Dental Implant Placement Procedure

Completion of drilling the hole for the implant and placing it. / Closing the surgical site. / Healing times. / Restoring the implant.

Completing the hole for the implant.

Step 8 - Drilling the hole for the implant.

Once the pilot hole has been completed, the dentist will continue the drilling process using a set of bits, each of which has a slightly larger diameter.

As each one is used in turn, the hole will gradually become larger, until it is the correct diameter for the implant that's been selected.

What size implant will be placed?

The length and diameter of the implant that's chosen will depend on the amount of bone that's available at the surgical site.

Larger has advantages.

In general, the dentist will want to select an implant that's as large as reasonably possible. That's because longer and larger diameter ones distribute their load to the surrounding bone more favorably than comparatively smaller ones.

Implant sizes.

• Most dental implants that are placed are on the order of 4mm in diameter (around 3/16ths of an inch).
• Some dentists consider a diameter of 3.25mm to be the smallest that can insure adequate strength.
• Tooth implants greater than 4mm are available but they're not widely used because sufficient bone width for them is not often available.

Confirming the dimensions and orientation of the hole.

Step 9 - Double checking the implant's hole.

Once the hole for the implant has been completed, an alignment pin is placed in it so the dentist can confirm that it meets the needed orientation and depth requirements.

Step 10 - The dentist will thread the hole.

The dentist will now need to use a thread-forming tool (a screw tap) to create threads in the bone that match those found on the implant.

Once that's been completed, the hole is ready to receive the implant.

Treatment variation - Self-tapping.

Some types of dental implants have a self-tapping feature.

As they're screwed into place, their cutting edge creates the grooves needed for the implant's threads. No separate threading step is required.

Step 11 - The dentist will place the implant.

Once the hole has been properly shaped, the dentist can go ahead and insert the dental implant into the jawbone.

They can do this either:

• Using their dental drill (via a special adapter that holds the implant).
• Manually using a hand wrench, some of which are actually small torque wrenches.

Placing the implant cap. Closing the flaps.

a) Placing the implant cap.

At this point, the dentist will screw a "healing" cap onto the exposed portion of the dental implant so its interior is sealed off from the oral environment.

b) Placing stitches.

They will then trim and shape the two flaps of gum tissue and reposition them back over the patient's jawbone and around the implant's healing cap. They will place a few sutures (stitches) to hold the gum tissue in place.

c) Healing times.

The stitches are usually left in place for about seven to ten days. After this time period the gum tissue will have healed sufficiently that they can be removed (a very painless procedure).

Usually, the implant is given a period of three to six months to osseointegrate (fuse) with the patient's jawbone before it's restored (Step 13). This will, however, vary on a case-by-case basis (see below).

d) Some implant protocols require two separate surgeries.

In some cases, a patient's implant procedure will require two separate surgical procedures.

The first surgery.

The initial surgery involves the placement of the dental implant itself as we have just described, with the exception that the gum tissue flaps are put back in place in a fashion where they completely cover over both the jawbone and the dental implant.

The second surgery.

A very minor procedure is then performed after the healing (osseointegration) of the dental implant has taken place. The purpose of this surgery is to trim back the gum tissue so the implant's healing cap is exposed (so it can later be removed and a final dental restoration placed).