Dental Implants

There are several approaches that may be used in implant placement, depending on the patient's particular needs.

Generally, an implant restoration consists of three phases:

• Phase One (Surgeon): Placement of the implant itself
• Phase Two (Restorative Dentist): Following implant healing, insertion of a post or other fixture that emerges through the gum
• Phase Three (Restorative Dentist): Seating the final crown or prosthesis. Below is an example of a typical treatment sequence for a common restoration, the single tooth replacement.

Phase One (Surgeon)

Appointment 1: Examination and treatment planning

Missing tooth to be replaced

Appointment 2: Placement of implant. At this time in some cases it is possible to also place a temporary crown on the fixture. This is usually done in the anterior area and is only possible if certain strict criteria are met.

Hole prepared to receive implant	Implant Seated and gum closed

Appointment 3 (10 - 14 days): Sutures removed

Appointment 4 (4 weeks): Site examined to assure proper healing

Appointment 5 (3 - 6 months): The implant is exposed if submerged at placement. A healing abutement is placed to contour the gum tissue and a letter is sent to the general dentist to confirm that the implant is now ready to restore with a tooth crown. Various parts and pieces that the general dentist will need to restore the implant are included with the letter.

Access hole in gum to expose implant

Phase Two (Restorative Dentist)

The restotative dentist will remove the healing abutement, place an impression coping and make an impression of your upper and lower arches. These will be sent to a dental lab and a restorative abutement and a crown will be fabricated.

Appointment 1: The final impression for the crown is taken and sent to the lab.

Phase Three (Restorative Dentist)

Appointment 1: Final crown is seated and the bite is refined.

There can be a number of variations in treatment. Under ideal circumstances it may be possible to place the implant without reflecting the gum, using a small punch hole for access to the jaw. In these cases a healing cap may be placed at the surgical appointment, negating the need for the secondary implant exposure surgery (Appointment 5). Conversely, surgery may reveal less bone than expected, and implant placement may be delayed while more bone is generated.