When is an implant placed?

An implant is an artificial root that can accommodate different types of prostheses

An implant can be placed either immediately after a tooth extraction or after the bone and gum have healed.

The surgical procedure is often simple and painless. It is performed under local anesthesia, as for treating a cavity.

The definitive prosthesis is made after the bone around the implant has solidified (within 2 to 6 months).

In certain conditions, a temporary prosthesis can be placed immediately after the implant is placed.

Indications & contraindications:

Implants can have a lifespan of several decades

To place an implant, the volume and quality of the jawbone must be sufficient. These parameters are generally assessed using a scanner.

However, it is also possible to increase bone volume using a bone graft. It is also important that the neighboring teeth and gums are healthy.

Absolute contraindications are rare: these are mainly irradiation of the face, or a high risk of infective endocarditis (infection of a heart valve by bacteria from the mouth).

Relative contraindications are more frequent: poor hygiene, smoking, unbalanced diabetes, etc.

Our advice:

Implants are a solution of choice because they can replace one or more teeth without affecting the other teeth, and offer a prosthesis that is both fixed and comfortable.

Implants have a lifespan of several decades.

If you are concerned, you must, like all implant wearers, observe extremely rigorous dental hygiene and carry out check-ups very regularly.

Implant planning & guided surgery

For complex cases, implant planning using computer software is necessary in order to obtain precise surgical placement of the implants.

This planning allows to optimize both:

the 3D spatial positioning of the implants in relation to the available bone structure.
the desired final prosthetic aesthetics.

This planning will result in the creation of a surgical guide that will allow the use of minimally traumatic surgical techniques, while reducing the total duration of the procedure and therefore postoperative edema.

Implant-supported prosthesis

Different types of prosthesis can be made on implants, in the same way as on the root of the teeth.

The implant is a support of choice for different prostheses

Aesthetics remains a constant concern of the practitioner

Prosthesis fixed on implant:

Implants replace the roots of the teeth. Crowns and bridges can therefore be made on implants as well as on the roots of the teeth.

One or more impressions are taken at the level of the implants; the crown or bridge are then made by a dental technician and are fixed to the implants by screwing or gluing.

Removable prosthesis on implants:

Removable prostheses, whether partial or complete, can be stabilized by implants. Implants can be put in place before the prosthesis is made or under an existing prosthesis.

The prosthesis is fixed to the implant(s) by means of attachment that often take the form of small snaps or bars.

In some cases, stabilizing a partial removable prosthesis allows the removal of hooks that would be unsightly.

Immediate loading of a prosthesis on an implant (IMF)

Specific surgical technique for placing a temporary fixed prosthesis immediately after implant placement.

In most clinical situations, it is necessary to wait 2 to 6 months before fixing a prosthesis on an implant.

This is the time required to obtain "osseointegration".

To obtain this integration with the bone, the implant must not be stressed during this critical period, otherwise there is a risk of failure.

In certain favorable cases, however, it is possible to place a temporary fixed prosthesis very quickly on the implant: this is immediate loading.

One situation is particularly suitable for this loading: that of the anterior teeth visible when smiling.

It is possible to place a temporary tooth on the implant when an anterior tooth is to be replaced and the bone conditions allow it.

This requires:

Excellent stability of the implant at the time of placement.
Do not bite on the temporary tooth for a period of 2 to 6 months, i.e. during bone integration.

The prosthetic tooth is also designed to be slightly smaller in order to avoid any contact with the opposing teeth.

ADVANTAGES

Fixation of the implant-supported prosthesis a few hours after implant placement.
Rapid restoration of aesthetic and functional needs.
Reduction in the number of sessions required for treatment and post-operative follow-up.
Elimination of the fear of a period of toothlessness when placing an implant.
Absence of discomfort linked to the instability of a removable temporary prosthesis.

GOOD TO KNOW

The objective of immediate loading is not to chew immediately on the prosthesis but to provide a solution of comfort and an aesthetic aspect.

Whenever this intervention is possible, it saves time while maintaining the same success rate for implant placement.

Prosthesis completion times after implant placement:

Generally speaking, we wait until an implant is well integrated into the bone in which it was placed to make the prosthesis (between two and six months).

