How long does it take to place a dental implant?
Your incisor is going the way of all earthly things. That's why your dentist has suggested an implant so that you can delight those around you with a pretty smile again. But how long will it take for you to get through the procedure? Find out for yourself!
The path to dentures: short and sweet
You should allow at least three to four months from the preliminary consultation to the screwing of the implant crown in the lower jaw and at least six to eight months in the upper jaw. If additional bone has to be built up, the whole procedure will take a few weeks longer. The length of time also depends on how much time your dentist allows to pass between the preliminary examination and the operation.
Structure of the dental implant
An implant is not an artificial tooth that is fitted into the jaw in one piece (1). In fact, a complete dental implant consists of several parts:
Implant: Actually, only the artificial tooth root made of titanium or zirconia is called an implant. However, people don't really care about the exact definition of implantology. In the meantime, it has become customary to call the entire artificial tooth an implant.
Implant abutment: The so-called abutment is placed on the artificial root. This is the intermediate piece to the actual denture. The surface is completely smooth so that the gums can form a tight seal. This forms a barrier for germs of all kinds.
Implant crown: Like an iceberg, you only see the tip of the entire implant. This superstructure replaces the actual tooth that you have lost. With titanium implants, the metal may show through the crown. This does not happen with zirconia. This is why dentists usually recommend this ceramic-like material for front teeth.
Dental implant procedure: This is the timetable
The long road to a tooth replacement with an implant begins with a preliminary examination. The dentist checks whether the jawbone can support an artificial tooth root. To do this, he usually takes an X-ray.
It is also important to rule out inflammation. For a single implant, it is sufficient for the dentist to check you once. If you need several artificial teeth, you may have to visit the practice several times.
After the preliminary examination, the doctor draws up a treatment and cost plan for the dental implant. If the bone is not strong enough, bone augmentation can be used to strengthen it.
The operation: not for the faint-hearted
Under local anesthesia, the dentist inserts the actual implant into the jawbone. You cannot see the operation. However, the cutting of the gums and the subsequent drilling and milling can be very uncomfortable for sensitive people.
If desired, the operation can also be performed under general anesthesia. However, this carries more risks than local anesthesia. Talk to your dentist about this! He can tell you whether general anesthesia is suitable for you.
With template for perfect position
To place the implant, the doctor first cuts open the gums. The jawbone is now exposed. It is now important to find the exact position of the artificial tooth root. The doctor usually finds this using a template, which he adapts precisely to your jawbone (2).
Now it's time to drill: In principle, this is done in the same way as inserting a dowel. However, the dentist starts with a small drill and gradually increases the drill size.
Sometimes the dentist also has to mill bone. With the so-called All-on-4 implants, the angle of the implants plays an important role. This can usually only be achieved by milling away bone.
Once the drill hole is ready, the dentist screws the implant into place. An internal screw is placed on the artificial tooth root to seal it tightly. He then sutures the gum over the tooth root. Without complications, the operation takes about 20 minutes per tooth.
Special case: Open wound healing
You don't want to walk around for months without a front tooth? In this case, your doctor can perform an open wound healing procedure. To do this, a so-called gum former is placed on the implant. The gum is sewn in around it. The doctor can now attach a temporary denture to the gum former.
No fisimatents allowed!
A lot depends on your behavior after the operation. Above all, you must not smoke or drink coffee or alcohol (3). In general, you should take care of yourself and your mouth. It is better to avoid exertion and stress of any kind so that your body can cope with the procedure quickly.
Perfect oral hygiene is important from now on. Disinfectant rinses prevent the wound above the implant from becoming infected. Some dentists prescribe an antibiotic to prevent inflammation.
Important:An antibiotic has a strong impact on your intestinal flora. Therefore, make sure you rebuild your intestinal microbiome after taking it. You can do this with fermented foods such as yogurt, kefir or kombucha. Preparations with Lactobacillus bacteria also help to colonize beneficial bacteria in the digestive system.
Ingrowth takes several months
The doctor checks the wound after several days. The stitches are usually removed after 10 days. However, ingrowth takes several months. The lower jaw is somewhat harder than the upper jaw, which is why bone mass is formed more quickly here.
However, here too it takes between two and four months for the implant to be firmly seated. In the upper jaw, the dental implant can take up to six months. While the artificial tooth root is growing in, you should visit your dentist regularly for check-ups.
Is the implant firmly seated in the jaw?
