Dental Implant Surgery: Step By Step

Dental implant surgery is the modern way to replace missing, severely damaged, or unhealthy teeth. This method provides life-long teeth and prevents bone loss.
Dr Joseph Cipriano

Dental implant surgery has become the gold standard for replacing missing, severely damaged, or unhealthy teeth. This method is preferred because tooth loss leads to bone loss, however with implants, a "root" is implanted in the bone, so patients won't lose the bone in their jaw over time. With dental implant surgery, a metal screw-like tooth root is implanted within the jaw to replace missing teeth or failing bridges and dentures. This process is relatively simple on the whole, however, the overall health of the patient's gums and jaw will ultimately determine the exact approach a dentist or oral surgeon will use to complete the procedure successfully.

Healthy Smiles of Staten Island takes everything into account when deciding the best course of action regarding our patients' dental implant needs, so let's take a look at the process that Dr. Cipriano uses to give his patients back their best smiles.

Type of Dental Implants

Dr. Cipriano uses endosteal implants. These are the most common implants, and they're so common for a reason. They work. These small screw-like implants are made from titanium, and they're surgically inserted deep into the jawbone where they perform the same action as a tooth root on every level. They hold the tooth in place, provide unmatched stability, and they prevent bone loss. In fact, they actually promote bone growth. Endosteal implants can be used to anchor one tooth, All-on-4 implants, or even a full set of replacement teeth.

So now that we understand the type of dental implants that Dr. Cipriano uses. The next step is breaking down the procedure. We're committed to giving our patients all the information they need about their oral health and discussing it with them at every step, so let's take a look at those steps.

Evaluation

While many dental implant providers tout their same-day implants, we don't do that here at Healthy Smiles. Why? Because although it sounds like a huge convenience, it actually is counterproductive. Doing anything correctly takes time, and if there's anything you want to be done correctly, it's dental implants.

Overall Oral Health

First, we evaluate your teeth, gums, and jawbone to determine their overall health and what approach will work best for your case. We'll take 3d x-rays and devise an overall plan with options that will fit your individual needs. Sometimes, that need is not to have implants at all. While they're the preferred option in a perfect world, sometimes a patient's oral health makes them an unfit candidate for implants. In these cases, the risk just outweighs the benefits of dental implants by too great a margin. Sometimes, a bridge or dentures is the only option. We'll never push for something that won't serve our patients' best interests.

Bone Graft Evaluation

Part of determining if a patient is a good candidate for dental implants is determining if they'll need a bone graft. Implants can easily be implanted into a healthy jaw. However, if a jaw has too much bone loss, a graft will need to be placed to provide adequate bone to allow the acceptance of the implant. Think of hanging a flat screen on your wall. You want the screws to go into the studs. If you try anchoring it to the drywall, you'll end up with a broken television. The same idea holds true with implants.

Number of Implants

Of course, we'll need to determine the number of implants you require. If you only have a few teeth that need to be replaced, one or two implants may be all you need. Conversely, if you need a whole-mouth replacement, you'll need several implants.

After the evaluation is completed, it's time to determine a course of action. If the bone is healthy, Dr. Cipriano can move directly to extraction to begin the process. If there is too much bone loss, he'll add a bone graft to promote bone growth in the area, creating a solid foundation for the implants later on.

Let's take a look at how each of these scenarios plays out.

Extraction

While we prefer to preserve as many natural teeth as possible, that's not always achievable. This is especially true if a patient is seeking implants. There are even scenarios in which teeth that are healthy now might have to be removed now to prevent problems later, such as wisdom teeth. In general, however, extractions are only recommended if:

  • One or more teeth are severely decayed or damaged, leaving them unable to be restored with other methods.
  • Severe periodontal disease or gum disease has weakened the support structures surrounding the tooth, leading to a loose tooth.

