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Dental implants are a great treatment option for qualified candidates. With an initial success rate of 98 percent, implants will prevent further bone loss and actually stimulate bone growth. They also restore a patient’s smile and give them back their self-confidence.
Determining the appropriate treatment plan for patients who may need dental implants requires a highly-coordinated approach between the referring dentist and oral surgeon. The first step is building a timeline discussed between the oral surgeon, referring dentist and the patient. It is important to design a plan that a patient is comfortable with and ensures the best possible outcome.
1. Referral
Making a referral when the patient is considering replacement options (implants, fixed bridges, partial dentures or possibly no replacement of the tooth) allows the oral surgeon to help the patient make the most informed decision.
Once an implant consult has been carried out, a treatment plan is generated. For more complicated cases, a second consult may be required at our office or at the general dental office to make sure the treatment steps are understood by the patient.
Insurance and financing is also discussed at this consult since many insurance plans will often not cover implant dentistry.
2. Exam
An initial exam allows the oral surgeon to consider key factors that influence treatment.
- Are there minimally restored teeth adjacent to the site? If so, an implant is most often the treatment of choice.
- Have the adjacent teeth had endodontic treatment? If so, implants are also the best choice since endodontically-treated teeth fail at a high rate as bridge abutments.
- What is the status of bone? Implants ideally require healthy bone. Rebuilding the bone can be costly and require substantial healing time.
- Other key factors include the periodontal status of the patient and rate of decay.
When referring for an implant consult, it is most helpful to fabricate study models prior to the consult and discuss with the patient what type of temporary is recommended during the healing period.
3. Surgery: Restoring Your Patient’s Smile
While the majority of implants we perform are placed at the time of extraction, it is not always the case. How long it takes before a patient’s smile is restored depends on the treatment plan and the condition of the bone.
- If implants have excellent primary stability, which usually means abundant healthy bone, immediate temporization is carried out and a patient never loses their smile. The temporary is worn for 3-4 months before a final restoration is made.
- If implants have less than excellent primary stability, then 6-8 weeks of healing is required prior to temporization.
- A popular treatment performed today for patients who have a terminal dentition or have lost all their teeth is the fixed hybrid prosthesis. Implants are placed and a temporary denture is converted to an immediate temporary. The patient gets their smile back immediately, while a final prosthesis is made after three months of healing.
4. Following Up: A Team Approach
After time for the area to heal, usually a period of 8-16 weeks, the patient is referred back to the general dentist for fabrication of the impression. The timeline is dependent upon the site. If an implant is placed in a healed site with minimal need for graft repair, the eight-week time frame is utilized. For implants where substantial graft repair is required, a 16-week time frame or slightly longer, is utilized.
Dental implants is a significant decision for many patients. Having a general dentist and oral surgeon working together makes that decision easier.
Dr. David W. Todd, DMD, MD, has been active in his profession. He has authored 18 articles in various publications and made numerous presentations at state, regional, and national meetings. For Dr. Todd’s full bio click here.
