Dental implants: An illustrated guide to tooth implant placement.

What procedure does a dentist follow when they place dental implants?

The following series of pages illustrate the steps that a dentist typically follows when they place dental implants. In most cases, a person's implant surgery can be performed right in their dentist's office.

What types of anesthesia are utilized with dental implant surgery?

A) Local anesthetic is usually all that is needed.

Most dental implant surgeries can be performed with the dentist just administering a local anesthetic.

While the general public typically refers to local anesthetic as "novocaine," it has not been used widely in dentistry for some decades. At this point in time it is most likely that the local anesthetic that a dentist will administer is lidocaine.

As you probably know, local anesthetics are administered by way of an injection (shot). In general, the anesthetic is placed in the "local" area where its effect is required. This same local anesthetic technique is the one that is used when a dentist places a filling or extracts a tooth for a patient.

B) The patient or dentist may determine that a deeper level of anesthesia makes a better choice.

1) Conscious sedation.

It can be possible that a patient's planned implant surgery may require conscious sedation technique in addition to the administration of a local anesthetic.

Conscious sedation refers to the use of a medication that causes the patient to become very relaxed or drowsy. The patient is still awake in the sense that they are responsive to stimuli (hence the use of a local anesthetic is still required) and all of their protective reflexes are functional. The idea is that this sedated state allows the surgical procedure to be a more pleasant experience for the patient.

2) General anesthesia.

Other implant patients may require general anesthesia when their dental implants are placed.

With this technique, the medication administered places the patient in a deep sleep. (One where the patient is unable to feel pain or move around.)

C) The type of anesthesia used may be influenced by expected treatment time or case difficulty.

A decision about which type of anesthesia should be utilized with a dental implant surgery may be influenced by case difficulty or expected treatment time.

• For simple dental implant surgeries which might take an hour or so (such as the placement of one or two implants), the use of just local anesthetic may be quite suitable.
• For more complex cases and those requiring longer surgical times, both the patient and the surgeon may benefit from the addition of conscious sedation or else general anesthesia technique.

How dentists place dental implants.

Step 1 - The dentist will access that portion of the jawbone where the dental implant will be placed.

Initially the dentist will need to access the bone that lies in the region where the tooth implant will be placed. To do so, the dentist will create a few incisions in the patient's gums that outline two separate flaps of gum tissue. The dentist will then use a hand instrument to push and peel each flap of gum tissue back, so the bone that lies underneath is revealed.

Once the gum tissue flaps have been raised, the dentist will evaluate the shape of the bone that has been exposed. Ideally this area of bone should to be relatively flat and smooth on top. If the dentist feels that the bone does not meet these conditions, they will use their dental drill to contour the bone so it takes on the needed shape.

Treatment variation: A less invasive way to access the jaw bone.

In those instances where there is no question about the suitability of the gum tissue and bone in the region where the tooth implant will be placed. And no concerns about being able to suitably position the implant itself. There is a chance that the surgeon can access the jawbone by way of using a tissue punch instead creating tissue flaps.

This technique involves using a circular punch to create a hole through the patient's gum tissue (one slightly larger in diameter than the planned implant). The implant drilling and placement process can then be performed through this hole.