A dental implant is today the most durable solution dentistry offers for a missing tooth. Unlike a bridge, which requires preparation of neighbouring teeth, or a denture, which rests on the gums and palate, an implant replaces the very foundation of a tooth - the root. After more than 50 years of clinical practice and millions of implants placed worldwide, we now know almost everything there is to know about when an implant makes sense, how it is planned, how it is placed and what can be expected from it. In this guide we explain the complete journey from first consultation to finished crown.

What a dental implant actually is

An implant is a small screw, most often made of medical-grade titanium, surgically placed into the jawbone where a tooth is missing. In appearance and size it corresponds to a natural tooth root - typical length is 8 to 13 mm, diameter 3.3 to 5 mm. After placement, the bone gradually fuses to the implant surface in a process called osseointegration. Once that process is complete (3 to 6 months), a crown is placed on the implant and takes over the function of the lost tooth.

An implant has three parts: the body (the part inside the bone), the abutment (the connecting piece coming out of the gum), and the crown (the visible part that looks like a tooth). The body stays in the bone - if for any reason it must be changed, it has to be removed and a new one placed. What can actually be replaced over the years are the abutment and crown - both can be exchanged individually without touching the implant in the bone, which gives the system exceptional longevity.

Who is an implant recommended for

Implants are an option in a wide range of situations:

  • A single missing tooth when you do not want to grind down neighbouring teeth (a bridge is the alternative but requires sacrificing the structure of adjacent teeth).
  • Several missing teeth in a row - multiple implants can be placed, or a bridge supported by implants.
  • An edentulous patient - the All-on-4 or All-on-6 concept allows fixed teeth on just 4 or 6 implants per arch.
  • Loose denture - implants can serve as anchors that hold a complete denture firmly in place.
  • An aesthetically critical front tooth, where bridges often fail to deliver an ideal result.

When an implant is not the best option

While indications are broad, there are situations where an implant is not the first choice:

  • Active cancer treated with radiation or high-dose bisphosphonates - increased risk of osteonecrosis of the jaw.
  • Uncontrolled diabetes - slower healing and a higher risk of failure.
  • Active heavy smokers (more than 10 cigarettes per day) - significantly reduced osseointegration success. Not an absolute contraindication, but reduction or cessation is advised at least 2 weeks before and 2 months after placement.
  • Insufficient bone - not an absolute barrier, but requires prior augmentation.
  • Under 18 - the jaw is not yet fully grown.

Material - titanium, zirconia or something else

Titanium has been the standard for decades. It is unique in its capacity for osseointegration - bone bonds directly to its surface. Modern titanium implants have a microstructured surface (sand-blasted, etched, hydroxyapatite-coated) that further accelerates fusion.

Zirconia implants are a newer option. The main advantage is aesthetics - they are white, so any potential metallic shadow under thin gums is avoided. They are indicated for patients with metal allergies, although titanium allergy is exceedingly rare. The downside is somewhat reduced longevity compared with titanium and a limited range of compatible systems.

In our clinic we use the Alpha Bio implant system - a top-tier Israeli system with strong clinical documentation, a microstructured surface for accelerated osseointegration, and a comprehensive size range covering every indication. A professional approach from planning to follow-up - no compromise on system quality, no "no-name" alternatives.

3D CBCT planning - why it is mandatory

Before every implant placement in our clinic we obtain a CBCT scan (Cone Beam Computed Tomography) - a 3D image of the jaw showing exact bone height and width, the position of the inferior alveolar nerve, the maxillary sinus and other anatomical structures.

Without CBCT, an implant is placed "blind" - significantly increasing the risk of serious complications (nerve injury, sinus perforation, placement into bone that is too thin). A 2D X-ray cannot show bone thickness or the precise nerve position.

From the CBCT we build a digital plan - software simulates implant position, length, diameter and angle. When maximum precision is required, we also fabricate a surgical guide that ensures the implant goes exactly where planned.

Placement procedure step by step

1. Consultation and exam. First appointment (45-60 min) - examination, medical history, decision on material and type of work. CBCT scan if needed.

2. Planning. Digital analysis of the CBCT, selection of implant dimensions, surgical guide if indicated.

3. Surgical placement. The placement itself takes 30-60 minutes per implant. Performed under local anaesthesia, painless. A small gum flap is opened, the bone bed is prepared with a sequence of drills of increasing diameter, the implant is placed and the gum is closed with sutures. The patient goes home 30 minutes after the procedure.

4. Healing (osseointegration). 3-4 months in the lower jaw, 4-6 months in the upper. During this period the implant fuses with bone. The patient functions normally - if the implant is in a visible area, a temporary aesthetic replacement is provided.

5. Uncovering and abutment. After healing, a small procedure exposes the implant (if it was buried), a healing abutment shapes the gums for 2-3 weeks, then an impression is taken for the crown.

6. Crown placement. A zirconia or e.max crown is placed onto the abutment. The tooth is functional the same day.

Immediate implants - same-day placement

In certain situations, an implant can be placed the same day a tooth is extracted. These are immediate implants. They shorten the process (4-5 months instead of 6+) and preserve bone that would otherwise resorb after extraction.

Not every case is suitable: the tooth must be free of acute infection, the bone must have sufficient volume, and good primary stability of the implant in the fresh socket must be achievable. Suitability is assessed clinically and on CBCT.

Bone augmentation and sinus lift

When years have passed since tooth loss, bone often resorbs - becoming too narrow or too short for an implant. In these situations augmentation is performed - adding synthetic or autologous bone before or during implant placement.

