How long does dental implant treatment take?
There are many different reasons why people have dental implants. Some want implants to replace teeth that have been missing for a long time or to help retain or eliminate dentures. Others may need an implant to replace a tooth that has been recently extracted because of decay, gum disease, infection or injury. In some cases, a tooth can be extracted and the implant placed in the gap immediately. Length of treatment varies depending on the type of implant procedure. The number of implants placed, their location in the mouth and whether bone grafting is required, can also affect how long treatment can take.
The time frame for fitting the implant and replacement teeth can depend on many different factors. Placing a single implant may take about half an hour, several implants will naturally take longer. But it is important to remember that the entire process, from start to finish, can take several months.
Treatment can take longer if the tooth was extracted due to an infection in the root or gum. Your dentist may wait a few months after removing the tooth, to allow the infection to clear, before placing an implant. Also, if bone needs to be built up in your jaw before implants can be fitted, you will need bone grafting, which will increase the length of time your treatment will take.
Stages and timescales
Dental implant treatment is usually a two-step process. Following any preparatory treatment, such as extractions or bone grafting, a titanium post is placed into a new, healing or healed extraction site. This will eventually act as your new tooth root. The implant post may then be completely covered and hidden beneath a layer of gum (you won’t be able to see it in your mouth). The stitches are normally removed or dissolve by themselves after seven to fourteen days.
Alternatively, during this first stage, the dentist may attach a healing abutment (sulcus former) to the implant and close the gum around it. Dr Ian Hallam of Meon Dental, Petersfield explains, “This shapes the gum during the healing phase and avoids the need for another surgical appointment later to expose the implant. The impression stage can be completed, once the implant is integrated.”
Dr Alan Carter of Dentistry@No3, Dunfermline adds, “In most cases we fit the sulcus former with the implant at the initial surgery. Therefore, usually, the only time a local anaesthetic is used, is at the implant placement stage. The subsequent implant procedures are often carried out with no need for local anaesthetic.”
In a straightforward case, many dentists will want to leave the gum to heal and the implant to fuse (osseointegrate) with the jawbone, before fitting permanent, replacement teeth. There is usually a period of healing lasting from six weeks to six months. The upper jaw usually takes a little longer, due to softer bone. The bone in the lower jaw can be denser, which speeds up the process.
You may also need to make several visits to your dentist during the following few weeks, for the adjustment of temporary teeth or dentures and so that the healing of the implant site can be monitored.
At the end of the required healing period, if a healing abutment (sulcus former) was not placed during the initial surgery, a second procedure takes place. This involves making a new incision into the gum to uncover the top of the implant. Sometimes, extra time may be needed for your implant to fuse and integrate with the bone. If the site has healed well, your implant dentist will then place the abutment, which connects your new artificial tooth to the implant post.
In some cases, the first teeth fitted to your implants are not the final ones, but a prototype of the planned design. This allows the implant dentist to check the implants and determine when they are ready to support a permanent tooth. The temporary teeth also give the gums time to mature around each implant and can help with aesthetics, particularly if the teeth involved are at the front of the mouth and visible.
The final replacement teeth are generally fitted between three and nine months after the implants were placed. Your dentist will make sure that they fit properly, match your other teeth and feel comfortable.
Regular examination and hygiene appointments are important to keep your teeth and gums clean and healthy, in particular around the implants. It is important to meticulously clean around the implants every day. Learn more about the main steps of dental implant treatment.
What are ‘same day implants’ and ‘immediate restoration’?
‘Same day implants’ or ‘immediate restoration’ is when the crown, bridge or denture is fitted on top of a dental implant or implants straight away. This means you can be provided with replacement teeth on the same day.
Dr Colin Neil of Confident Dental Implants Centre, Stroud says, “For it to be possible to attach teeth to the implants on the same day, it is important that the implants have sufficient stability. Sometimes it may be necessary to extract teeth and allow the sockets to heal, with or without bone grafting, before the implants can be placed. During this time a temporary restoration can be provided. However, in many cases, with thorough planning and the latest techniques, I find it can be predictable and preferable to provide fixed provisional implant teeth on the same day as extraction. This can be carried out in the lower or upper jaw.”
Several implants are usually fitted, and a few hours later, a complete arch of temporary or permanent teeth can be fixed in place. Some precautions are needed after surgery to allow the implants to integrate successfully with the jaw bone. Not all patients are suitable for immediate restoration and need to discuss this treatment option with their dentist at the planning stage.