Tooth extraction is generally done using local anesthesia. Novacaine or lidocaine is used to numb the teeth to be extracted along with the surrounding bone and gum tissues. If any pain is detected at any point, more anesthesia will be administered. Throughout the extraction process, precautions are also taken to protect the surrounding healthy bone and gum tissue.

Bone Grafting

If your jawbone is too soft or thin, you'll most likely require a bone graft before Dr. Cipriano can insert the dental implants. Your mouth's chewing action puts stress on the jawbone, and if that bone can't support the implant will almost certainly fail, leading to the loss of those sparkly new teeth. Bone grafts are how we ensure that your bone is healthy, sufficiently robust, and ready to accept the implant.

Bone grafting involves inserting bone into the area of the jaw that needs to be strengthened. Over the course of 3 to 4 months, the existing bone will replace the graft, leaving a healthy, strong jawbone that can accept the implants.

Getting the Implant

Once the initial assessment and any corrective measures such as bone grafting are completed, it's time to get the implants. This involves a few different steps that are used to ensure that the implants are the best that they can be.

Installing the Implants

A 3D printed surgical guide that fits exactly over the neighboring teeth will be inserted into the mouth. It looks almost like clear Invisalign retainers with a circle guide in the place of the missing teeth. This allows total precision when placing the implant. Then, we use a tissue punch to make a hole in the gum that's the same diameter as the implant. This removes the need for incisions and stitches, making it a relatively painless procedure in case you were wondering do dental implants hurt?

After that, an implant drill is used to make the initial hole where the implant will be placed. It's very similar to drilling a pilot hole a little smaller than the final screw to be used in a piece of wood. It provides a guide and prevents damage to the surrounding bone when the implant is installed. The surgical guide and special drill work together to ensure that the drill bottoms out exactly where it's supposed to, so there's no such thing as drilling too deeply or not deeply enough.

Finally, we insert the implant. Using the prepared hole, the implant is torqued (screwed) into the jawbone, and a metal healing cap is placed on the end of the implant to protect it and prevent tissue from growing over it. After 3 months of healing time, it's on to the next step.

3D Scan

At your following visit, we'll take an x-ray (periapical) to ensure the implants have healed correctly and take the second digital scan of the crown or new artificial tooth to be used in place of the missing tooth. The entire process usually takes about 15 minutes. Although it's a short visit, it's a vital process in the dental implant process.

Adding the Crown

What we call crowns as they relate to dental implants are not the same as crowns on existing teeth. While those crowns are fitted over existing teeth that have been ground to resemble a post on which the crown can be anchored, these crowns are simply the top of the implant and connected by an abutment. They're typically made of a metal alloy that's boned with porcelain to create natural-looking teeth that will stand the test of time.

This is the final stretch, the big finale, the final payoff. This is when you get your set of new teeth. These implants are permanent and can't be removed. They're designed to look and feel like natural teeth. Your smile will be perfect. Your bite will be perfect. These are full replacements that are just as good as the original, and they'll never wear out.

Surgery Timeline and Recovery

At Healthy Smiles of Staten Island, all dental implant procedures are performed from start to finish by Dr. Cipriano and our team. This completely in-house approach significantly decreases the implant timeline and makes it far easier to achieve the desired results. It saves patients time by only having to visit one doctor throughout the entire process. It also saves them money for the same reason.

By using one dentist, the implant process generally only takes between 6 to 8 months - including extractions and bone grafting if necessary - and four office visits. However, general dentists who rely on the help of other oral surgeons generally have a timeline of 9 months to a year in some cases.

Are Dental Implants Right for You?

Dental implants are the gold standard for tooth replacement, but are they right for you? That's a question that only you can answer with the help of our highly-experienced Staten Island dental implant dentist Dr. Cipriano. If you've been considering dental implants, we'd love to meet you and provide you with a consultation. At Healthy Smiles of Staten Island, it's our mission to provide the highest quality oral health and rejuvenation possible. Schedule an appointment today, and let's talk about your dental implants