Wait time to restore dental implants
June 21, 2016
Wait Time to Restore Dental Implants
Must we WAIT to restore dental implants? The biggest challenge with dental implants is the waiting game. In an era of immediate gratification, dental implants do not fit well. Despite all the advances we have, our bodies ability to heal and healing time can not be altered (as of now. Who knows the future?). Even when offices and clinics state that they can do “teeth in a day” they merely mean a provisional, or prototype/temporary, is placed and the final restoration will be delivered later after everything heals.
Variation in Bone Density
Different parts of the jaw have different bone density. This is important because the density will contribute to the immediate AND long term stability. Lower front jaw bone is VERY dense, but upper back jawbone is very SOFT. Implants can be placed, but the methods are different. So is the delay in restoring.
General Rules of Thumb in Wait Time to Restore Dental Implants
Every person is different, but generally speaking, we have some rules of thumb that we follow when restoring implants:
Lower front teeth: 3 months
Lower back teeth: 5 months
Upper front teeth: 5 months
Upper back teeth: 6 months
Osseointegration
The fancy term dentists use for “bone fusing to implants” is osseointegration. The root, os, means bone. So what we are saying is we need the bone and implant to integrate before we — USE them. If we disturb the process, then it simply fails and we must start over, but starting over ADDS to the process, so we start over “from behind”. This is another reason that we tell patients that dental implant treatment is a commitment of both money and TIME.
Immediate Load
In some cases, we can “load” implants right away. Load means “use”, or load the implant fixture with stress and bite forces. Not ALL cases can do this, but if we CAN, it can save considerable amounts of time.
Types of Bone
Beyond what you WANT to know is the types of bone. You may hear the term cancellous and cortical when referring to bone. Cortical bone is VERY dense, so while sturdy is “good” it is also difficult to drill into for implant placement. The lower front jawbone is almost entirely cortical bone. Most bone is cancelleous or trabecular bone with an outer layer of cortical bone. This means it may be difficult at the start of implant placement but becomes easier to drill during the remainder of treatment. It also means that a sensation of pressure may be felt while the implant is placed due to compaction of bone to make it more like cortical bone (for stability). If the bone can’t be treated in a way to make implants more stable, then we allow more time to pass to get better osseointegration.
Dental Implant Surface Texture
As technology improves, we are learning that the surface of implants speeds things up. The quicker things bond, heal, and become more stable, the sooner we can finish the case. The current thought is to roughen the surface (not smooth, and after milling the thread design) and bathe in acid. This induces the body’s healing factors and leads to long term success.
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