With the evolution of implants, this period tends to decrease; in some cases, it is possible to make a temporary prosthesis immediately after implant placement. This allows, especially for anterior teeth, to have a completely aesthetic temporary prosthesis.

Implant prostheses must be regularly monitored in the same way as prostheses on natural teeth.

Rigorous dental hygiene helps limit the risk of infection that would cause loosening at the implant level in the same way as at the teeth level.

Implant maintenance

While the success rate of implants is now undisputed, their lifespan nevertheless depends on careful maintenance and attentive monitoring.

AFTER IMPLANT PLACEMENT:

The success of the treatment requires meticulous daily care on your part as well as regular follow-up in the office to monitor your gum health and the bone level around your implants.
Implant maintenance allows for the detection of possible complications as early as possible: bone loss around the implant, loss of gums or implant mobility.

"It is essential to have your implants checked every year."

IMPLANT COMPLICATIONS:

Infectious complications: as with tooth roots, implants are subject to external "attacks" (bacteria, acidic foods, etc.). There may then be a loss of tooth tissue, this is called peri-implantitis.

This is an infectious phenomenon caused, among other things, by insufficient cleaning around the implants.

Mechanical complications: rarer, these complications are similar to fractures of the implants themselves, or of the screws used to fix the prosthesis in the implant.

PREVENTION OF COMPLICATIONS:

Prevention of infectious complications involves careful cleaning of the gum/implant junction, at least twice a day, with meticulous brushing using a toothbrush and interdental care instruments (dental floss or interdental brush).
It must be combined with professional cleaning in the office, once or several times a year, depending on the recommendations adapted to your case.
Prevention of mechanical complications involves regular monitoring of the occlusion, i.e. precise adjustment of the contacts between the teeth. These adjustments are made by light grinding of teeth or implant prostheses.

PLEASE NOTE:

The implants are perfectly well integrated, without any risk of allergy and remain sustainable with daily oral hygiene.

Professional cleaning in the office is crucial for the preservation of your implants. It will eliminate plaque or tartar deposits in areas that you do not have access to.

Pain & Dental Implants

After the placement of a dental implant, the post-operative effects (discomfort, hematoma, possible pain) are managed in a manner adapted to each individual.

WHAT ARE THE POST-OPERATIVE CARE?

After the placement of implants, various reactions may appear:

Pain: this mainly depends on the extent of the intervention, i.e. the number of implants placed in the session. Furthermore, post-operative pain varies greatly from one person to another. Generally speaking, for the placement of 1 or 2 implants, there is no or little pain.

For more important procedures, discomfort is to be expected for a few days.

Edema: this is a swelling of the gum and cheek linked to the inflammatory reaction that follows any surgical procedure. It is often present in a very slight way.

In some cases, it can be more significant.

A hematoma: this is due to internal bleeding that persists temporarily after the procedure and occurs occasionally. When it is extensive, it can seem impressive but it is rarely worrying.

When these postoperative effects seem to you to be greater than your dentist expected, do not hesitate to report it to him quickly in order to detect a possible complication.

STRESS AND PAIN MANAGEMENT

Stress and pain related to dental implant placement can be prevented and treated effectively with a well-adapted prescription, in line with your state of health and the importance of the planned intervention.

GOOD TO KNOW

Follow the post-operative advice given carefully and do not wait for the first signs of pain to begin treatment.

If you cannot tolerate the prescribed medication or if it does not seem effective enough, we will modify the treatment.

Your implant passport

The implant passport given by your practitioner after the procedure allows the traceability and monitoring of your new implant.

Implants can resolve, in a fixed and lasting manner, the majority of aesthetic and functional problems linked to the loss of a single tooth as well as partial or complete edentulism.

In the event that an implant revision is necessary, and so that you are monitored as best as possible, it is important that the practitioner concerned has as much information as possible on the work previously carried out.

Dental surgeons and the National Order of Dental Surgeons (ONCD) therefore offer you an implant passport.

This passport is intended to be given to you. It meets the various standards in terms of traceability and allows you to track your implant device and its progress.

