Placing dental implants requires a strong jaw bone. Patients who have lost a lot of jawbone may need a bone graft before undergoing the procedure for dental implants. Your dentist will determine whether or not a bone graft will be necessary.
You will receive instructions before the surgery on how to prepare for it. It is highly recommended that you stop smoking several months before the procedure as it can negatively affect the fusing of the implant to the bone (a process called osseointegration). This can result in implant failure.
You will receive a local anesthetic that numbs the implant site and the area around it. This means that you will remain awake, but you won’t be able to feel anything in the areas where the anesthetic was applied. You may still feel pressure and vibrations, which may be uncomfortable, but no pain. Some clinics also offer conscious sedation or partial sedation, which numbs the implant site, but also affects your conscious state; you will still be awake, but not fully aware of your surroundings.
Once the anesthetic has taken effect, your dentist will cut into the gum to access the jawbone and assess the implant site. The bone will need to be relatively flat and smooth to receive the implant, so it may be necessary to drill through it to reshape it.
Several different drills are used to create the pilot hole for the implant. Your dentist may also use additional tools such as a plastic jig or an alignment pin to help guide the pilot drill. As the hole is being created, the area may be flushed with water or saline to keep the bone cool and prevent overheating caused by the drilling. Once completed, the alignment of the hole will be checked. The hole will be finished using a drill bit that is the right size for the implant. The size and type of the implant will have been chosen before the procedure, based on the condition of the jawbone. Your dentist will want to choose the largest implant that the bone can sustain as those carry the load to the bone better than smaller implants do. Most implants are about 4 mm in diameter.
Finally, the implant will be placed. Skilled surgeons will be able to minimize any discomfort in putting the implant in. The site will then be closed using an implant cap and stitches, which are left in up to two weeks, at which point they will be removed. It will take three to six months for the implant to fuse with the jawbone (osseointegration) before the restoration (abutment and crown) is placed. A temporary crown may be placed in the meantime.
Once it’s determined that the implant is ready to support the restoration (either a crown, a bridge, or a denture), the implant cap will be removed and replaced with an abutment. The dental prosthetic is placed on top of this.
After the procedure, you will be advised to stay on a soft-food diet temporarily to allow the implant to more fully osseointegrate. Any discomfort experienced after surgery is usually described as a dull ache in the jaw after the anesthetic wears off and is gone within a week. Once the restoration is complete, you should be able to treat and use the implant like a normal tooth.