The first step both in determining of whether implant procedure is possible and in the procedure itself is the analysis of standard orthopan image. If the patient decides to begin with the procedure, then 3D orthopan is also needed. After the analysis of 3D image, we will be able to determine is the jaw bone strong enough to receive the implant or it will be necessary first to strengthen the jaw bone with a layer of artificial bone. To be implant-ready, bone have to be of a certain height and a certain thickness in the region where the implant is needed, Also, implant cannot pass near the nerves.
After the detailed therapy plan is formulated, patient receives necessary medications which will help prepare the organism for implant placement. Also, patient has to sign a statement, declaring he/she is willing to undergo a dental implant procedure. The process of removing all the teeth indicated for removal is next, and it is advisable to finish this in one day, of course under sedation. The placement of screws can begin as soon as the wounds from the removal of teeth heal, which is a matter of days. It is also advisable to set all the screws in one day, when all the equipment is set and the patient is sedated, instead of dividing the process in several sessions. Placement of screws may take from 30 minutes to several hours for each screw.
The day after the insertion, the patient is examined and then send for four month rest until screws grow-in with the bone. If more than a few teeth are missing the patient will receive temporary denture to wear until he/she is ready for the permanent denture. If the patient chooses Nobel Active implant system he/she will get a temporary denture which if fixed to the screws (like a permanent denture) and not removable ones, which resemble traditional day-only dentures.
As the screws are becoming firmly part of the jaw, dental crowns are being made. The patient chooses the color, length and shape of crowns. To make the process absolutely precise, a mold is made by opening the screws for a short time of removing the temporary denture if the patient has one (in case of Nobel Active implants). After the mold is taken an abutment is chosen for each implant, according to its particular position and setting, and after that the permanent dental crowns are made, which takes 7 to 14 days.
During the placing of crowns it is necessary to make two or free tests in 7 to 10 days interval, to make final corrections possible, including shape, placement and color of crowns. After that, abutment is finally tighten and dental crowns are “cemented” which finishes the whole implant procedure.
After a few months it will be obvious if the implants have satisfactorily became a part of a patient’s jaw, which is the case in almost 99% percent of operations. Such high success rate is made possible in the first place by following the principle of only choosing implant treatment if all the preconditions are met. Patient can help implant integration by living healthy, especially avoiding cholesterol rich food.
Placing of implants is normally done in local anesthesia, by using special surgical sedation with prolonged effect. During the more complex implant procedures I advise patients to undergo a complete sedation, either orally or intravenously. A qualified anesthesiologist is always present during the whole procedure. In Cvejnanović dental practice we have a complete surgery room, absolutely sterile.
Of course there is. On one hand, the makers of implants are issuing warranties, even with worldwide coverage in some cases (Nobel Biocare for example), so in case of any problem the patient will get the replacement for free. In reality, extremely small number of procedures need any later work, as implants are fixed for life. Less than 3% of patients returns for any kind of repair work, and it is almost always in these cases the rejection of implant by the organism which causes the problem, and not the faulty implant or bad work by the dentist. All the patients with any problem whatsoever are immediately taken in for corrections, totally free, even if it takes a completely new set of implants.