Implant Types and Systems
There are three main implant systems used in the USA. Each implant system providers different sizes and types of implants with different attachment systems. Which implant type is used is often dependent on each patient and the condition of their dental health. Subsequently, what type of crown to be made is determined by what kind of abutment is required to attach to the implant. The most commonly seen implant crowns are abutment-supported crowns and screw-retained crowns.
2+ Unit Crowns/Bridges/Dentures
Like single unit implants, implant bridges and dentures provide more stability than their non-implant counterparts. These implant prosthetics stay in full contact with the gums, preventing food from getting caught underneath. By offering more points of attachment to the bridge, implant bridges can also be made to replace more missing teeth without compromising the structural integrity of the prosthetic. (Please note: an implant denture is also known as an "extended" implant bridge).
In general, implant bridges require at least two implants to secure the prosthetic crown. Longer bridges require more implants and surgeries may be scheduled apart to allow the patients to heal in between. Once all of the implants are completed, the standard four to six month healing process for the bone to fuse to the implants applies. In the meanwhile, patients can opt to make a provisional bridge or removable denture to cover up the missing teeth.
The Procedure: After the jawbone has completely healed around the implants, patients must return for Stage 2. On the next visit, any provisional bridges will be temporarily removed for the impression for the permanent bridge will be taken. The provisional bridge will then be re-cemented until the next visit when the implant bridge has returned. Depending on the type of implant, the bridge will either be cemented on or tightened onto the implants.
Before You Come In:Please consult with the doctor to see if you are eligible for an implant bridge. Low bone density and/or not enough spacing for a bridge requires more planning. Take antibiotics and painkillers as prescribed before and after the implant surgery.
What You Can Expect Afterwards: After the initial surgery, you may feel sore for a week or two. Avoid brushing your teeth near the implant and avoid extraneous exercise. Continue to take medications as directed. You should not feel the implant after it has healed. Return in a week or two to have the sutures removed. After the initial placement of the screw-retained bridges, the prosthetic may feel tight and occasionally need to be adjusted as you get used to it. Maintain bridge for lasting duration. Avoid eating hard material that may crack the bridge. Keep area clean and brush regularly to prevent gum disease which may cause gums to recede and create gaps under the bridge.
Screw-Retained Buccal View
Abutment for Crown
The Procedure: Approximately four to six months after the implant surgery is completed or once the bone has completely healed around the implant, the next step a small incision into the gums will be made to reveal the implant head - a quick painless procedure. A small round ring (collar) will be inserted to guide the tissue to heal around the top of the implant. (Some patients may not require Stage 2.) Once the gums has healed again, about two weeks, the abutment will be connected to the implant and an impression will be taken. The impression will be sent to a lab specializing in implant crowns. In the meanwhile, a temporary crown will be fabricated at the office and temporarily cemented or a healing cap will be inserted to protect the implant. Once the permanent crown returns from the lab (about two weeks) the doctor will make any additional adjustments chairside.
What if I had an implant done at another office?
The process to make the implant crown is the same as if it was done in our office. However, Stage 2 will be done with the dentist who performed the implant surgery. The dentist or oral surgeon should provide you with the implant system, type and size, Once those are available, please call us office for a consultation.
What if I don't have those information?
Please come in for a consultation and to take a x-ray. Dr. Lee will use her extensive knowledge of implants to help you figure out the correct information.
What if I'm from a different country?
Different implant systems and their associated tools are used all over the world. If we do not have the right tools, Dr. Lee may be able to troubleshoot or provide a temporary solution. Make an appointment to come in and let Dr. Lee take a look.
Please see our other section on removable implant dentures - overdentures. CLICK HERE.
Implants are long-term investments; great because they require little maintenance, last longer than regular crowns and offer more stability than normal crowns. They are also a convenient alternative to bridges which depend on the support of surrounding healthy teeth. They are becoming increasingly popular because they are anchored in the jawbone much like real teeth. And unlike bridges, they leave no gap between the gums and prosthetic where food may get stuck.
What is an implant?
The actual "implant" refers to the titanium screw (hypoallergenic and undetectable by metal detectors) that is surgically planted into the jawbone. Over time the bone will heal around the implant – making it a permanent part of the jaw. A connective piece, called the abutment, attaches to the top of the implant and provides a point of attachment for the implant crown.
How are visits scheduled for implant restorations?
Implants are typically completed in four to five visits over a 6 month – 1 year period. *Additional follow-up visits not included.
0 - Extraction & Bone Graft
1 – Implant Surgery (Placement)
2 – Suture Removal
3 – Stage 2 (Healing collar)
3/4 – Abutment seating and impression
4/5 – Permanent crown
The Procedure: The implant surgery starts with surgically pulling back the gums to reveal the jawbone. A special implant drill will create a hole for the implant to be planted. During this stage, if there is not enough bone to support an implant, an additional bone graft treatment will be performed. The gums will then be sutured closed and over time will heal over the implant. Typically, patients return a week or two after the surgery to have the sutures removed. After the initial placement surgery, the bone will naturally heal around the implant; solidifying around the body.
Before You Come In: It is recommended that you eat before each procedure, especially the initial surgery. Dr. Lee will prescribe antibiotics to be taken an hour before the implant surgery (four pills). Pain medication will also be prescribed for after the surgery. We ask patients to have their pharmacy updated for this purpose.
What You Can Expect Afterwards:After the initial surgery, you may feel sore for a week or two. Avoid brushing your teeth near the implant and avoid extraneous exercise. Continue to take medications as directed. You should not feel the implant after it has healed.
Implant Bridge Abutments Before Bridge Completion
Bone Graft Healed
Screw-retained crowns, as the name suggests, are held in by screws to the implant below. Abutment supported crowns, on the other hand, are permanently cemented onto the abutment - similar to regular crowns. The connecting screws and abutment are both dependent on the size, shape, and form of the top of the implants.
Screw- Retained Occlusal View
Abutment-Supported Implant Crown