A TWO-PART PASSPORT

The “Implant Surgery” section mentions the name of the implant, the name of the manufacturer and the batch number, the position of the dental implant, as well as its length, diameter and composition.
The “Supra-implant prosthesis” section specifies whether the prosthesis is fixed or sealed, the type of cement used (temporary or permanent) and its batch number, the material used for the prosthetic abutment and the fixed prosthesis...

WHAT TO KNOW

Keep this document carefully so that it is accessible at all times and wherever you are.

PRE-IMPLANT SURGERY

Pre-implant analysis:

The placement of dental implants requires in-depth preparation, carried out using various examinations.

PROSTHETIC PROJECT IMPLEMENTATION

When it comes to simple prosthetic projects (one or two teeth), treatment planning is relatively easy.

For complex projects, a more in-depth analysis is sometimes necessary, with the creation of various "models" or "guides" to anticipate and predict, on models and/or in the mouth, the position of the future prosthetic teeth.

Fully computerized planning can also be implemented.

A dental and oral examination will be carried out in order to assess the condition of the area to be implanted and to look for possible cavities or gingivitis, to be treated prior to the problem of missing teeth.

SURGICAL PLANNING

Once the prosthetic project has been validated, the surgeon must see under what conditions it is possible to place implants to support the future prosthesis. The bone volume is analyzed to determine whether or not a bone graft is necessary.

The length and diameter of each implant are also determined at this time.

The patient's state of health is taken into account during the preliminary analysis.
The preparation and placement of implants are carried out according to a well-defined protocol.

Pre-implant bone grafts

In order to ensure good anchoring, implants must be placed in a sufficient bone volume, increased if necessary by a graft.

The bone volume available to place the implants is assessed using three-dimensional imaging techniques that quantify the height and thickness of bone available in the area to be implanted.

The most common examinations for an analysis of the bone volume of the jaws are the scanner and the Cone Beam (3-dimensional panoramic X-ray).

These X-ray examinations are not reimbursed by Social Security.

How is bone grafting performed?

There are different types of bone grafts. Depending on the type of graft performed, the procedure can be performed in the office or in the clinic, under local or general anesthesia.

In all cases, the procedure is performed under very strict aseptic conditions in the operating room.

In general, there are two types of bone grafts:

Autografts: the bone is taken from the person receiving the graft. The bone is most often taken from the jaw, near the area to be grafted. For larger grafts, the bone can be taken from the skull.
"No-harvest" grafts: the bone defect can then be filled with different materials of synthetic, human or animal origin. In all cases, these materials undergo a series of treatments guaranteeing them very high safety of use.

What are the after-effects of the procedure?

The after-effects of a bone graft depend on the nature and extent of the graft.

As with any surgical procedure, pre-implant bone grafts are followed by a healing period, during which pain or swelling may appear.

GOOD TO KNOW

To ensure that this healing period takes place in the best possible conditions, you will be given medication prescriptions and post-operative advice.

Intra sinus bone graft or Sinus lift

When placing dental implants in the upper molars, the surgeon is often faced with a lack of bone volume.

NATURE OF THE BONE GRAFT

To place the graft, access must be made to the inside of the sinus. Two main techniques are described:

The lateral approach: it allows for large volume grafts. Access is made on the external wall of the maxillary sinus to obtain a wide visibility of the operating area.
The crestal approach (or osteotome technique): this technique is reserved for small volume grafts.

The material is pushed into the bottom of the sinus by the implant drilling well.

Four steps characterize this grafting technique:

Detachment of the gum.
Access to the maxillary sinus.
Lifting of the membrane.
Placement of the graft.

The graft will resorb and be replaced by the newly formed bone resulting in a thickening of the sinus floor.

Depending on the situation, the implants can be placed simultaneously with the bone graft or in a delayed manner.

CONTRAINDICATIONS TO SINUS LIFT

Contraindications to sinus lift are rare.

As before any surgical procedure, the patient's state of health will be checked beforehand. The state of the sinus must also be the subject of particular attention and, in case of doubt, an ENT opinion will be requested.

POST-OPERATIVE CARE

The post-operative course of sinus lift is most often simple and not very painful.

Edema, slight bleeding and a hematoma may appear. In all cases, following the prescription and advice of your dental surgeon is imperative.

GOOD TO KNOW

During the first few weeks, avoid stressing the operated area.

Smoking is still a contraindication.