Plate 02 · Procedures
Dental implants
We place; you restore. That division only works if the placement is driven by the restoration you intend to make, so we would rather have your plan before we plan ours. An implant put where the bone is, rather than where the tooth should be, is a prosthetic problem for the rest of its life.
For the referring practice
Single-tooth and partially edentulous implant placement, immediate or delayed, planned from a CBCT against a stated restorative endpoint.
In plain language
A titanium root placed into the jawbone, which your own dentist later builds a tooth onto. It is two appointments months apart, not one.
Both are always on this page. The switch in the header decides the order everything else is presented in, not whether you are allowed to read it.
01
When we would operate
And, just as importantly, when we would not. A referral that ends in a recommendation to do nothing is a good outcome, not a wasted appointment.
- Single-tooth replacement where the adjacent teeth are sound and should not be prepared
- Free-end saddles where a removable partial denture is being declined or has failed
- Failed endodontics or vertical root fracture with an intact facial plate
- Congenitally absent lateral incisors, once growth is complete
- Overdenture retention in the atrophic mandible — two-implant bar or locators
02
How it is done
Planning
CBCT with a radiographic or scan-based guide, merged with an intraoral scan. We plan the emergence profile first and the osteotomy second. Where the case is guided, you get the plan and the planned restorative position before the surgical date.
Immediate versus delayed placement
Immediate placement into a fresh socket is appropriate with an intact facial plate, no active suppuration, and enough apical and palatal bone for primary stability. It does not prevent facial ridge remodelling on its own — a graft into the buccal gap is part of the technique, not an optional extra.
Loading protocol
Immediate (within a week), early (one week to two months) or conventional (beyond two months). Immediate provisionalisation is considered where insertion torque and implant stability quotient are both adequate and the occlusion can be kept off it. Those are thresholds we use to decide, not predictors we can promise.
Second stage and handback
Healing abutment placed at second stage or at placement where a one-stage protocol suits. We send you the fixture record, the platform, the torque and the healing abutment height, with the date the site is ready to impress.
| Term | What it records |
|---|---|
| System & platform | Manufacturer, connection, platform diameter |
| Dimensions | Diameter × length, in millimetres |
| Insertion torque | Ncm at final seating |
| Stability | ISQ where measured, buccal and mesial |
| Graft | Material, membrane, and the gap it filled |
| Ready to restore | A date, not a season |
- CBCT of the planned site with a small field of view — we do not need the whole head.
- An intraoral scan or study models, plus opposing arch.
- The restorative plan: screw- or cement-retained, single or splinted, and who is restoring.
- For the anterior maxilla, a photograph at full smile. Lip line decides more than bone volume does.
A note back to you
The single most useful thing you can send is the restorative plan. Screw-retained or cement-retained, single or splinted, what the opposing dentition is doing, and whether the patient has a parafunctional habit you have been managing. We will return the fixture record with a date the site is ready to impress, and we are happy to place a healing abutment to the height you specify.
04 · Consent
Risks, stated rather than softened.
Every figure below is a published-literature range and is labelled as one. None of them is a claim about this practice's results, and there are no success rates anywhere on this site. You should hear all of this out loud before you consent to anything, not only read it.
Failure of osseointegration
The implant does not bond to the bone and becomes mobile, usually within the first months. It is removed, the site is allowed to heal or is grafted, and replacement is usually possible later. Smoking, uncontrolled diabetes and a history of periodontitis all raise the risk.
Literature: early failure commonly reported in the low single-digit percentages
Peri-implantitis
Inflammation with progressive bone loss around an integrated implant, years later. It is the main long-term threat to an implant and it is largely a maintenance and hygiene problem. Implants are not immune to disease because they are not teeth.
Literature: prevalence estimates vary very widely, roughly 10–20% of implants at 5–10 years
Inferior alveolar or mental nerve injury
A specific risk of posterior mandibular placement and of osteotomy preparation beyond the planned depth. Planned safety margins to the canal are the whole reason we insist on CBCT rather than a panoramic.
Sinus perforation
In the posterior maxilla, entry into the maxillary sinus. Small perforations are managed at the time; larger ones may abort placement in favour of grafting and a later attempt.
MRONJ
Medication-related osteonecrosis of the jaw. A real, if uncommon, risk in patients on antiresorptive or antiangiogenic drugs — bisphosphonates, denosumab, and some oncology agents. Risk is far higher with intravenous oncology dosing than with oral osteoporosis dosing, but it is not zero in either. Tell us every drug, including ones stopped in the last few years, because denosumab and zoledronate have long tissue effects.
Aesthetic outcome
Recession, a grey shine-through of the fixture, or a papilla that does not fill. Thin biotypes and high lip lines carry more of this risk, and no technique removes it. We will tell you before we start if we think the aesthetic result is the hard part of your case.
Mechanical complications
Screw loosening, abutment or screw fracture, ceramic chipping. Usually restorative rather than surgical, and usually manageable.
05
What the timeline looks like
Recovery varies between people. The general recovery instructions — bleeding, swelling, diet, medication timing and dry socket — are on the after-your-surgery page.
06 · For patients
The questions people actually ask us in the chair.
How many appointments is this really?
Usually: a planning visit with a scan, the placement, a check at a week or two, then a wait of three to six months while the bone grows onto the implant. Only then does your own dentist make the tooth. If a tooth is being removed first, add two to four months before placement.
Will I have a gap in the meantime?
Sometimes we can put a temporary tooth on the implant the same day, but only when the implant is very solid at placement and we can keep your bite off it. Otherwise there are removable temporary options, and your dentist will arrange one. Ask before the day so you are not surprised.
Does it hurt more than an extraction?
Usually less. There is no tooth being levered out. Most people describe a dull ache for two or three days and manage on paracetamol and ibuprofen.
07
More on this procedure
Next
Send us this case with the imaging listed above, or call the referral line on (612) 555-0150 if it needs to be seen sooner than a form allows.
If your dentist has already referred you, we will contact you to book. If you would like a second opinion, you can come to us directly.