Steps of dental implantation, information about implant surgery
A detailed guide to dental implants, leaving no questions unanswered
The dental implant procedure consists of interdependent steps, so we will explain it to you step by step.
On our website, we uncover the complete steps of the implant placement process and examine the various types of surgeries. However, before you continue reading, we would like to inform you that our other pages also cover this topic, where you can find answers to the following questions:
What is a dental implant, and what should you know about it?
Are you curious about whether to replace your teeth with traditional methods or through implantation, or are you unsure how to determine which dental implant is best for you?
Would you like to know which types of dental implants are available at our practice?
Are you curious about what steps to take after dental implant placement and what potential issues may arise?
Do you want to understand what a crown or bridge on an implant means, or are you interested in the topic of fixed dentures secured with implants?
Dental Implantation Step by Step
Dental implantation consists of interdependent, sequential steps. The process of dental implant placement is generally consistent, though it may vary slightly for each individual case. To facilitate understanding, we have outlined the steps of dental implantation in a clear, point-by-point format, making the procedure easy to comprehend:
I. Planning for dental implantation
Before implantation, thorough planning is crucial, as its neglect or inadequate execution by an unprepared operator can lead to permanent issues. Dental implant planning involves the following steps: data collection, data analysis, and treatment planning.
1. Data collection for screw-type dental implants
For successful dental implant planning, data is essential. This data can be gathered from multiple sources for the planning process.
1.1 Clinical intra oral examination
Primary information is gathered during an oral examination. This allows for the assessment of the missing tooth's environment, its anatomy, the condition of adjacent teeth, and, if applicable, the characteristics of the tooth to be extracted. We also analyze the oral hygiene and periodontal condition, as this can reveal dental issues that may affect the planned procedures.
1.2. Patient expectations
It is crucial to listen to and consider our patient's expectations and needs during the consultation, as this information can fundamentally influence the planning process.
1.3. Radiological examination
In the 21st century, the careful use of dental X-rays provides a wealth of information. At Helvetic Clinics, a 3D CT scan is performed before every dental implant surgery to accurately map the surgical area. A panoramic X-ray only provides a 2-dimensional image of the affected area, which is insufficient for precise planning.
A CT scan allows us to assess the presence of adequate bone volume, available space, bone thickness, and its structure. It also helps us evaluate the need for bone grafting.
1.4. Digital impression taking
If the dental implant is to be placed using guided implantation, the planning phase is complemented by obtaining a digital impression with an intraoral scanner.
2. Data Analysis
Processing the information gathered during data collection is the responsibility of the treating physician. The available data is consolidated and analyzed systematically. If necessary, the situation is also discussed with specialist colleagues in a medical consultation.
By evaluating the data from clinical, X-ray, and other examinations, the specialist forms an ideal solution to address the patient's issues.
- Is bone grafting necessary?
- What are the advantages and disadvantages of each type of implant screw for the specific procedure?
- Should the implantation be performed in one or two stages?
- Is it possible to perform guided dental implantation using a drill guide template?
- Is there an option for immediate provisional placement after the freshly completed implantation?
3. Establishing a treatment plan
To ensure that the possible solutions envisioned by the specialist are clear to our patients, a treatment plan must be prepared.
The treatment plan includes all essential information needed to provide a clear understanding of the planned procedure's details. It outlines the required treatments, the duration of each treatment, healing times, and possible alternatives. Additionally, it specifies the costs involved, including the price of the dental implant, and clearly states the warranty conditions for the implant placement.
The prepared document is reviewed with our patients, and we strive to provide clear and satisfactory answers to all questions. The advantages and disadvantages of dental implantation are compared to ensure an informed decision. If the treatment plan meets the patient’s approval, it is confirmed by signing the document.
II. Dental implantation, per se the placement of an artificial tooth
1. Preparation for Dental Implantation and Preliminary Treatments
To ensure the success of our dental procedures, we must perform the preparatory tasks outlined and recommended in the treatment plan before the dental implantation. Most commonly, we establish the proper oral hygiene conditions by removing tartar and plaque, thereby creating a clean and inflammation-free environment for the surgical procedures.
2. Dental implant surgery
Dental implantation is always performed under local anesthesia, ensuring that the patient feels no pain during the procedure. Placing a dental implant is considered a surgical intervention as it slightly disrupts the body's integrity towards the external environment.
