There are several approaches that may be used in implant placement, depending on the patient's particular needs. Generally, an implant restoration consists of three phases: (1) placement of the implant itself, (2) following implant healing, insertion of a post or other fixture that emerges through the gum, and (3) seating the final crown or prosthesis. Below is an example of a typical treatment sequence for a common restoration, the single tooth replacement. (Click here to see Single Tooth Implant-Clinical Case ).
Phase One (Surgeon)
Appointment 1
Examination and treatment planning
Missing tooth to be replaced
Appointment 2
Placement of implant
Hole prepared to receive implant
Implant Seated and gum closed
Appointment 3 (10 - 14 days)
Post-operative appointment/ tissue check
Appointment 4 (4 weeks)
Site examined to assure proper healing
Appointment 5 (3 - 6 months)
Implant exposed, if submerged at the insertion appointment
Access hole in gum to expose implant
Appointment 6 (1 - 3 weeks after exposure)
Study models taken that record exact location of implant
When the study models are poured they produce an exact replica of the patient's jaws, with the implant simulation in place. Using the models, the dentist orders the exact size of post or fixture that will be attached to the implant and used to hold the restoration (such as a crown). The surgeon or the restorative dentist may perform this step.
Phase Two (Restorative Dentist)
The restorative dentist can use the study models, with the post attached to the simulated implant, to analyze the case before the patient is seen. The post may be contoured to the desired shape on the models, so only minimal refinements are needed when seated in the mouth.
Appointment 7
Post seated permanently in the implant, and shape refined
Temporary crown placed on post
(Final impressions for the crown may be taken at this appointment)
Post seated in implant
Post-shaped to receive crown
Appointment 8 (if needed)
Final impression for crown taken and sent to lab
Phase Three (Restorative Dentist)
Appointment 9
Final crown seated and occlusion (bite) refined
There can be a number of variations in treatment. Under ideal circumstances it may be possible to place the implant without reflecting the gum, using a small punch hole for access to the jaw. In these cases a healing cap may be placed at the surgical appointment, negating the need for the secondary implant exposure surgery (Appointment 5). Conversely, surgery may reveal less bone than expected, and implant placement may be delayed while more bone is generated.