Dental Implant

The procedures for
dental implant treatment would be:

Consultation

During this time X-Rays and CBCT scans will be taken to do a full assessment. Here the surgeon will check whether you are a good candidate for dental implants. He will assess whether the existing bone width, height are adequate for implant placement. If not then he will recommend procedures such a bone grafting to build a strong base for the implant. See more about bone grafting.

The CBCT scan is the latest technique to assess the bone width, height, and location of other important structures in 3-D. The scan can also be used to construct a computerized surgical guide to ensure an accurate implant placement. See more about CBCT.

You will then be advised regarding the total cost involved before deciding which is the best option for yourself.

Implant placement surgery

At the clinic, implants are placed under local anesthesia. It is a very safe procedure, and a local anesthetic will be gently administered with the least discomfort.
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The procedure will involve drilling into the bone and implant placed. The discomfort is usually minimum, and the surgical area will usually require closure with resorbable or non-resorbable sutures.
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Once placed, implants will need to heal for a period of 3 months for normal implants, or 6 months for immediate or those needing bone grafting.
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You will be provided with medications such as antibiotics and painkillers to go home with.
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Regular review appointments will be given to you during the healing period.

Stability of the After-Surgery

After the healing period, an OPG x-ray will be taken to check the bone integration is complete. The implant will then exposed with or without local anesthesia. The implant strength/stability will be tested using the OSSTELL system.

Crown Placement

Once the implant is ready for loading, then crowns can be constructed. At Bangsar Utama Dental, single implant crowns are prepared using the CEREC system. Here, digital scanning is performed, crowns designed, and then milled on-site.

The time taken for a single crown is approximately 2 hours. It means that the crowns will be ready on the same day.
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However, multiple-unit implant bridges will take around 2 weeks to complete.

Single Tooth Dental Implant

The most common procedure in implantology is replacement of a single missing tooth.

The causes of single tooth loss could be:

Trauma – fall, accidents
Badly carious tooth
Periodontal (gum) problem

The advantage of using dental implant to replace a missing single tooth:

Wearing cumbersome removable plastic denture can be avoided
Unlink bridge treatment, trimming the adjacent teeth is not needed. Thus, reducing the lifespan of the other tooth
Future issues can be managed individually without involving other teeth
The normal gum contour can be preserved, especially for front teeth, resulting in better aesthetic

For single tooth replacement, 2 techniques can be used, depending on the suitability after clinical assessment. The techniques are:

1) Conventional :

Extraction of the tooth is carried out and the socket is allowed to heal for a few weeks. Then surgery is carried out to place the implant under local anesthesia. Bone grafting might be required, depending on the bone level at the time.
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After placement, the implant is allowed to heal for 3 months before the crown can be made. A temporary prosthesis will be provided during this period (for eg denture). In our practice, Cerec Cad Cam crowns are used. This means the crown will be ready and issued on the same day.

2) Immediate implant:

If no infection is present, the tooth can be extracted, and the implant placed at the same time. Bone grafting might be required. Temporary prosthesis will be provided. With this procedure, a longer healing period of between 4-6 months is necessary.

Implant Bridge

Implant bridge can be used in cases of multiple missing teeth. Here, fewer implants can be used to replace a few missing teeth. For example, 4 missing teeth can be replaced with a 4-unit bridge supported by 2 implants only. A full mouth implant bridge can be provided for edentulous (all teeth missing) patients.

The advantage of using implant-supported bridges:

Less number of implants used (compared to using single tooth implants) in replacing
multiple missing teeth, thus lowering the cost
A simpler surgery
Can choose the area with enough bone for implant placement, thus reducing the need for
complicated bone grafting procedures

Our specialist will discuss with you the details of the procedures required, the best treatment option once we see you personally at the clinic for your consultations. Investigations necessary would be OPG X-ray, CBCT scans, and study models.

Implant-Retained Dentures

The other option for dental implant treatment is using removable plastic dentures. As the name suggests, the dentures can be removed by the user without having to go to the dentist. This facilitates cleaning, the denture can be easily cleaned under the tap after a meal and during nighttime. The dentures are usually made of high-quality plastic, with a metal base for extra strength.

This denture type is typically much smaller than conventional dentures so it is more comfortable to wear. Using this method, less number of implants can be placed (compared to implant bridges). That means less surgery and at a lower cost. Although the denture can be removed, once locked into the implants it is very firm and the wearer can enjoy an almost normal diet.

The advantages of using dentures, especially for totally edentulous patients are:

Less surgical procedure, hence less post-operative discomfort
Lower cost
Easier to clean and easy to maintain
Very firm in place compared to normal dentures
Dentures can be made smaller for more comfort
Reduce the need for additional bone grafting procedures in most cases

For edentulous cases (all teeth missing), usually requires 4 implants in the upper jaw, and 4 implants in the lower jaw. Compared with implant bridges which requires double the number of implants.

Bone Grafting (Augmentation)

What is Bone Grafting?

Bone grafting is a procedure where bone is used to reconstruct areas in the jaw with inadequate bone, so that implants can be placed. The source of bone can be either patients' own bone, of artificial bone (calcium particles).Diagram below shows the sequence of events following a tooth loss. The alveolar bone will gradually recede, leaving bone which is much smaller than before. The reduced bone height is inadequate to support a denture, and makes implant placement impossible.

Inadequate bone, post dental extraction.

Bone grafting procedure to rebuild the lost bone.

What is Bone Grafting?

What about sinus bone grafts (sinus-lift)?

In some patients, the maxillary sinus is too close to the planned implant site, and it needs to be bone grafted. We use specialized instruments, (piezo surgery) to gently lift your sinus membrane up, and place bone beneath it, in order to successfully place an implant.