Dental Implant Placement
A dental implant can be placed into the jawbone in a flap or a flapless manner. In a flap procedure, gums are peeled away from jawbone and a hole is made in the jawbone to accommodate the placement of the implant screw. In flapless approach, the hole is directly made through the gums into the jawbone without peeling the gums away from the jawbone.
After the placement of the implant screw, periodontist will place either a cover screw or a healing abutment over the top part of the implant screw. If a cover screw is placed, the patient will need to come back at appropriate time to have the cover screw replaced with a healing abutment prior to the start of implant crown fabrication. The purpose of placing a healing abutment is to contour the gums around the future implant crown in order to make the gums look nicer around the crown. Because healing abutments are hand-screwed into the implant screw, sometimes healing abutments may become loose. If so, do not worry because the periodontist can easily screw back the healing abutments.
An implant screw typically needs about 3 months to integrate with the jawbone. In situations where there is a deficiency of jawbone that simultaneous bone grafting is needed at the time of implant screw placement, then this period may be lengthened. During the period where the patient is waiting for his/her implant screw to integrate with jawbone, the dentist will provide patient with a temporary tooth in the form of a denture (“flipper”), a retainer, a bridge, or others.
In more advanced situations where maximizing the gum contour around the future implant crown is required, the periodontist may inform the restorative dentist to give the patient a temporary implant crown to wear for a period of time before giving the patient the final implant crown. This is critical especially at the front teeth where esthetics is important. Sometimes, an additional gum grafting may be required around the implant to maximize implant esthetics. Remember, an implant crown needs to have healthy and natural looking gums to look nice!