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When is a Dental Implant Healed into the Bone?

dr ben healed into bone

When is a Dental Implant Healed into the Bone?

That’s a really good question. These are technical questions that I think are kind of neat to challenge me to explain in this way.  

We have an implant dentistry at this concept of mechanical stability versus biological stability. An implant that’s placed initially in the implant pilot hole, or the hole that we drill, is going to always be a little smaller than the implant itself. An implant is like a screw. If you imagine drilling a pilot hole in some wood or something, it’s about the same. Unlike the wood, though, the bone changes after you’ve placed this implant. In the initial placement of the implant, we have some implied mechanical stability, meaning it’s in there tight. We want to get the implant in tight enough so that it can be used in whatever way that we need to use it under those circumstances. That tightness is measured in Newton centimeters. We do have tools that we use chairside to determine how these implants go in a certain amount of tightness, per se. If it’s tight enough, it can be used right away. You can think of it like that. Now, over time, that stability decreases because bone ends up healing. In order for the bone to heal to the implant, it has to absorb a little bit and make room for a new bone to form into it. So, it loosens up a little bit. These curves cross in a certain way, the healing curve and the initial mechanical stability curve, and the point at which they cross where the initial stability is gone. Now we’re dealing more with the biological stability or the healing stability. The actual number, or whatever we decide that number is, doesn’t matter.  

The real question is, is it tight enough to not get impacted by that initial use so that it loosens up on itself? It’s a really important question in making decisions and determinations as to what it is that we’re doing with this implant. Will it be a good idea for us to use it right away? Should we decide to let it sleep or heal below the gum line? Should we even use a mini-implant versus a standard implant? A mini-implant is one piece, and so there’s always a piece sticking up out of the gums, whereas a standard implant has these attachments we can screw on and off to allow for it to heal without being disturbed.  

Mini Dental Implants or Standard Dental Implants? 

A really important question and kind of a long-winded answer, but a lot of those decisions that we make surrounding what type of implants should be used here, how should we determine what strategy to use, whether it be immediately placed or delayed placement? Should we do bone grafting or should we put the implant in right away after the extraction? Those are all the things that go through my head and go through the heads of dentists that understand these types of things and trying to achieve the patient’s goals, right? Everybody wants to have something done really quickly. Single stage surgery, if possible where you don’t have to come back very often. All of those things are exciting. Sometimes it’s just not practical because the risk of having an implant problem is too great under the circumstances that are presented now. That’s also why oftentimes when you call our office, or maybe another dental office, we say, we’d really like to see you for a consultation. Because some of these measurements and some of these tolerances need to be evaluated with a 3D image or a ray so that we can answer that question.  

If the question becomes how much is an implant? We need to know what process to take. Meaning, we need to ask you what we’re trying to achieve first. Then we need to take X-rays and evaluate what type of strategy we should use. And then thirdly, what we really want to know is what type of timeline and what type of implant. All those things, it all kind of wraps all into one. So that’s why we offer free consultation, so that we can have an opportunity to give you all these answers. How much is it going to cost? How much time is it going to take? It all wraps into this question. 

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