Replacing a single missing tooth without any infection is a relatively simple procedure. You will have a local anesthetic placed in the area of the implant, this will be the only slightly uncomfortable part, after this you will not feel anything. A small flap will be raised to expose your bone, and you will hear the sound of the drills as we prepare the bone to receive the implant. We might use three or four drills. After we check the angulations our trained assistants will open the sterile package of the implants and it will be gently placed inside the bone. Sutures will then be given and the wound closed.
You will be asked to continue the antibiotics for five days and the pain medication as required. A gauze will be placed in your mouth to control any bleeding if present. An ice pack will be provided and you will be told to keep it in place for the rest of the day. Ice will help control any pain and swelling. We do not expect you to have any major pain after a single uncomplicated implant.
Your sutures will be removed after a week to ten days. A provisional prosthesis will be provided to you and our prosthetic team we will see you after approximately 8 weeks after surgery to start the procedure to have your tooth placed on the implant.
During the prosthetic procedure an abutment will be placed on the implant and an impression of the abutment will be taken. X-rays might be taken to check .The color of your teeth will be matched and the impression sent to the laboratory. We might have you come in for a trial of the tooth to make sure you are happy with the result, and then our prosthetic team will cement the crown on the implant. It is imperative that you then see the hygiene team at the Implant Center for a bi-yearly check up and cleaning. We consider this to be one of the most important aspects of implant dentistry. There is no use in having an expensive procedure done if you are not going to have regular check ups and cleanings.
All implant procedures are complicated in nature. However, with our experience in implantology we consider those single implants to be complicated that require more than average skill in the placement and restoration. All implants in the front part of the mouth of the upper jaw upto the pre-molars are considered to be a complicated surgical procedure because we are dealing with what is called the ESTHETIC ZONE. In such cases mistakes cannot be made as the patients smile will be affected. So if you are missing any front teeth in the upper jaw understand that it will be a complicated surgical procedure.
Replacing single implants in an infected site is considered to be a complicated implant surgery, because in most cases any infection will result in destruction of the bone some sort of bone grafting procedures will have to be done. These days every dentist wants to do a bone graft….not all cases are suitable nor do they require any bone grafting. Be aware of this.
In most cases that we deal with in the Implant Center of extracting and replacing infected teeth we would like to wait for at least a month before placing a dental implant.. What this waiting period does is the help the body remove all the infected material so that the implant can be placed in a non-infected site.
After the implant is placed, we normally wait an extended period of time before restoring the implant as in most cases because of the infected tooth that is being replaced the healing process might be delayed.
If you need to have more than one implant it becomes a complicated case.
At the implant Center you will be required to have at least two appointments before you see Dr. Rahman for your surgery. At these appointments the team that will place your teeth will take some impressions and place the teeth on the model, so that we can see exactly where the implants have to be placed for optimal and best results so that you will be satisfied with the outcome. This will be considered the most important step in your treatment plan.
If you are having two or more implants in the upper jaw in the front, this is the most complicated implant surgery other than major reconstructions. We at the Implant Center, will ensure that all steps are taken so that the teeth that are placed on the implants are the best possible in all aspects of shape, color shade and esthetics.
You will have a minimum of two appointments prior to your surgery. In this after the x-rays are taken the prosthesis will be constructed on the models so that each and every aspect of your treatment is looked at before we start surgery. After your implant surgery is done you will have a minimum of three or four appointments with our prosthodontist and laboratory technicians to ensure optimal results.
If implants are going to be placed in the anterior lower jaw we have to be careful of the very this bone that is encountered in the front part of the jaw. We might have to use some bone grafting procedures to augment the bone. In most cases the lower jaw is not considered to be in the esthetic zone.
The Lower Jaw
Dental implants in the lower posterior (back) part of the jaw has many serious complications. You have a major nerve which supplies the teeth and we MUST under all circumstances avoid it. In our 30 years of experience we have NEVER injured the nerve that is how careful we are about it.
