The Process of Getting Dental Implants: What to Expect

Dr. Lieblick: Welcome back to Oral Surgery Insights. I’m Dr. Russ Lieblick. Dr. Brandon Rehrer is with me again today, and Brandon, we’re set to discuss a subject that truly highlights some of the most significant ways we can restore both function and aesthetics for our patients: the dental implant process.

Dr. Rehrer: It’s a key part of modern dentistry, Russ, and definitely a major focus in our surgical practice. Tooth loss, unfortunately, is still a common problem, whether it's from advanced decay, gum disease, an injury, or even conditions people are born with. Understanding the whole journey of getting dental implants can be very helpful for patients thinking about this excellent way to restore their teeth.

Dr. Lieblick: Absolutely. When people lose teeth, it affects more than just their ability to chew. It can change how they speak, their confidence, and even the overall shape of their face over time. Dental implants offer a remarkably effective and lasting solution, designed to act and feel much like natural teeth. We're essentially giving them a new, strong foundation where a tooth once was.

Dr. Rehrer: The technology and surgical methods have created one of the most successful treatments in medicine or dentistry. The whole process happens quickly and easily for patients. On our end it needs careful planning and execution, but the outcome – a fully restored, functional, and natural-looking smile – can be truly life-changing for many. Our goal today is to walk our listeners through what that process usually involves.

Dr. Lieblick: I think most will find it’s way easier than they think. The journey always starts with an initial consultation. This is much more than a quick check; it’s a detailed look into the patient's specific situation, their overall health, and what they hope to achieve with the treatment. This early groundwork is so important for creating a successful plan.

Dr. Rehrer: Precisely. We begin by carefully reviewing the patient’s medical and dental history. Certain health conditions or medications can affect treatment planning or how well they heal, so getting the complete health picture is essential. After that, we do a detailed clinical exam of the mouth, looking at the existing teeth, gum tissues, and the areas where implants are being considered. We check tissue health, how the teeth bite together, and the amount of space available.

Dr. Lieblick: The way you explain it, it sounds long and tedious. It’s far from it. We do this every day, so all of this can be done in a few minutes. Along with the clinical exam, advanced diagnostic imaging is essential to get all of the information. CBCT has become the standard for detailed implant planning. This 3D imaging lets us see the jawbone in three dimensions with amazing accuracy.

Dr. Rehrer: With CBCT, we can measure bone height and width exactly, check bone density, and crucially, find the precise location of important anatomical structures like nerves (such as the inferior alveolar nerve in the lower jaw) and the maxillary sinuses in the upper jaw. This detailed anatomical map is fundamental for planning safe and ideal implant placement, making sure we choose the right implant size and angle while staying clear of these critical areas.

Dr. Lieblick: This first consultation phase is also very much about listening to the patient. Understanding their concerns, what they hope for, and any worries they might have about the process is key to building trust and working together on a treatment plan. We encourage them to ask questions and share their thoughts openly.

Dr. Rehrer: Making sure patients are fully informed is a basic part of good practice, but we want to make a patient's needs also address their desires. Once we've gathered all the diagnostic information and understand their goals, we talk through the different treatment options. This includes the placement of implants, the kind of final tooth replacement – whether it's a single crown, a bridge, or an implant-supported denture – and a realistic idea of the treatment timeline and overall costs.

Dr. Lieblick: We also make sure patients have a clear picture of any potential risks or complications, even though they're not common with modern techniques. Our aim is to give patients all the information they need to make a well-informed choice that fits their individual needs.

Dr. Rehrer: This thorough planning phase sets a strong foundation. It’s a partnership, where we combine our surgical knowledge with the patient's personal goals to decide on the best treatment approach.

Dr. Lieblick: Once the treatment plan is set and the patient is ready to move forward, the next step is usually the implant placement surgery itself.  

Dr. Rehrer: Keeping patients comfortable and safe during this procedure is, naturally, our top priority. We offer a range of anesthesia and sedation options, chosen based on the individual patient and how complex the surgery is, something we've talked about in an earlier episode. This can be anything from local anesthesia just to numb the specific area to an IV general anesthetic.

Dr. Lieblick: When the patient is comfortably anesthetized or asleep, the tooth is removed and the socket is reshaped for the implant. If the tooth is already missing, a small precise incision is made in the gum tissue to access where the implant will go.

Dr. Rehrer: Preparing the implant site is a very careful process. The depth and angle are critically controlled. We do this every day, so for many patients it can seem very fast, but it’s really important to do it exactly right.

