At the first appointment, photos and x-rays of the patient’s mouth are taken. Sometimes a special study is requested (CT scan), which is done in a specialised centre outside of the clinic. This study gives the doctors a precise view (even in 3-D) of the amount and quality of the patient’s bone, which is a great help in planning their treatment. It may be necessary to create a provisional prosthesis (splint) for the patient to wear while having the CT scan so the dentist can also see where the artificial teeth should go. The surgeon and the dentist, working as a team, decide how many implants, where they should go and how the final prosthesis should be designed.
The implants are put into the upper arch during the first operation. The upper jaw cannot be used for 7 days to 2 weeks so that the gums can heal. Afterwards, the dentist will adjust the provisional dentures (soft relining of the prosthesis) so the patient can wear it while waiting for the implants to be integrated (“soldered” into the bone).
On the upper arch, the bone should heal around the implants for 3 months, after which the patient has the second operation, to make sure the implants are integrated (“soldered” into the bone).In the second operation, the surgeon exposes the implants and inserts a second component that sticks out through the gum (called a healing abutment) and checks that the implants are completely fixed and no bone has been lost.
After waiting 7-10 days, during which time the patient cannot wear the prosthesis in order to allow the gums to heal, the patient must visit their dentist to readjust the provisional prosthesis.
After that, the dentist starts making the permanent prosthesis. These procedures include preliminary impressions, final impressions, wax moulds, metal tests, ceramic tests and inserting the prosthesis. After all of the adjustments have been completed to the patient and the dentist’s satisfaction, the patient can start with regular maintenance and re-assessment appointments.
Many patients with fixed prostheses on implants say they are very comfortable and that the replacement teeth feel and function like their own natural teeth.