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Abutment? Implant? Bone grafting? Making sense of dental implants and the treatment plan given to us

Dental Implants are the new craze in the dental world. It's easy, you come in, you pay a ton of money, and Boom! You have a new titanium tooth! Both dentists and patients wish this was true but reality is here to rear it's ugly head. Dental implants do take time and there are many factors that go into successfully placing and restoring them. This article is a very brief but informative guide for patients to make sense of the dental implant process.

1) The anatomy of a dental implant

Every dental implant has 3 parts:

1. Implant: the screw that is placed in the bone.

2. Abutment: think of this as the middle man. It connects the Implant to the crown.

3. Crown: this is what is seen in the mouth and connects to the implant via the abutment

Dental Implant Anatomy

2) Why bone grafting?

To place a Dental Implant you have to have adequate bone in the area to support it. It's analogous to placing a screw in a piece of wood. If the screw is wider than the wood it is inserted to it will not stay. Same goes for Dental Implants. It has been shown that bone volume shrinks up to 50% in the first 6 months after tooth extraction. To solve this issue bone grafting is done to preserve bone width and to regrow bone in areas where Dental Implants are being placed.

Bone grafting can be done:

1. at the time of tooth extraction

2. prior to implant placement in an area where the tooth has been missing

3. at the time of implant placement

3) What is a sinus lift?

The maxillary sinus is an air filled sac above the roots of the back upper teeth namely the molars and premolars. The roots of the teeth act as tenting poles to hold the air sac up and out of the way. When teeth are pulled the air sac starts to droop down and fill in the space previously occupied by roots. In order to place a Dental Implant to replace the space occupied by the previous teeth the maxillary sinus needs to be pushed back up and out of the way. The sinus lift procedure gently pushes the air sac back up and allows the implant to reclaim the lost space.

Sinus Lift Diagram

Sinus Lift diagram with implant placement

4. Understanding the treatment plan and treatment time

Every treatment plan for Dental Implants consists of 2 phases.

1) Surgical Phase (3-6 months): teeth extraction, bone grafting, implant placement, sinus lifting

2) Restorative Phase (2 weeks to 1 month): Placing the crown and abutment on the Dental Implant

The Surgical Phase: this phase has a longer duration due to the healing time required for the bone to grow around Dental Implants and deficient areas. Bone is a very slow growing cell and requires 3-6 months depending on the volume of the area being grafted.

The Restorative Phase: once the implants have successfully healed your dental professional will take impressions and send them to the dental lab so they can make custom fitting abutments and crowns. Once back from the lab these restorative pieces will be attached to your Dental Implant.

Hopefully this guide educates and helps our patients navigate the complicated world of Dental Implants.

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