DENTAL IMPLANTS

About Dental Implant Surgery

Implants to replace teeth have existed for decades, but only in the last 15 to 20 years have reliable metals and systems been used. It is now possible to rebuild completely the structures that support the teeth, so that dentures no longer slip or click. Bridges can be placed where only partial dentures were once a possibility. Single teeth can be replaced, avoiding bridges and the cutting away of healthy teeth. Implants are made of titanium, the same metal used in jet aircraft, because of its strength and light weight. Titanium allows bone to grow right up to it without a fibrous interface. This characteristic means that titanium implants are locked solidly in the bone to support the desired dental reconstruction. For the most part, the operation can be performed at our own state-of-the-art facility, Park Meadows Outpatient Surgery, under local anesthesia. Most patients prefer, however, to “go to sleep” with intravenous (IV) sedation or general anesthesia for the procedure. After the implants are placed, the dentures can be worn immediately or a partial fitted denture can be used to cover the toothless area.

The Operation

The surgery can be performed on a outpatient basis and under a local anesthetic or IV sedation. The incision is made in the gum tissue and the bone is exposed. A hole is drilled in the bone in the location determined best for each implant by the restoring dentist and the surgeon. The number of implants placed depends on the number of missing teeth. Bone may be grafted if there is not enough at the surgical site, using either freeze-dried donated bone or the patient’s own bone. Once the implants are placed, the incisions are closed with sutures that will dissolve on their own in about 1 week.

Recovery

The recovery period for dental implants usually involves swelling in the cheek or the jaw area. You may experience bleeding for up to 24 hours. The sutures that are placed dissolve on their own in the first 5 to 7 days. Occasionally, implants may become exposed; this is usually of no consequence, and they should be kept clean with gentle brushing and rinsing as directed.

With more extensive implant surgery, bruising may appear on the cheek. The swelling usually resolves beginning the third day; however, your jaw may be sore for up to one week. Tooth brushing may be resumed the day following surgery, but care should be taken with brushing the actual surgical site. A normal diet can be continued if the implants are placed only on one side allowing you to chew on the opposite side. If surgery was performed on both sides of the mouth, then a soft diet is best so as not to cause trauma to the surgical sites. If dentures are to be worn over the implants, adjustments may be necessary for the first week or two, as well as replacement of the soft liner, and some patients notice a slight change in the occlusion of the dentures following the surgery.

Complications

Possible complications of implant surgery include loss of the implants, chronic infections, or loss of the healing abutments (posts) that may become unscrewed from the top of the implant. If this occurs, make sure to save the abutment and bring it back to the doctor to be replaced. Bleeding is rare, but in the case of surgery into the sinus and midface to place the implants, bleeding from the nose may occur for 24 to 48 hours. Permanent numbness to the lip or tongue, damage to adjacent teeth, or TMJ problems are also possible.

Pre-operative Instructions

You may need to schedule 2 days off from work or school to give yourself enough time to recover.
If the surgery is going to include anesthesia or intravenous (IV) sedation, do not eat or drink after midnight, or as your surgeon directs.
Arrange to have someone drive you home after surgery.
Wear comfortable clothes. Button-closure shirts with sleeves that roll up easily (for IV access) are preferred.

Post-operative Instructions

Bite on gauze as needed to control bleeding.
Apply ice to face for the first 24 hours.
Keep head elevated on 2 pillows for one week while sleeping.
Eat a soft diet to protect the surgical sites.
Rinse with warm salt water, beginning the day following surgery, 4 times per day. (Dilution: ½ teaspoon salt in 1 cup of lukewarm water.)
If bone is harvested from another part of the body, it is important to protect this area also. If a hip graft is taken, showering is permitted, but do not soak the incision. If bone is taken from the cranium (skull), showering and shampooing are permitted, but do not color your hair for 1 month.
If a sinus bone graft was placed then, it is very important that you do not blow your nose for 2 weeks.