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1. Consultation: 40 minutes typically
A careful medical history is taken by Dr Young. There are some medical conditions that may make implant treatment inappropriate so a very rigorous screening approach is employed. Certain medical conditions require Dr Young to liaise with your doctor or medical specialist in order to ensure implant success.
Please note: we will always ask for your written permission to liaise with your doctor (or specialist) before writing to them.
A careful examination of your jaws and mouth including evaluation of gum health, your cosmetic aims and a detailed evaluation of the bone and gum in the areas where you need dental implants.
Low dose radiographs will be taken usually.
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Typical low dose x-ray that is used to assist in implant surgery. |
At the end of the consultation, the implantation procedure will be discussed and the likely cosmetic result that can be achieved will be described.
Alternatives to implant treatment will be considered and discussed to make sure you make the right choice for your dental and medical health. We can usually give you a verbal estimate for treatment on the day unless the implant treatment is very complex.
2. Impression Visit (10 minute appointment)
Molds are taken of your teeth so that a surgical guide (stent) can be made.
A surgical guide ensures that the implant is placed in the best possible position to achieve good cosmetics and optimal implant longevity.
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A plastic surgical guide (or stent) is made similar to a denture with metal tubes to ensure accurate implant placement. |
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This shows how a surgical guide stabilizes the drill to ensure that the implant is placed in the ideal position. |
3. Implantation Procedure
This is carried out comfortably under local anaesthetic for most patients as an outpatient procedure. It may take from 30 minutes to over 1 hour.
Conscious Sedation
A small proportion of our patients (approximately 10%) take a low dose of an oral sedative before undergoing the surgery. We use temazepam which makes patients feel relaxed. It is used either for patients who are unduly anxious or for patients who need to undergo extensive or prolonged surgery.
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The implant team will wear sterile gowns, gloves, masks and hats. |
You will be covered in sterile drapes. All instrumentation used will be sterile.
More profound conscious sedation can be arranged if needed. This is called intra-venous conscious sedation. This involves a small injection in the back of your hand. Conscious sedation means you are able to understand what is happening but you are relaxed. It is not a general anaesthetic
When the implant is placed in position, sometimes the gum is gently stitched over. On other occasions, the implant is left just visible
However, when your denture or bridge is in place, the implant would be hidden.
Fusion Period (range 6 weeks to 4 months)
This is the time take for the adjacent bone to fuse or bond to the dental implant (osseo-integration). The healing time ranges from just 8 weeks to 4 months. (8 weeks is common and 4 months rare).
FAQ: How will we know if the implant has healed (fused to the bone)?
Answer: We use a radio-wave technique to test the implant before fitting teeth on any implant.
This device (Osstell mentor ™) gives a reading of implant ‘grip’ onto the bone (Implant Stability Quotient or ISQ). An ISQ value of 60% is usually what we like to get before we start to restore an implant. Testing your implant is quick and painless.
4. Uncovering the Implant (Implant Exposure)
A minor operation to uncover the implant if the implant has been buried.
5. Impression of the Implant
This is just like having an impression for a normal crown.
6. Visit the Dental Technician for Cosmetic Matching of Your Teeth
For some patients, the best results come from a visit to the dental technician who will be making your crown(s) or bridge (s). For others (often when replacing back teeth with implants) this visit is not necessary.
7. Fabrication of the Crown by our Dental Technicians
This takes 2-3 weeks to make. It is custom made for each patient and the technician will work hard to ensure a good cosmetic result. Somtimes the crown neeeds a little adjustment at the chairside. Sometimes, the crown will be returned for cosmetic changes.
8. Fitting of the Crown or Bridge: (20 minute appointment)
Peter will fit the crowns without cement first so that you can see the result. If the fit, shape and colour is natural, the work will be fitted.
If you are not sure we will fit the crown with light cement and you can wear the crowns for a few weeks to see how they look in different lighting.
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Post fitted to implant. |
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Crown fitted immediately after post fitted. |
Minor adjustments of crowns and bridges can be made at the chair side. If a substantial change is needed, the work would be returned to the dental technician for adjustment. Be reassured that we will not fit the work unless you are pleased with how it looks and feels.
We are pleased to say that no patient we have treated in the last 20 years has been dissatisfied with the cosmetic results achieved. We feel this refelcts or dedication and efficiency in our implant work.
9. Post Fitting Review Appointment (20 minutes)
A low dose x-ray is taken 2 weeks after the crowns or bridges are fitted to enure the crown and implant fit perfectly and to establish bone levels as a reference point.
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2 implants with crowns fitted.
Excellent bone levels are seen here and this means the implants are very healthy.
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Cleaning your Implants
Our hygienist will show you how to clean and look after your implant(s).
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We recommend the
Waterpik Cordless Dental Water Jet WP-450 (Sonicare). |
Do you have a tooth or teeth that need extracting BEFORE implant treatment is carried out?
If this is the case the teeth will need to be removed BEFORE implant treatment can proceed. If the extractions are straightforward then your dentist can carry out the extraction (s).
However, there are circumstances when the extractions are best carried out by Dr Young and these include:
· The presence of long term infection for many months / years
· Root fractures: there is little to get hold of with conventional extraction forceps
· Fusion of the root to the bone (‘ankylosis’)
· Extremely dense bone
In these circumstances, Dr Young will remove the roots using a very gentle technique developed especially for when implant treatment is planned. This removes the entire tooth and root BUT preserves the bone. This allows the implant procedure to be carried out as soon as possible.
A poor extraction technique (taking away too much bone) will hinder the implantation procedure and may mean a bone patch is need before implants can be inserted – with additional costs.
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