Techniques and treatment for your first dental implant procedure

If you are new to dental implants and would like to start your journey on this excellent technique for replacing missing teeth, the key factor I must drum home is that planning is the vital step. Without careful treatment planning and an in depth assessment of the overall aims, non-ideal results may occur.

Let us discuss single missing teeth at the back of the mouth.

The initial stages
Usually the aesthetic demands of a missing molar or premolar tooth are low and the reason for replacement is functional. An upper premolar tooth is usually an ideal place to start your first treatment.

After a thorough case examination, a long cone periapical radiograph is required. If you are digital, measure the inter dental width and the available height. Although your software may not be calibrated 100%, there is usually only an error of 1-2%. For a premolar dental implant, a width of around 4mm is ideal. The requirements are that around each implant, 1mm of bone is present and 2mm from the adjacent tooth. Therefore, you will require a minimum of 8mm interdental space and 6mm width. Needless to say, these are ideal measurements.

Special investigations
If you are unsure about the bucco-lingual/palatal width, a CBCT scan is essential. This will provide highly accurate information in 3D terms and allow you to assess the relevant anatomy. In the case of posterior teeth in the upper arch, this will be the sinus floor.

Study models and a diagnostic wax up are essential in planning your case. This will allow you to analyse the occlusion in detail, analyse the final dimensions of the crown and make any specific changes that are necessary. At this stage, you should also have a good idea whether the final crown will be cement retained or screw retained.

The dental implant
At Progressive Dentistry we use Astra Tech and Nobel Biocare dental implants. This decision was taken on the overwhelming evidence backing up both systems and designs. There are certain advantages of both systems and this will be discussed within another article. However, the main factor in deciding which system will suit you depends on the level of training received and your knowledge of all aspects of the implant. This is essential so that whatever situation you encounter, you will have the knowledge to proceed.

The other major implant systems include Straumann, Biomet 3i, Zimmer, Biohorizons, Ankylos, Friadent, Implant Direct, Southern to name a few.

Mentoring
On your first placement, I would strongly advise that an experienced dental implant dentist is there to guide you. The first implant can be daunting and having someone to verify each stage is priceless.