissue collar around the implant site which has been guided by healing abutment and impression is taken using impression material.

Deliver Screw-Retained Crown

There are two choices for crown.

  • Removable. This type is similar to a conventional removable denture and can be a partial or full denture. It is mounted on a metal frame which is attached to the implant abutment.  It can be removed for repair or daily cleaning.
  • Fixed. In this type, an artificial tooth is permanently screwed or cemented onto an individual implant abutment. These implants are very strong, and can resist chewing forces several teeth can be replaced by one implant if they are connected together.

Complications:

  1. Perforated buccal or lingual plates of bone
  2. Nerve injury can lead to altered nerve sensation in the form of anesthesia, paresthesia or hyperesthesia
  3. Exposure of implant  during the healing period
  4. Mobility of implant
  5. Swelling of gum and face
  6. Minor bleeding

So if there is any of the complications or other related to implant immediate consultation of doctor is necessary.

Suresh-Dahal
Dr Suresh Dahal
BPKIHS Dharan

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