First, it is necessary to carry out an examination and diagnosis: a mouth examination, clinical history, X-rays, models of the mouth and other complementary tests that the dentist requires based on each patient’s needs.
Once the case has been selected, the treatment consists of a series of stages, divided into a Surgical Phase and a Prosthetic Phase. Both phases are carried out by specialists and dentists with specific training and experience in the technique. If the patient does not have any teeth, it will not normally be necessary to carry out any preparatory treatment, but if on the contrary it is necessary to remove any teeth in poor condition, it will be necessary to wait until the gum has healed before fitting the implants (which may take 2, 3 or more months). However, nowadays we can solve many cases immediately, removing teeth, fitting dental implants, and then the fixed teeth just a few hours later (see dental implants and same-day teeth).
In turn, the surgical phase consists of two steps:
- First step: "Dental implant placement".
- Using a highly precise technique, the dental implants or fixtures are fitted into the bone. The operation lasts between 1 and 2 hours, and is normally done with local anaesthetic. Patients do not normally notice any significant discomfort either during or after the operation. In jaws without any teeth, between 4 and 6 dental implants are normally fitted, as in this case it is not necessary to fit one implant for each tooth.
- Second step: "connecting the healing abutment".
- The second step is carried out after a healing period of between 3 or 4 months, depending if the implants are fitted in the lower or upper jaw. This period is essential in order for osseointegration to occur, when the implants become permanently attached to the bone. At this point a small operation is carried out to connect sections called abutments to the dental implants. These are then used to attach the completed prosthesis in a later phase. During the osseointegration stage a temporary denture or bridge can be used, mainly for aesthetic reasons..
- Today this second step is not normally necessary, as the dental implant is fixed firmly in place and the healing abutment is attached in the same procedure.
Third step: prosthetic phase
- Once the gum has healed from the second surgical phase (more or less fifteen days), the Prosthetic Phase begins. A series of imprints of the mouth are taken, followed by between 1 to 4 visits to the dentist to evaluate the adjustment, functioning and appearance of the new teeth.
- Obviously, all of these stages must be planned suitably in advance.
- The new prosthesis will require regular care and check-ups in the same way as natural teeth, as although the new teeth will not suffer from caries, problems may occur at the point where they exit the gum.