Dental implant surgery: Creating a hole in the jaw for the tooth implant.

What is the procedure that a dentist follows when they perform dental implant surgery? (continued)

2) The dentist will identify the proper location for the dental implant.

Once the bone has been accessed, the dentist will ultimately use a series of drills, each of increasing diameter, to prepare a hole into which the dental implant will be placed.

To start this process, the dentist will first use a small round bur (a dental drill bit) to make a divot in the bone. This divot both penetrates the hard, outermost layer of bone and helps to insure that the placement of the pilot drill (the first drill bit used deep inside the jawbone) is easily centered in the implant site.

3) Creating the pilot hole for the dental implant.

The first bone drill that a dentist will use when placing a dental implant is termed a pilot drill. A pilot drill is simply a small diameter drill bit which, as its name implies, is used to create a hole that acts as a guide for other drills. The hole created by a pilot drill is typically too small to accommodate an implant but creating this initial hole allows the dentist an opportunity to evaluate the alignment and depth of the hole in which the dental implant will ultimately be placed, once it has been enlarged sufficiently.

When using the pilot drill the dentist may make use of a plastic jig (that they have created ahead of time on plaster casts of the patient's mouth) that is positioned over the implant site so to help guide the pilot drill's orientation. Initially the pilot drill is used to create a hole about one third to one half of the length needed for the dental implant.

4) The dentist will evaluate the initial positioning of the implant pilot hole.

Once the initial portion of the pilot hole has been created the dentist will insert an alignment pin into it. The idea is that the alignment pin allows the dentist a chance to check the orientation of the pilot hole being created. If its alignment seems to be off target (such as tipped too far in one direction), since this hole is only half as deep as it will need to be, its orientation can still be corrected.

5) The dentist will finish drilling the dental implant's' pilot hole.

After checking the initial positioning of the pilot hole and taking note of any needed adjustments, the dentist will resume the drilling process with the pilot drill. This time the dentist will allow the drill to create a hole long enough to accommodate the full length of the body of the dental implant that will be placed. Measurement markings found on the pilot drill help the dentist to gauge this depth.

{ It is essential that the dentist does not overheat the bone during the drilling process. Over heating the bone can result in bone cell death which, in turn, will prevent the successful osseointegration of the dental implant. So to avoid the potential for over heating, the dentist must know that the bone drills they are using are sharp and that they are not used in a manner where excessive drill speed or pressure is involved. During the drilling process the dentist must continuously irrigate the tooth implant site with saline as a way of minimizing the amount of heat being generated. }

6) The dentist will perform a final check of the dental implant's pilot hole.

The dentist will reinsert the alignment pin into the now completed pilot hole. This will allow the dentist an opportunity to confirm that the overall alignment and positioning of the hole is suitable. Additionally, the measurement markings on the pin allow the dentist to confirm that the depth of the hole is sufficient to accommodate the length of the planned tooth implant.

In those cases where the positioning of the dental implant relative to anatomical structures is a concern, the dentist may take a x-ray of the implant site while the alignment pin is in position so they can evaluate this relationship.