Implant and Advanced Implant Surgery

What a Dental Implant Is

A dental implant is a titanium screw placed in the jawbone to take over the job of a lost tooth root. Bone grows onto its surface over the following months — a process called osseointegration — and once that bond is stable, a crown, a bridge or a full arch is fixed on top. The implant replaces the root; the visible part is prosthetic work.

That distinction matters for planning. The implant decides how much load the site can carry, the prosthetic work decides how the result looks and how it is cleaned. Both are planned together, before the first surgical step.

When an Implant Is the Right Answer — and When It Is Not

An implant is the strongest option when a single tooth is missing and the neighbouring teeth are healthy: unlike a conventional bridge, it does not require grinding down two intact teeth. It is equally the standard for several missing teeth, and for a whole jaw in the form of All-on-4 or All-on-6 concepts.

It is not automatically the right answer. Untreated gum disease has to be brought under control first, because the same bacteria attack the tissue around an implant. Poorly controlled diabetes, heavy smoking and certain medications shift the risk. And where bone height or width is insufficient, the honest sequence is bone grafting or a sinus lift first — not a shorter implant in the wrong place.

What the Evidence Says About Longevity

Pooled across long-term studies, implants show a 10-year survival of 96.4% (95% CI 95.2–97.5). The same review recalculated the figure while accounting for patients lost to follow-up and arrived at 93.2% (95% CI 90.1–95.8) — the more conservative number, and the one we quote when patients ask (Howe et al., 2019).

Survival is not the same as health. Across epidemiological data, peri-implantitis — inflammation with bone loss around an implant — affects about 22% of patients (95% CI 14–30), and the milder mucositis is reported in 19–65% (Derks & Tomasi, 2015). This is why recall appointments and cleaning are part of the treatment, not an optional extra.

Smoking has a measurable effect: 6.35% of implants failed in smokers (1,259 of 19,836) compared with 3.18% in non-smokers (1,923 of 60,464), alongside more postoperative infections and more marginal bone loss (Chrcanovic et al., 2015). We say this before treatment, not after.

How Implant Treatment Runs at Stom Dental Centre

1. Diagnosis. A CBCT scan shows bone height and width in three dimensions, plus the position of the nerve canal and the sinus. Gum health and the bite are assessed in the same appointment.

2. Planning. Implant number, position, diameter and length are decided on the 3D data together with the planned crown or bridge. Where the margin is tight — narrow bone, proximity to the nerve, full-arch cases — the plan is transferred with a patient-specific surgical guide.

3. Preparing the site, if needed. Bone grafting or an open or closed sinus lift creates the volume an implant needs to hold. Depending on the extent, this happens in the same session or several months earlier.

4. Placement. The implant is placed under local anaesthesia. Most patients describe pressure rather than pain; sedation is considered only where it is medically indicated and under specialist supervision.

5. Healing. Three to six months of osseointegration, depending on bone quality and whether grafting was involved. A temporary solution covers the gap in the visible region during this time.

6. The prosthetic phase. Crown, bridge or full-arch restoration is produced and fitted, with bite, shade and cleanability checked. The prosthetic phase is led by DDS PhD Telman Iskender.

7. Aftercare. You receive written aftercare instructions and an implant passport with the documented serial numbers, plus a recall schedule. For patients travelling home, we stay reachable and cooperate with the local dentist for check-ups.

Advanced Implant Surgery: When an Implant Alone Is Not Enough

Advanced implant surgery is the term for the cases where the bone has to be prepared or bypassed. Narrow ridges are widened, vertical height is rebuilt, the sinus floor is raised. In extreme upper-jaw atrophy, zygomatic implants anchor in the cheekbone instead of the jaw. For a fully edentulous jaw, All-on-4 or All-on-6 carry a fixed bridge on four or six implants.

Which route applies is a CBCT decision, not a catalogue decision. The plan you receive states which of these steps your case needs and in which order.

What the Written Plan Contains

Before treatment starts you receive a written, itemised treatment plan: the number of implants, the planned prosthetic work, the preparatory steps, the sequence of visits and what is included. Ask for it in writing — it is the norm at our clinic and a fair question to ask any clinic.

Every implant is documented with brand, batch and serial number in an implant passport, so any dentist anywhere can identify the system years later. The prosthetic work carries a written 10-year guarantee whose conditions are handed over before treatment.

Honest Limitations

An implant is not a tooth. It has no periodontal ligament, so it does not feel pressure the way a natural tooth does, and it reacts differently to overload. It cannot get cavities, but the tissue around it can become inflamed — see the peri-implantitis figures above.

Timelines are biological, not commercial: osseointegration takes months and cannot be shortened by wishing. Where bone is missing, treatment gets longer, not cheaper. And a site that has been infected needs to heal before an implant goes in.

If a case is borderline, we would rather say so at the planning stage than place an implant that has to be removed two years later.

Aftercare Decides the Long Term

Cleaning around implants is different from cleaning teeth: the transition between implant, abutment and crown needs interdental brushes or floss designed for it, and professional cleaning at recall intervals set for your risk profile. Patients who keep their recalls are the ones whose implants are still unremarkable at ten years.

If you notice bleeding, swelling or a change when biting, that is a reason to be seen early — peri-implant inflammation responds well when it is caught before bone is lost.