Dental Implants: Understanding the Procedure of Placing an Artificial Tooth on a Screw in the Mouth
A dental implant is a procedure where a titanium screw is surgically placed into the jawbone and a prosthetic tooth (crown) is attached to it, creating a permanent replacement for a missing tooth.
The Dental Implant Process
Components of a Dental Implant System
- The complete dental implant system consists of three main parts: the implant (titanium screw), the abutment (connector), and the crown (artificial tooth) 1
- The titanium screw is surgically embedded into the jawbone where it undergoes osseointegration - a process where bone cells grow and directly integrate with the titanium surface 2
- The abutment serves as the connector between the implant and the crown, which can be made of various materials including zirconia or titanium 1, 3
Surgical Procedure
- The procedure typically begins with extraction of the damaged tooth (if still present) and preparation of the implant site 1
- An osteotomy (surgical preparation of bone) is created using specialized drills to prepare the site for implant placement 1
- The implant is then inserted into the prepared site, maintaining proper 3D positioning to ensure optimal esthetics and function 1
- In some cases, a gap between the implant and surrounding bone may need to be filled with bone graft material to promote proper healing 1
Healing and Restoration
- After implant placement, a healing period of 3-6 months is typically required to allow for osseointegration 2, 4
- Following successful integration, the final restoration process begins with the placement of an abutment 1
- The crown (artificial tooth) is then attached to the abutment either by screwing or cementing, completing the restoration 1, 3
Types of Implant Restorations
Based on Timing of Placement
- Immediate implant placement (Type 1): Implant is placed immediately after tooth extraction 1
- Early implant placement (Type 2): Implant is placed 4-8 weeks after extraction, allowing for soft tissue healing 1
- Delayed implant placement: Implant is placed after complete healing of the extraction site 1
Based on Restoration Method
- Screw-retained crowns: The crown is attached directly to the implant with a screw, allowing for retrievability 1
- Cement-retained crowns: The crown is cemented onto an abutment that is attached to the implant 1
- Integrated Abutment Crown: A newer technique where the abutment and crown material are chemomechanically bonded, eliminating the need for cement 3
Clinical Considerations
Preoperative Assessment
- Radiographic evaluation is critical to determine the exact height, width, and contour of the alveolar ridge 2
- The locations of vital structures such as the maxillary sinuses and mandibular canals must be precisely determined 2
- Assessment of bone quality and quantity is essential for successful implant placement 1, 2
Potential Complications
- Infection at the implant site is a serious complication that may require implant removal 5
- Technical complications include screw loosening, ceramic fractures, and implant fracture 1
- Proper patient selection, surgical technique, and prosthetic design are crucial to minimize complications 1
Advanced Techniques
- Computer-aided design and manufacturing (CAD/CAM) allows for precise planning and fabrication of patient-specific implants and restorations 1, 5
- 3D imaging and surgical templates can ensure ideal implant positioning 1
- For cases with insufficient bone, various augmentation procedures may be necessary before implant placement 2