The parts of a dental implant

The word implant is commonly used for the whole assembly. It is really three parts, fitted at separate stages.

The fixture, or implant body
A threaded titanium post, roughly the size of the root it replaces, placed in the jawbone. This is the part that bone grows onto, which is why implant treatment is measured in months rather than weeks.
The abutment
The connector that fastens into the fixture and passes through the gum. It is placed once the implant has integrated, and its shape determines how the gum sits around the crown.
The crown, bridge or attachment
The visible part, and the part used for chewing. One implant can carry one crown, and two or more can carry a bridge.
Osseointegration
The term for the healing process. Bone cells grow onto the microscopic texture of the titanium until the fixture is held firmly in the jaw. It is living bone bonding to a surface, and it usually takes several months, depending on the site and on how healing progresses.
Implant-retained overdenture
A lower denture that does not stay in place can be made to attach to two or more implants, which stops it lifting during chewing. See dentures and partials and fixed bridges.

What decides whether an implant will work for you

Implants do well in the right circumstances. Much of the assessment concerns whether the site and your general health can support one.

  • Bone volume and quality. There has to be enough height and width of bone in the right position. The nerve to the lip limits depth in the lower jaw and the sinus can sit low in the upper jaw, so imaging of the site comes first. A graft can often rebuild a ridge that has shrunk.
  • Gum health. Active gum disease is treated first, because the same bacteria can cause problems around an implant.
  • Smoking and general health. Smoking can impair healing in gum and bone and is associated with a higher rate of failure, and diabetes that is not well controlled can slow healing. Neither rules treatment out on its own, though both change the risk.
  • Medications and past treatment. Bisphosphonates and other antiresorptive drugs, taken for osteoporosis or as part of cancer care, change the way the jaw heals, and a low dose tablet is a different situation from high dose intravenous treatment. Radiotherapy to the jaws also alters healing. Bring the names and doses with you.

Extensive grafting, sinus procedures and complicated medical histories are often referred to a specialist. Contact the office and we can explain what is likely to apply in your case.

How implant treatment proceeds, start to finish

The usual sequence for a single missing tooth is as follows.

  1. Assessment and planning

    An examination, x-rays and any further imaging the site requires, followed by a discussion of the plan and the alternatives, which include a bridge, a partial denture and leaving the gap as it is. We will review the fee with you before treatment begins. Planning also covers who will carry out the surgical stage.

  2. Extraction and grafting, if needed

    If the tooth is still present it is removed first, often with graft material placed in the socket to help the ridge hold its shape.

  3. The surgical stage

    The fixture is placed in the jawbone under local anesthetic and the site is left to heal, usually with a healing cap over the implant. Depending on the case, this stage may be carried out here or by a specialist such as an oral surgeon or a periodontist, and that is settled with you during planning. Ask when you call if you would like to know how a case like yours is usually handled.

  4. Healing, then the crown

    Integration takes months, and during that time there is little to do beyond keeping the area clean. A temporary tooth can often be arranged if the gap would show. An impression or scan then records the implant position, the abutment is placed, and the crown is made and shade matched, with the bite adjusted so that the implant is not overloaded.

Dental implant compared with a fixed bridge

For one missing tooth with a natural tooth on each side, the condition of those neighboring teeth usually determines the choice.

Consideration Single implant and crown Three-unit fixed bridge
Neighboring teeth Left untouched. Nothing is reduced. Both are prepared for crowns. If they already carry large fillings, little is lost. If they are intact, that is a real cost.
Time and surgery Months, most of it healing, with a surgical stage under local anesthetic. Two or three visits over a few weeks, with no surgery involved.
Bone and cleaning The implant loads the bone, so the ridge tends to keep its shape. It is cleaned much as a natural tooth is. The ridge under the false tooth shrinks over time, and floss has to be threaded underneath every day.
If it fails later An implant can often be removed, the site regrafted and treatment attempted again. Decay or a fracture in one supporting tooth usually means the loss of the whole bridge.

Dental implant questions

Does getting a dental implant hurt?

The surgical stage is done under local anesthetic, so you feel pressure rather than sharp pain. The surgical site is smaller than the socket left by an extraction. Afterward there is usually some soreness and swelling for a few days. Ask your pharmacist or physician what is suitable for you to take, and call the office if the discomfort is increasing rather than settling.

How long does the whole process take, and will there be a gap while the implant heals?

For a straightforward site with good bone, the usual range is a few months from placement to the finished crown, and most of that is healing with no appointments. If a tooth has to be removed first, or the ridge needs grafting, that adds time. Where the gap would show when you speak or smile, a temporary tooth can usually be arranged.

What does a dental implant cost?

The fee has separate components: the surgical stage, the abutment and the crown, with any grafting billed separately, so a single number rarely covers everything. We will review the fee with you before treatment begins. See insurance and financing.

Can an implant fail?

Yes. Early failure means the implant never integrates, which appears in the first months and means removing it, letting the site heal and considering another attempt. Later failure usually involves infection in the surrounding tissue, load beyond what the implant was designed to take, or both. Implants have a long history of use, and with good maintenance many serve well for years.