Conventional dental implants are most commonly used to replace already missing teeth. It is not typically a painful procedure – each case is different and your dentist will explain the pros and cons and potential complications of each individual situation with you on a case by case basis, but generally having a tooth extracted is a more painful healing process than placing an implant.
There are typically 3 phases for placing an implant. First, we need to evaluate the bone present. There needs to be an adequate amount of bone present both “side to side” and vertically to make sure there is enough space to place an implant. This is most often achieved by taking a CBCT (Cone beam computed tomography), which in its simplest term would be a 3D X-ray.
This shows us exactly how much bone is present and from this 3D image we can determine what size implant will work best in each individual case. The Second phase is the actual placement of the implant. For this the patient is numbed with local anesthetic, which is the same thing used when doing a filling or an extraction. You will be numb in the area of the implant placement and it will not hurt. The implant is placed into the jaw where the root of the tooth had originally been. Then a silver disk or “healing cap” is placed on the implant while the bone integrates with the implant. This is an important distinction because it is often thought of as the implant being the tooth that is replaced. However, the implant is actually the part that is inserted into the jaw that the tooth will connect to when ready. After the implant is placed there is typically 3 months of healing before it is ready to have the tooth attached. This can be thought of as the healing time. For example when a bone is broken it is put in a cast. The cast immobilizes or stabilizes the bone so that it is not moving – it will not heal if it is constantly bending and moving. Similarly, then implant will not heal / the bone will not grow around the implant and lock it into place if you were chewing on it with the tooth attached. The Final step is to attach the new tooth to the implant. There are various ways, but the most common way we do it is to take an impression that is sent to a lab. Then the lab sends back the tooth that locks onto the implant and is held in place with a screw through the top of the implant crown. This is then covered with a tooth colored filling and can still be accessed if any maintenance or changes require access in the future.
In the past if a tooth was missing, there were 2 options to replace it: 1.) Bridge. A bridge will replace a missing or some missing teeth. However a bridge uses teeth on either side of the missing tooth to attach to which need to be shaved down to accommodate this bridge. 2.) The second way to replace missing teeth is a partial. A partial is often more economical, but its main drawback is that it is removable, meaning you take it out and put it back in yourself on a regular basis. 3.) The newest and often best replacement of a missing tooth is an implant. This replaces the missing tooth without having to disturb the teeth next to the space like a bridge and it is fixed, meaning it doesn’t come out like a partial and is generally the preferred way to replace a missing tooth.
In some cases immediate implants can be placed – meaning that when we extract the remains of a tooth we can put an implant in that same day. This decreases the amount of steps involved in order to have an implant placed making it much easier and less time consuming for patients. There are pros and cons to this approach and it can not always be done every time, therefore each case would be discussed in depth with your dentist.
Conventional implants can also be used to hold in dentures or even make a more permanent set of teeth that are only able to be removed by the dentist. These are among the most complex cases and can be discussed on an individual basis with your dentist.