You as the patient can be rest assured that all pre-cautions will be taken including x-rays, if need be CT scans and different actions during surgery to making sure that you are safe.
In addition, the bone in the back part of the lower jaw is very soft and we have to be careful to make sure the implant succeeds by giving you adequate time to heal. Expect a little longer healing time in the back part of your mouth.
The Upper Jaw
The upper jaw has its own sets of complications. We are working under your nose, and in the back part is your maxillary sinus, which is an empty space. Your sinus is the area which gets infected when you have a sinusitis.
Dr. Amin ur Rahman has been a pioneer in doing sinus lift procedures and placing implants in the posterior part of the jaw. Very few trained surgeons can do it in our country and you must be careful if you are considering having implants in the back part of the upper jaw as to what your implant surgeon is capable of doing.
At the Implant Center, we train other dentists and Dr Rahman has been doing sinus procedure for over 30 years. Experience matters here, in addition he has been teaching sinus lifts and other complicated procedures to graduate students at the University of Michigan Ann Arbor and the University of North Carolina at Chapel Hill.
If you need a sinus lift procedure expect t o have at least one year before you can have teeth on the implants, that's how long it can take.
In the back part of your upper jaw apart from the sinus there are other complications that have to be addressed. Most important is the direction of the implants to be placed because you might not be able to open your mouth wide enough to place the implant. In addition, the bone in the back of the upper jaw is very soft and we have to be careful while drilling not to drill too much bone. In most cases with the back upper jaw, we at the Implant Center always give more time for healing.
Only in rare cases do we take a tooth out and place an implant straight away, the back teeth have three roots and it can become difficult to put the tooth on the implant at a proper angle, se we normally wait after a tooth is taken out to place the implant.
The maxillary sinus lift procedure is a very specialized procedure and unless the dentist is very well trained the chances of complications are tremendous. At the Implant Center, Dr Amin ur Rahman is a pioneer in the sinus lift procedure and has been doing it for over 30 years, so the confidence that we have is unmatched in Pakistan. We know what we are doing.
There are two types of sinus lift procedures, one is called the Osteotome Sinus lift (closed sinus lift)and the other is called the Full sinus Lift (Open sinus lift).
The Osteotome Sinus Lift, can only be done if you have about 4-5mm of bone below your sinus. A flap is reflected the bone exposed and special instruments are used called Osteotomes to break the bone and insert the bone graft into the sinus. The sinus membrane is a very very delicate tissue in the sinus and that is what we are trying to LIFT is a sinus lift. Obviously we have to be extremely careful not to tear this membrane (Called Schnedrain membrane). In some cases we can place the implant at the same time and in most cases we wait about 4-6 months to place the implant.
A full sinus lift procedure is a major surgical procedure requiring extensive training. In case you have less than 3 mm of bone under you sinus we do the full Sinus Lift. In this case a hole is drilled in the side of your upper jaw, the sinus membrane is the very gently lifted to the extent we want to, bone is then placed under the membrane and the site is closed. Almost is all cases we wait for about 6 months before we come and place the implant, only in very rare cases do we place an implant at the same time.
Full mouth rehabilitation refers to the placing of implants in jaws that do not have ant teeth, in other words edentoulous jaws.
If you have no teeth in your jaws then you have two basic choices, you can either have a fixed prosthesis, or a removable prosthesis.
If you want fixed teeth, the minimum number of dental implants required will be FOUR in each jaw. It would be better to have six implants or even eight implants in EACH jaw. The higher the number the more the stability and long term success.
A removable prosthesis is one which you can remove and clean and put back. This is an extremely cost effective way to restore your missing teeth. In most cases four implants are placed in each jaw and a ball abutment is used in your denture to clip the denture on. We can also do the same with two implants in each jaw. If you decide to have a removable prosthesis but change your mind later on, we can always put in more implants and give you a fixed prosthesis.