What actually happens during a dental implant, stage by stage

Stage 1 — Assessment and CBCT scan

We measure bone height, width and density in three dimensions and locate the nerve canal or sinus floor. This scan decides implant length, diameter and angle, and tells us whether a bone graft or sinus lift is needed before anything else happens.

We also check gum health. Active gum disease is treated first — an implant placed into infected tissue is an implant that will fail.

Stage 2 — Placing the fixture

Under local anaesthesia, the gum is opened, the site is prepared with graduated drills under saline cooling, and a titanium fixture is threaded into the bone. A single implant typically takes 30–45 minutes. Most patients report pressure, not pain, and take a mild painkiller for a day or two.

Swelling peaks around 48 hours. Soft food, no smoking, and gentle rinsing for a week.

Stage 3 — Osseointegration (the waiting part)

Bone cells grow directly onto the titanium surface. This is biology and cannot be rushed: roughly 3 months in the lower jaw and 4–6 months in the upper jaw, longer if a graft was placed. During this time you wear a temporary tooth so nobody can tell anything is missing.

Stage 4 — Abutment and crown

Once the implant is stable, we expose it, fit an abutment, and take a digital impression. The lab builds a zirconia or metal-ceramic crown matched to your adjacent teeth. Fitting takes one or two short appointments.

What makes implants fail

Three things, in order: smoking, uncontrolled diabetes, and poor cleaning around the implant. Peri-implantitis behaves like gum disease and can loosen a fixture years later. An implant is not maintenance-free — it needs the same brushing, interdental cleaning and six-monthly checks as a natural tooth.

• Success rates above 95% over ten years in healthy, non-smoking patients
• Daily interdental brush or floss around the implant is essential
• Report any bleeding or looseness immediately — early treatment saves the implant