Under local anesthesia, the first step for many implant procedures is the exposure of the bone where the implant is to be placed. This is followed by placement of the implant onto the exposed jawbone. Implants that are placed on the bone are called endosteal implants and are made of titanium, or a titanium alloy, because this metal does not adversely interact with biological tissue. After placement of the implant, a cover screw is put in and the wound is closed with stitches and allowed to heal. In general, placements in the lower jaw need to heal about three months, while placements in the upper jaw need to heal about six months.
After healing, in a second surgical procedure, the implant is uncovered, the cover screw is removed and a healing abutment or a temporary crown is placed in the implant. Temporary dental crowns are generally used for aesthetic reasons when the implant is in a place that is visible. Both healing abutments and temporary crowns allow the tissue around the implant to be trained to grow around the final prosthetics tooth. After about two months, the soft tissue will be healed to receive the final prosthetic tooth.
Perhaps one of the most frequently asked questions I get is whether or not to use a fixed ("permanent") bridge or a dental implant to replace one or two missing teeth.
I usually always prefer an implant because they are much more stabilizing for the jaw itself and implants present many benefits.
Replacing a lost tooth is vital to maintaining the overall health and function of the surrounding teeth. It helps avoid tooth migration and loss of structure. It is necessary to avoid loss of bone from the jaw in that area. Dental implants are an effective means of counteracting these problems. Dental implants are also very strong and provide a feel as close to a natural tooth as can be currently achieved. Further, implants reduce the impact of the lost tooth on surrounding teeth, as traditional bridge structures often require reduction (filing down) of the two adjacent teeth to hold the bridge in place with crowns. Implanting avoids such alterations to the surrounding teeth when replacing a lost tooth.
Many people have very mild soreness, bleeding, or swelling, which can be treated with first aid and over the counter medicines, and can return to work the day after surgery. In between the first and second surgery, there is a recovery period of three to six months while the implants associate with the bone. This growth of the bones around the titanium posts may induce a few weeks of soreness. This discomfort can usually be controlled using over the counter medicine.