The procedure can be broken down into multiple steps, each with its own emphasis. The first stage of any dental implant procedure is the planning stage. During the planning stage, your dentist will locate key structures like the sinuses as well as ascertain the orientation of the bone for correct implantation. If your dentist feels it is necessary, he or she may also order a CT scan at this point.

After planning, your dentist moves on to the procedure proper by preparing the bone with precision drills to prevent osteonecrosis (bone death). Next, your dentist will implant the titanium screw itself. Another appointment will be scheduled after the bone has had time to grow into place, a process called osseointegration. After osseointegration dental crowns, dental bridges or other restorative work may be placed on the screws.

What if you do not have enough existing bone? For patients without enough existing maxillary or mandibular bone, bone grafting will be necessary.  Enough bone is needed in three dimensions to securely integrate with the implant, so bone grafting is necessary where there is not enough maxillary or mandibular bone in terms of front to back depth or thickness; top to bottom height; or left to right width.Good bone height is particularly important to assure ample anchorage of the implant’s root-like shape because it has to support the mechanical stress of chewing, just like a natural tooth.

In a typical bone graft procedure, the clinician creates a large flap of the gingiva or gum to fully expose the jawbone at the graft site, performs a type of block and onlay graft in and on existing bone, then installs a membrane designed to repel unwanted infection-causing bacteria found in the oral cavity. Then the mucosa, the moist tissue that lines your mouth, is carefully sutured over the site. You will then be sent home with a course of systemic antibiotics and topical antibacterial mouth rinses. The graft site must be allowed to heal for several months before the implant can be placed.

The time allotted for healing will depend on a number of factors including the difficulty of the procedure as well as the skill of the dentist. Naturally, simpler procedures will generally have shorter healing times. Generally healing is given 2-6 months though studies are now showing that early implantation may not actually lengthen healing times.

An increasingly common strategy to save bone and reduce healing times includes the placement of an implant shortly after removal of the natural tooth. This process is called “immediate loading.” Immediate loading is becoming more common in the Implant Dentistry practice, as success rates for this procedure are now acceptable. The practice of immediate loading can cut months off the healing time.