Diagnostic phase involves a thorough
examination which the followings will be addressed: i.e.,
medical history, periodontal health, interarch width, the
occlusion, bone height and width, and the health and function
of the existing dentition. This is the phase where the success
of our implant treatment relies heavily upon. Base
on these data, we selects the size, length, and quantity
of the implant to be placed. In the case of multiple implant
placement, surgical guide will be constructed to ensure
path of draw especially in the case of bar and/or locator
use in implant restoration. Most importantly, the implant
location must be determined as it will dictate the efficiency
of implant function and restorative capability.
Surgical placement of the implant
is actually very simple with all the preparation done in
phase one. At Cosmetic Dentist of Katy, we preferred our
patient to be premedicated with an antibiotic one day before
implant placement, along with an analgesic medication taken
prior to surgery, and also an antiinflammatory drugs. In
many case, corticosteroid is chosen with three days, 18
mg dosage of dexamethasone preferred. With all these
medications, patient will expected to have very little,
if any, complication. In the case of sinus membrane lift,
Claritin 10mg may be prescribed to prevent sinusitis. During
the implant surgery, we usually place bone graft and physical
barrier (barrier membrane) to ensure osseointegration surrounding
our implant and prevention of epithelial migration. Finally,
Goretex suture is used to minimize plaque retention around
the suture site and prevent infection and graft exposure.
The time period between implant
placement and uncovering stage to place healing abutment
is about 6-8 months preferrably. This time period
is to allow osseointegration to occur at implant to bone
interface. To ensure this has occurred, we torque our implant
to 32 N-Cm. In many case early implant loading (before six
months) has been attempted, the surgeon or dentist usually
will NOT torque his or her implant. We feel that this
stage is very important to ensure the longevity and optimal
function of our implant. Uncovering implant and placing
healing abutment required only a small incision (less than
5 mm) and takes very little time (10-15 minutes). In most
of the time, the patient will not required any pain medication.
The objective of this stage is to uncover the implant
and sculp the tissue to receive the abutment. In many case,
tissue thickness surrounding the abutment can be increased
at this stage.
Implant restoration usually done 4 weeks after implant
uncovering. At this stage, the healing abutment is removed
and replaced with restorative abutment. In the case of single
tooth, zirconia abutment is used. We preferred the new zirconia
abutment due to strength and esthetic of the final restoration.
Gold screw is used tighten the abutment. In the case of
implant supported prosthesis, we use bar if there is adequate
interarch width or locator. The success of implant restoration
rests heavily in the diagnostic phases. Incorrect implant
placement location will tremendously affect the longevity
of implant function.
Maintenance of implant is very similar to maintenance
of regular teeth. Oral hygiene should be adequate. Periodic
recall should be performed with attention to the occlusion
and periodontal health surrounding the implant. There should
not be any bleeding or inflammation of the surrounding gingiva.
Moreover, lateral force on the implant should be restricted
or eliminated if possible with selective occlusal adjustment.
At Cosmetic Dentist of Katy,
accountability is an integral part of implant treatment.
Dr. Bui is responsible for all the diagnostic, surgical,
and restorative phases of implant treatment. This allows
for proper planing and more error free in using implant
as your restorative treatment therapy.