Updated: November 11, 2017
If your jaw does not have enough bone to hold an implant, you can go for the procedure to build up the bone which may include bone grafting or bone distraction.
It will take about four to twelve months for the bone to be ready for the implant for any of these procedure. In most of the cases single-tooth implants will work and look like your natural teeth. However, for some patients, it will be difficult to make the implant look exactly like your natural teeth. In some cases, because there is not enough jaw bone, your implant will be inserted on an angle in the bone and will not be placed straight.
Once you have enough bone to successfully hold an implant, implants in your jaw can be placed. With the help of a root-form implant which is designed to serve as the root of the tooth, the implant is placed in the jawbone in the space created by the missing tooth.
If implants were placed in the lower jaw, it will take four to five months to go for the next surgery. For upper jaw it will take six to seven months. The bone and the implants fuse during this time.
Once the implants have become fused with the bone, you can go for the second surgery. Whether the implant is ready for the second surgery will be confirmed by taking an X-ray.
A new incision is made to expose the tops of the implants. A collar called a healing cap, is placed on the top of the implant after it is exposed which guides the gum tissue to heal correctly. The collar is a round piece of metal that holds the gum away from the top of the implant.
The collar will be in place for 10 to 14 days and will be removed after the tissue heals around the collar. Then an abutment is screwed into the implant and a final impression is made of the abutment for each tooth.
An abutment is screwed onto the implant and tightened in such a way so that it will fit properly. After the abutment is attached to the implant, a temporary crown is placed on the abutment. In some cases, you won't need a healing cap and you may get the abutment and temporary crown immediately after the implants are uncovered during the second surgery.
The temporary crown will be in place for four to six weeks. The gums will heal around it and will look like the gums around your natural teeth. The temporary crown is made of softer material than the permanent crown which helps to cushion and protect the implant from the pressure of chewing, and gives the jawbone the opportunity to gradually get stronger.
The crown can be created from a model of your teeth and gum tissue that includes the abutment which may take two to three weeks. The crown can be either cemented or screwed to the abutment.
A cemented crown cement may look better because there is no screw hole in the crown to be seen where as a screwed crown are easier for your dentist to remove if there is a requirement to reach the implant or the tissue around the implant.
Failure of implants because of infection is rare. Failure can happen if the bite has not been properly adjusted. Also clenching or grinding teeth can put a lot of pressure on the implant causing bone loss, and the implant to break or fail.
When the bone is being drilled or the implant is being placed in lower jaw, there is a possibility that a nerve that runs through the jawbone sometimes can be injured causing numbness or tingling.
It usually involves the lower part of the lip and chin or one side of the tongue. The numbness can be temporary, until the nerve heals, or it can be permanent. However, it is not common for the nerve to be injured as X-rays and computed tomography (CT) scans can help your dentist to see where the nerve is located and minimize the possibility of injuring the nerve.
In the upper jaw, there is a risk of drilling through the jawbone into one of your sinuses which is located above your upper teeth or nasal cavity. This could cause an infection. To avoid this, special X-rays are taken before your surgery to help your surgeon to determine where your nerves and sinuses are located.