Accordingly, the procedure begins with creating a nearly sterile environment. The oral cavity is disinfected with an antiseptic mouthwash to reduce the number of bacteria, and the patient's face is cleaned with a similar antiseptic skin wipe. A dental implant can be placed in one of four ways:
2.1. Procedure for immediate implantation
If a hopeless tooth has not yet been extracted, it is possible, under certain conditions, to place the implant immediately at the time of extraction. In such cases, after the very careful (atraumatic) removal of the tooth, we immediately prepare the site in the empty tooth socket and place the implant. For immediate implantation, flap creation and sutures are generally not required.
2.2. One-stage dental implantation procedure
In cases where the implant is to be placed into a healed alveolar ridge where a tooth has previously been removed, the procedure can be performed in a single stage. If there is sufficient bone available, a small incision is made in the edentulous area, and the gum covering the alveolar ridge is reflected (flap creation). Using a specialized surgical drill, a small hole is created in the bone. The titanium screw, unpacked from its sterile packaging, is then inserted into the prepared hole.
In the case of a firmly secured dental implant (primary stability), a healing abutment (gum-shaping screw) is inserted in to the implant in this phase. This abutment will shape the gum over the implant in the following months. The flap is closed with sutures, which can be removed 7-10 days later.
2.3. Two-Stage Dental Implantation Procedure
The two-stage dental implantation procedure follows similar steps to the one-stage implantation, with the exception that a healing abutment is not placed at the time of surgery. Instead, a cover screw is applied, and the gum is fully closed over the implant, allowing the artificial root to heal in a sealed environment. In this case, the implant will be exposed and uncovered only months later, after the osseointegration process is complete. This approach is typically chosen when there is low primary stability or when bone grafting is performed simultaneously with the implantation.
2.4. Guided Implantation Procedure
Today, it is also possible to place the planned dental implant using a drill guide created after digital planning. The main advantage of this method is that it completely eliminates any potential positioning uncertainties introduced by the operator’s hands. The implant is placed exactly where the treating dentist intended.
The pre-planned surgical template guides the surgeon’s hand—and essentially the drill—through both depth and positioning. An additional advantage of this method is that it often eliminates the need for flap creation and sutures, resulting in milder postoperative complications during the healing phase. Guided surgery is generally indicated when the bone availability provides limited space for implant placement.
III. Steps after dental implant healing: gum shaping, implant prosthesis
After the healing period, the dental implants are ready to be loaded, allowing for the placement of the final dental restorations.
1. Gum shaping
In the case of two-stage dental implantation, a healing abutment is necessary, as the implant has healed closed under the gum after the initial placement.
Gum shaping always precedes the phase of creating the dental prosthesis, as it requires the gum to be in its final healed state.
The placement of the healing abutment occurs after a small incision, which is also performed under anesthesia. This procedure is called implant uncovering. Gum healing takes a few weeks.
2. Creation and Planning of Dental Prosthetics
The final phase of the implantation treatment is the creation of the dental prosthesis. During this phase, we select the most suitable type of prosthesis for addressing the tooth loss. Depending on the situation, the implant can be fitted with a crown, bridge, or, in cases of complete edentulism, a removable denture or a fixed denture. Regardless of the chosen prosthesis, a negative imprint of the oral structures, also known as an impression, is required.
3. Impression taking
An essential step in creating the implant-supported dental prosthesis is taking a traditional or digital impression, which is then sent to the dental laboratory. A negative mold is made using impression material or by scanning the oral structures, providing the dental technician with the necessary information to fabricate the prosthesis.
4. Fabrication of dental prosthetics for implants
The various types of dental prosthetics for implants will be discussed in detail on the following pages:
5. Try-In of Dental Implant Prosthetics
The dental prosthetics crafted by the master dental technician are placed in the mouth for try-in. Each work phase and trial allows for necessary adjustments to be made.
6. Fitting of the dental prosthesis
The completed prosthesis is placed in the mouth and connected to the implanted implant body.
7. Follow-Up Examination and Adjustments
The follow-up examination is an essential part of the treatment process, during which we assess and fine-tune the completed dental prosthesis.
The information provided above answers many questions. If you have further inquiries, please contact us at 053 930 1323 to schedule a consultation about the dental implant procedure.
FAQ - Frequently asked questions about the dental implant procedure
What are the advantages of dental implants over bridges?
In the case of a bridge placed on natural teeth, the neighboring natural roots are subjected to the load, whereas with dental implants, the implanted artificial root bears the load, even if adjacent natural teeth are present.
Does poor oral hygiene affect the outcome?
We always recommend addressing oral hygiene before dental implantation.
Is it possible to replace multiple teeth with dental implants?
Certainly. By increasing the number of implanted artificial roots, it is possible to replace all missing teeth in an entire jaw.
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