The doctor can take another X-ray to check whether the bone around the artificial tooth root has grown well. A tapping test is also common: if the doctor taps on the head with the handle of an instrument, you should hear a bright sound. However, there are also more modern methods that are less empirical, such as a resonance frequency analysis (4).
After the bone, the gums
If the root is firmly ingrown, it is the gum's turn. Exception: This step is not necessary in the case of open wound healing. In this case, the gums have already grown close to the abutment.
The use of the so-called gingiva shaper or gum shaper begins with an injection. The gums are locally anaesthetized so that the dentist can cut them open. He then removes the seal from the implant and screws on the gingiva former instead. Ideally, the gums will now grow tightly around the gum former.
Two weeks gingiva former
After about two weeks, the abutment replaces the gingiva former and the final prosthesis can be attached to the implant. Now it is up to you to take good care of your dentures. Dental implants require careful care - in addition to toothbrushing, you should clean them regularly with interdental brushes.
In addition, an aMMP-8 test twice a year helps to prevent the possible loss of an implant. This saliva test measures the amount of activated matrix metalloproteinase 8. This enzyme can break down collagen - an extremely important protein in the body that gives connective tissue such as gums and bones their strength.
What about pain?
The description so far shows you that implantation is always associated with pain. However, it is impossible to give a general indication of its intensity or duration.
Everyone reacts differently to jaw surgery. Some people survive the insertion of the artificial tooth root without any problems and only need a painkiller immediately after the operation. Others, on the other hand, suffer for days.
Tip:Find out about pain relief during the preliminary examination. Make it clear to your dentist that you are sensitive to pain and do not intend to endure too much pain.
Conclusion: What lasts a long time will finally be good?
Placing an implant is a process that takes several months. After a preliminary examination, the artificial tooth root is first anchored in the jaw. Once the root has grown into the jawbone, a gingiva former ensures the correct shape of the gums. The abutment and crown can only be fitted after these steps have been completed.
The final prosthesis in the mouth does not mean that a happy ending is permanent. Hygiene in the oral cavity plays just as important a role when inserting implants as it does when maintaining them.
Careful care, which consists of brushing your teeth at least twice a day and using dental floss and interdental brushes daily, is a prerequisite for a long partnership with your implant. You also need to schedule dental hygiene appointments three to six times a year.
A simple saliva test to detect collagen degradation (aMMP-8 test) determines your individual risk of complications such as peri-implantitis. Just as a diabetic regularly checks their blood sugar, you should check your aMMP-8 level twice a year to prevent complications later on. This regular saliva test also helps to assess the overall current health of your oral cavity.
List of sources:
- (1) Gaviria L, Salcido JP, Guda T, Ong JL. Current trends in dental implants. J Korean Assoc Oral Maxillofac Surg. 2014 Apr;40(2):50-60. doi: 10.5125/jkaoms.2014.40.2.50. Epub 2014 Apr 28. PMID: 24868501; PMCID: PMC4028797. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028797/)
- (2) Schnutenhaus S, Edelmann C, Rudolph H, Dreyhaupt J, Luthardt RG. 3D accuracy of implant positions in template-guided implant placement as a function of the remaining teeth and the surgical procedure: a retrospective study. Clin Oral Investig. 2018;22(6):2363‐2372. doi:10.1007/s00784-018-2339-8 (https://pubmed.ncbi.nlm.nih.gov/29356920/)
- (3) Soares, Evelise & Fávaro, Wagner & Cagnon, Valéria & Bertran, Celso & Camilli, José. (2009). Effects of alcohol and nicotine on the mechanical resistance of bone and bone neoformation around hydroxyapatite implants. Journal of bone and mineral metabolism. 28. 101-7. 10.1007/s00774-009-0115-1. (https://www.researchgate.net/publication/26730654_Effects_of_alcohol_and_nicotine_on_the_mechanical_resistance_of_bone_and_bone_neoformation_around_hydroxyapatite_implants)
- (4) Vayron R, Nguyen VH, Lecuelle B, Albini Lomami H, Meningaud JP, Bosc R, Haiat G. Comparison of Resonance Frequency Analysis and of Quantitative Ultrasound to Assess Dental Implant Osseointegration. Sensors (Basel). 2018 May 2;18(5):1397. doi: 10.3390/s18051397. PMID: 29724028; PMCID: PMC5982662. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5982662/)