Sinus lift is a specific augmentation in the back of the upper jaw, where the maxillary sinus membrane is lifted and bone is added underneath it. It allows implant placement in areas where there would not be enough vertical bone.

Augmentations extend the total treatment by 4-9 months, but in modern implantology they are routine procedures with high success rates.

All-on-4 and All-on-6 - fixed teeth on an edentulous jaw

Patients who have lost all their teeth or wear a complete denture can today receive fixed teeth on just 4 or 6 implants per jaw (All-on-4 / All-on-6 concept). It was developed in the 1990s (Dr Paulo Maló) and is today the dominant approach for edentulous patients.

Advantages: fixed teeth (not removable like a denture), better chewing function (up to 90% of natural force), better aesthetics (the teeth look natural and do not cover the palate), arrest of jawbone loss.

In many cases, a temporary fixed prosthesis is placed on the same day as the implants - the patient leaves the clinic with teeth. The final restoration is fitted 3-6 months later.

What can go wrong - complications

Implants have one of the best success rates in medicine - over 96% at 10 years with properly selected and placed systems. But like any intervention, complications can occur:

  • Failure of osseointegration. The implant does not bond to bone and must be removed. Occurs in 2-4% of cases. The patient typically does not pay for a replacement implant if failure occurs within the warranty period.
  • Peri-implantitis. Inflammation around the implant, similar to periodontitis. The main cause is poor hygiene. Treatable in early stages, dangerous in advanced.
  • Nerve injury. Very rare with CBCT planning. Without CBCT - a significant risk in the posterior lower jaw.
  • Sinus perforation. In the upper jaw. A small perforation often closes spontaneously; a larger one requires intervention.
  • Aesthetic complications. Gum recession, visible implant. More frequent with thin gum biotype.

Hygiene around implants

An implant does not decay like a natural tooth, but is even more sensitive to bacterial plaque due to the different structure of the gum-implant junction.

  • Brushing twice a day with a soft brush, paying particular attention to the area where the implant emerges from the gum.
  • Floss for implants or super-floss - every day, non-negotiable.
  • Interdental brushes in small sizes (3-4 mm) for the gap between the implant and an adjacent tooth.
  • Oral irrigator - particularly useful for implant patients, because the pressurised water jet reaches the area just below the gum margin around the implant where a brush and floss physically cannot. Recommended once a day, ideally in the evening before brushing.
  • Chlorhexidine mouthwash periodically (not constantly).
  • Professional cleaning at the dentist every 4-6 months instead of the standard 6 (implants require closer monitoring).

How long an implant lasts

Clinical data show that more than 90% of implants function without problems even at 20 years. Single implants in low-risk conditions can last the patient's entire life. The crown on the implant is a different story - it can be replaced periodically (every 10-20 years) without removing the implant itself.

Longevity is most affected by: quality of the implant system, precision of planning and placement, patient hygiene, smoking, general health (diabetes, autoimmune disease) and bruxism.

Cost of implants

The cost varies in a broad range. The main factors:

  • Implant system type (the top-tier Alpha Bio system we use - premium quality at a transparent price; "no-name" systems can be 50% cheaper but lack clinical documentation).
  • Whether augmentation or sinus lift is needed.
  • Case complexity (single tooth vs. All-on-4).
  • Crown material (zirconia, e.max).

In our clinic you always receive a detailed treatment plan with pricing before any work starts. No "surprises" mid-treatment. An implant is a serious investment - financially and biologically - so clarity is essential from the first appointment.

Myths about implants

"An implant is painful." - The placement itself is painless (local anaesthesia). Mild tenderness for 2-3 days after the procedure is possible, similar to a tooth extraction. Most patients no longer take painkillers by day two.

"An implant can be rejected like a foreign organ." - No. Titanium is biocompatible and does not provoke an immune response. "Failure" of osseointegration is not immune rejection but failed mechanical integration.

"Patients over 70 cannot have implants." - Myth. Age in itself is not a contraindication. General health matters, not calendar age. We have placed implants in patients in their 80s.

"Implants last forever." - An implant can last a lifetime, but excellent hygiene and regular check-ups are required. Manufacturer lifetime warranties cover the implant body only, not the crown.

"Implants cause cancer." - Absolute myth. There is no validated study supporting this. The health of millions of implant patients has been tracked for decades.

Tips before your consultation

Before your first appointment it is useful to prepare: a list of medications you take (especially anticoagulants, bisphosphonates, corticosteroids), data on chronic conditions (diabetes, cardiac, autoimmune), allergy history, prior X-rays or CBCT scans if you have them. Be candid about smoking and oral hygiene frequency.

Questions worth asking: Which implant system do you use and why? What is the cost of CBCT and is it taken before every placement? Do you use digital surgical guides? What does the warranty cover and what does it not? Who continues the therapy if you are not available (continuity of long-term care)?

Conclusion

Dental implants are the most fundamental solution modern dentistry offers for missing teeth. The combination of longevity (20+ years), natural appearance, bone preservation and the absence of any need to grind down adjacent teeth makes them a first-line choice for most patients.

But an implant is not a universal solution. It requires thorough preparation, good general health, good hygiene and, of course, a competent dentist and a high-quality implant system. With us you receive the top-tier Alpha Bio implant system, 3D CBCT planning before every placement, digital guidance where indicated, a professional approach from consultation to follow-up - and a clear plan with a fixed price up front.

If you are considering an implant - for a single tooth or for full jaw rehabilitation - a first consultation is always a good starting point. It does not commit you. Examination, scan, plan - and the decision is yours.