Dr. Lieblick: Once the site is perfectly prepared, the titanium implant, which looks like a small screw, is gently and precisely placed into this prepared channel. Its design, often with a special textured surface, is made to maximize stability and help the bone grow onto it. We make sure it's placed at the correct depth and angle for the best long-term function and appearance of the final teeth.

Dr. Rehrer: After placement, a healing abutment, which rises above the gum tissue is placed on the implant. We still see some surgeons using the old-school method of letting the tissue heal over the implants, but we haven’t used that technique in over 20 years.

Dr. Lieblick: After the implant is surgically placed, we move into a very important healing period. So… we wait…. But it’s a bit more than that. This is a remarkable biological process, Brandon, and it's how dental implants work. 

Dr. Rehrer: It truly is a fascinating thing to see happen.  Basically, the jawbone grows onto and fuses tightly with the implant surface, making it a stable and permanent part of the jaw. 

Dr. Lieblick: This process starts almost right after the implant is placed. The initial surgery creates a controlled spot that kicks off the body’s natural healing response.  

Dr. Rehrer: Then, specialized bone-forming cells, called osteoblasts, travel to the implant surface and start laying down new bone material directly onto the titanium. The micro-textured surface of modern implants is specially designed to help these cells attach and encourage bone to grow there. Over weeks and months, this new bone gets stronger and hardens, creating an incredibly solid bond.

Dr. Lieblick: This healing period usually takes 12 weeks.  During this time, it's vital that the implant stays stable and isn't disturbed, so this fusion can happen successfully.

Dr. Rehrer: Patients following their post-operative instructions carefully during this phase is essential. This includes keeping their mouth very clean to prevent infection and not chewing on the implant. Of course, habits like smoking are off-limits.

Dr. Lieblick: After the healing period, we confirm the implant is healed and stable with a gentle test to make sure it has successfully fused before moving on to making the final tooth. The success rate in our practice is incredibly high, beating the published statistics by over 2%... which is bringing us closer and closer to a 100% success rate.

Dr. Rehrer: After the test appointment, the patient is ready for the prosthetic part – creating and attaching their new tooth or teeth. 

Dr. Lieblick: The patient now sees their dentist. It’s a seamless process because we work hard with our restoring dentist colleagues to make sure it’s easy. The dentist makes an abutment and a crown. The abutment is a connector piece that screws into the implant fixture and sticks out just above the gum line. It serves as the base that the final crown will be attached to.

Dr. Rehrer: There are different types of abutments available, but our referring dentists use custom abutments. These are individually designed and made using CAD/CAM technology to perfectly match the patient's gum contours and the specific needs of the final tooth replacement. Custom abutments often give better aesthetic results, but they’re also better for functional results and the long-term success of the implant.

Dr. Lieblick: The custom abutment and crown are made at the same time. Often this is done with intraoral scanning. It’s all digital, no impressions, and much faster than impressions.

Dr. Rehrer: At the dental lab, technicians use these impressions or digital models to carefully make the final prosthesis. This could be a single crown for one implant, a dental bridge supported by several implants, or a full-arch denture held in by strategically placed implants. The choice of materials for these restorations – like high-strength ceramics such as zirconia, depends on how much chewing force they need to handle and how they look.

Dr. Lieblick: When the final restoration is ready, the patient returns to their dentist for the seating appointment. During this visit, the crown, bridge, or denture is carefully placed onto the abutment(s). The dentist checks the fit very carefully, makes sure the bite is correct, and ensures it looks natural and pleasing. They'll make any small adjustments needed to make sure it functions perfectly with the opposing teeth.

Dr. Rehrer: Seeing the patient's reaction when that final tooth is placed and they see their complete smile, often for the first time in years, is incredibly rewarding. It’s the end result of a detailed, multi-step process that truly can transform their oral health and their confidence.

Dr. Lieblick: So, Brandon, to sum up this journey for our listeners, the process of getting dental implants is a well-established, phased approach, but we’ve made it really simple and easy for most cases. Yes, it involves careful planning, precise surgery, an important healing period, and detailed work to create the final teeth, but we’ve created a 1-2-3 approach.

Dr. Rehrer: It truly is. 1, the tooth is removed and the implant is placed. 2, the implant is tested. 3, the implant is restored at the dentist’s office. Modern techniques and materials have made dental implant treatment one of the most predictable and successful procedures in all of dentistry.

Dr. Lieblick: It’s a clear example of advancements in biocompatible materials, surgical techniques, and diagnostic imaging. We always encourage people considering dental implants to have a consultation to explore whether this option is right for their specific situation. Thank you everyone for joining us on Oral Surgery Insights.

Dr. Rehrer: Indeed. We appreciate you spending your time with us, and we hope this discussion has been helpful and informative.