The questions we are asked most often in consultation.

The inflammatory response is most marked in the first 48 to 72 hours after surgery, in the form of swelling, and subsides progressively over the first week. Healing is, however, an individual process that varies from person to person: the return to usual activity depends on the extent of the surgery and on the characteristics of each case. The definitive rehabilitation is usually fitted between three and six months after surgery, once osseointegration has been confirmed.

It is worth distinguishing two stages. The first is the integration of the implant into the bone, which takes place in the months following surgery: in a healthy patient, or one with no relevant risk factors, integration rates are very high. The second is the longevity of the rehabilitation over the years, which depends on the design of the prosthetic rehabilitation itself — the emergence profile, the convexity and access for hygiene have to be correctly resolved — and on adherence to the maintenance protocols: daily oral hygiene, periodic review appointments and replacement of the prosthetic components subject to wear.

The cost varies and depends on several factors: the number of implants required, the degree of bone atrophy, whether or not a bone graft is needed, any correction or improvement of the attached gingiva around the implants, and the material selected for making the final rehabilitation. The estimate is given in writing at the assessment consultation, after a careful clinical and imaging assessment.

This is a solution designed for the long term, and there is literature following cases that have been in function for more than two decades. Longevity depends on maintenance: daily oral hygiene, periodic review appointments and replacement of the prosthetic components subject to wear, where applicable.

smoking is a risk factor for the integration of implants. Stopping is important in order to increase the success rate of the treatment. As for diabetes, provided it is controlled it is not a contraindication; if it is poorly controlled, it needs to be brought under control before the implants are placed. These are factors to weigh up in the planning and to discuss with the patient.

The panoramic radiograph is an excellent examination and gives us an overall view of the situation. It is, however, a two-dimensional projection: it does not allow bone volume to be quantified or anatomical structures to be located in three dimensions. Placing dental implants requires a three-dimensional study — cone beam computed tomography, CBCT — that allows the available bone and its relationship with the anatomical structures present, such as the nerves, to be assessed. It is on that study that the whole surgical plan is built.

You can send us the case and all the information you have on it. For discussion of the case it is important that we have a CBCT, clinical history and intraoral photographs. We reply within a short time with a preliminary appraisal. In these situations the patient will remain under your care: once the surgery is complete, they return to follow-up at your practice, where the prosthetic rehabilitation also takes place.

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