The duration of the operation varies according to the complexity of the operation (number and location of implants, volume of bone available, etc.).
The installation is carried out in the OR or in a room dedicated to this function in the dental office. After performing local anesthesia , the practitioner incises the gum. He digs the implant seat into the jawbone with a bur, places the implant and makes two stitches. For two to four months, depending on the location, the wound heals and the bone reforms around the implant: this is osseointegration . It is only after this step that the artificial tooth is fixed on the implant.
For aesthetic or functional reasons, he can place a temporary prosthesis . Can he fix a definitive prosthesis during the same session? Opinions are opposed. Dr Thomas Fortin, dental surgeon, prefers to avoid it:
“This presents a risk of infection, and in my opinion is the number one cause of implant failure. Most dentists prefer to do it in two stages: placing a temporary prosthesis while waiting for the bone to adhere to the implant. implant, then place the false tooth at another appointment. ”
After two to six months , the practitioner therefore checks whether the implant has integrated well into the jawbone. If it is firmly anchored, the prosthetic step with impression taking and try-in of the final prosthesis (crown, bridge or removable appliance) is initiated.
Bone grafting may be necessary
It is offered when the jawbone does not appear deep enough to receive the implant . “When a tooth is pulled out, the bone tends to get thinner over time,” explains Dr. Thomas Fortin. A part may also have been destroyed by mining. “If a little bone is missing, we can fill the space with synthetic biomaterials or human bone bank , says Dr. Ardouin. If a lot is needed, bone is taken, for example. , at the level of the lower wisdom teeth “. Alternatively, remove bone from the patient’s skull or hip, which requires hospitalization and general anesthesia. The bone is then fixed with screwswhich is removed when the implant is placed. This operation weighs down the surgery, and lengthens the delays. The risk of implant failure also increases.
Dental implant: better to be patient
Placing an implant and a prosthesis is a process that can last from a few weeks to over a year . It starts with the diagnosis and workup, then, if there is to be a tooth extraction, the dentist allows the gum to heal for two to three months. Six months must be added in the event of a bone graft, then two to six months after the placement of the implant to install the false tooth. Some practitioners reduce these delays by placing the implant just after extraction, or by placing the false tooth on the same day as the implant. “But the mouth must be healthy, and this is not true in the majority of cases”, recalls Dr. Ardouin.
Dental implants: what contraindications? what precautions?
“There are local contraindications : insufficient quantity or quality of bone, and general contraindications in cases of pregnancy , heart valve disease, bone disease, poorly controlled diabetes , chemotherapy or immunosuppressive treatment. after an organ transplant “, explains Dr. Fortin.
Precautions should be taken in the event of antiplatelet therapy or osteoporosis treated with bisphosphonates , as the latter weaken the jaws. “You have to put yourself in the place of the doctor who follows the patient, insists Dr. Lasry. It is he who gives his authorization for oral care.”
If you smoke a lot , the dentist is likely to refuse to have implants for you. You will have to temporarily concede to stop. In fact, smoking impairs healing and considerably increases the risk of failure of the bone integration of implants.
On the other hand, age, even advanced, does not prevent implantation .