According to Dr Dermot McNulty of Bath Spa Dentistry, “The decision whether to immediately place or delay insertion of an implant depends on a number of factors and no specific rules apply. An immediate approach will both reduce the number of appointments required, the duration of treatment and most importantly, usually involve only one surgical visit. Immediate implants have tremendous advantages but must not be used unless the ideal situation presents itself. ”
How does bone grafting affect the length of treatment?
If your dentist advises that you don’t have enough bone to support an implant, then you may be able to have the bone built up. The process is called bone grafting and it will usually increase the length of time your treatment will take.
You may need bone grafting if the bone in your jaw has shrunk. This can happen when the bone is not in regular use or as a result of infection. It is a natural process called resorption. Resorption shrinkage can take place when a gap is left, after a tooth has been lost. It also occurs with natural ageing and under a conventional denture. The pressure of a denture on the gums during chewing reduces the blood supply, which can also increase the rate of bone loss.
Minor bone grafting can be carried out on the same day as the implant placement. It may be necessary to provide the bone grafting first in a separate stage, depending on the volume of bone that is missing. After a bone graft, you can expect to wait four to six months for the bone to heal successfully, before having implants placed in your jaw. When appropriate, temporary teeth can be made, so you don’t have a gap during treatment.
Bone grafting provides a firm base and will greatly improve the outcome of the implants. If your bone volume needs to be increased, the extra time involved to improve its quantity and quality, is usually time well spent. Find out more about bone grafting.
Plasma Rich Growth Factor (PRGF)
To speed up the recovery period after implants, some dentists are using Plasma Rich Growth Factor (PRGF). This is a technique used to regenerate bone and soft tissue using a small amount of your own blood. The blood is placed in a centrifuge machine and spun. This separates the proteins, which are responsible for the healing of the wound, from the blood plasma. It is then applied to the area where tissue regeneration is necessary. The growth factors in PRGF stimulate and accelerate the body’s natural repair process, which is why it is beneficial in the post-implant healing process.
PRGF is already being used very successfully to aid recovery times in many other areas, including maxillofacial, cardiac and reconstructive surgery.
Other implant options
If you suddenly lose a tooth or know you are about to lose a tooth, then you may be able to replace it with an ‘immediate dental implant’. For this technique a tooth is removed and an implant placed immediately into the extraction site.
If you act quickly, usually within 48 hours before the gum grows down into the socket, then you can have a dental implant titanium post placed into the exact spot where your old tooth used to be. Before the procedure, it is important that this area is infection free and that there is enough bone. Depending on the condition of bone in your jaw, a replacement tooth can be fitted after a sufficient healing period.
Another option your dentist may consider is an ‘immediate implant and early loading’. This is different to immediate implant placement. It is where an implant can be placed into a new, healing or healed extraction site and is fitted with a new tooth at the same appointment. The temporary tooth is usually kept out of direct contact with other teeth for about three months, to allow it to heal. Then the implant can be permanently restored with the final crown.
Both of these placement options are not suitable for all patients and will need further discussion with your dentist.
Will I have teeth during the treatment?
If the teeth being replaced by the dental implants are visible, you are most likely to want to have some temporary teeth during the treatment period. Your dentist may attach replacement teeth on the same day that you have the implant, or you may have to wait several months to allow your mouth to heal. To avoid having spaces between your teeth or no teeth at all, you can be fitted with a temporary denture or bridge. If you already have full dentures, they can be modified to allow you to wear them when you are undergoing treatment.
Are implants worth the wait?
Dental implant placement and the fitting of replacement teeth typically requires at least two stages and can vary between six weeks and six months. There is a good reason for these timescales. Implants become part of your anatomy when they fuse and anchor with your jawbone. This can make them as strong and reliable as healthy, natural teeth.
Dr Alan Carter at Dentistry@No3, Dunfermline, concludes, “Implant treatment is not a race, let the body and your new implants heal at their natural pace, and then enjoy your new tooth or teeth for a very long time to come.”
If your implants are well cared for, and if the bone they are fitted to is sufficient, strong and healthy, you can expect them to last for many years. While six months may seem like a lengthy treatment process at the time, the long-term benefits of implants can certainly make them worth the wait.
Individual timescales and issues specific to your case can only be obtained from your implant dentist. After consultation and treatment planning, your implant dentist can give you some idea of how long your treatment is likely to take.
This article was written with advice from: