Treatment Phase 2: Surgery
Dental implant surgery can either be performed in-chair at Fremantle Implants, or in a theatre setting at Southbank Day Surgery in South Perth.
Adjunct surgical procedures, such as bone grafts, may be performed at the same time as the implant placement.
Stage 1: Placing the Implant
The implant is surgically placed in the jaw bone and underneath the gum. The implant will become the “root” of the replacement tooth.
The experience, skill and sensitivity of the practitioner are critical when placing the implant. The implant is screwed into place with a specialised torque-controlled drill to avoid overloading and damaging the surrounding bone.
Overloaded bone can die; a condition called osteonecrosis. The implant may then fail to fully integrate with the jaw bone. Bone loss may also occur around the implant.
An inexperienced dentist may damage the bone cells in the implant site due to overheating from a high speed drill. The bone may then not regenerate and lead to bone loss around the implant.
The gum, or a healing cover screw, will protect the implant while it is healing.
The healing period is between three to six months. This is determined by the bone density at the implant site.
Stage 2: Connecting the Healing Abutment
The second stage involves revealing the implant by cutting open the overlying gum, so that a healing abutment can be placed on top of the implant.
The healing abutment prepares the way for the final abutment which will connect the prosthesis to the implant.
The healing abutment is exposed above the gum. The gum is allowed to heal around the abutment to form a cuff or collar.
A temporary prosthesis, if one is used, can be attached to the healing abutment at this stage. This temporary prosthesis is for aesthetic reasons only and not functional. The abutment needs to be protected from chewing forces during this period to assure effective bone integration and healing.
The practitioner will also take this opportunity to check the implant for successful integration with the jaw bone.
Single Stage Surgery
In some cases such as a single tooth implant, it is possible to place a healing abutment at the same time as the implant.
The healing abutment is exposed above the gum and will protect the implant during healing.
The healing period is between three to six months.
This has certain limitations but can eliminate the need for a subsequent surgery to expose the implant and place the healing abutment.
Placing an Implant Immediately After Extraction
When a tooth is extracted, a dental implant can be placed into the site immediately. This means we don’t need to wait for the site to heal first before performing a separate surgery to place the implant.
Doing it this way not only shortens the treatment time, but it can also improve aesthetics because the soft tissue is preserved.
Implants placed this way can have a slightly higher rate of initial failure because the bone of the extraction site won’t have time to strengthen up before the implant is placed.
Instead of an implant, a bone graft is sometimes placed inside the hole left by the extracted tooth to maintain bone volume. When this has integrated with your jaw bone, the implant will then be placed in a separate surgery.
Choosing the Best Approach
The choice of one or two-stage surgery primarily depends on how best to reconstruct the soft tissue around the lost or extracted teeth, and how to maximise osteointegration. Both of these are key factors for the long term success of your implant.
We can help you understand your options, and recommend the best approach for your specific situation.
We offer a range of anaesthesia options such as gas (nitrous oxide) or IV (intravenous) sedation. For your safety, we always use a qualified anaesthetist.
General anaesthesia is only used in a theatre setting whether there is a supporting team of surgical staff.
Dr Chan is accredited to operate at Southbank Day Surgery.