Types of Dental Implants: Step-by-Step Guide to the Best Implant Procedures

Introduction

Dental implants are artificial tooth roots made of titanium that are placed surgically into the jawbone. Unlike dental bridges, implants do not rely on surrounding teeth for support. They offer durable and natural-looking solutions for missing teeth, restoring both function and aesthetics. The durability is long-lasting as implants fuse with the bone, providing a stable foundation for crowns, bridges, or dentures. In this article, types of dental implants are discussed in detail. Moreover, each and every type’s procedure is explained step by step. There are 9 major types of dental implants, which are discussed here:

1. Endosteal implant

Endosteal implant is the most common type of dental implant. The process involved surgery by directly placing the dental implant into the jawbone. This acts as artificial roots to hold replacement teeth, such as crowns, bridges, or dentures. The placement of endosteal implants consists of the following steps:

i. Initial Consultation and Tooth Extraction

• The dentist examines the patient’s health for diabetes or heart issues, etc., then evaluates the jawbone with the help of X-rays or 3D scans.
• Tooth extraction will be required if a damaged tooth is present. After removing the damaged tooth, healing time may be required before proceeding to implant placement.

ii. Bone Grafting & Implant Placement

• The dentist performs bone grafting if the jawbone is not thick or strong enough to support the implant. If grafting is performed, healing can take some time.
• The dentist inserts the endosteal implants surgically directly into the jawbone. The implant is usually a screw-shaped post made of titanium. The gum is stitched closed over the implant.

iii. Osseointegration

• The bone grows around the implant, anchoring it securely in place. This process is called osseointegration, which takes 3 to 6 months.
• The dentist temporarily covers the edentulous (missing tooth) space with a crown or denture.

iv. Abutment and Crown Placement

• After healing, minor surgery is performed to attach an abutment (a connector between the implant and the crown). Healing of gum tissues takes 1 to 2 weeks.
• Once the custom-made dental crown is ready, the dentist matches it with natural teeth and attaches it to the abutment, completing the restoration.

2. Subperiosteal Implants

i. Initial Consultation and Assessment

• The dentist evaluates bone structure and gum health with the help of X-rays or CT scans.
• Using traditional molds or digital scans, the dentist takes a custom impression of the jawbone that helps to create a custom metal framework that will fit snugly over the jawbone.

ii. Fabrication

iii. Placement

• Before surgery, local anesthesia or sedation is administered, and an incision is made in the gum to expose the jawbone.
• The custom metal framework is placed over the jawbone. The gum tissue is sutured back over the framework, leaving small metal posts exposed above the gum line, which will later hold the prosthetic teeth.
• The healing time is shorter than the endosteal implant, as the implant is not embedded into the bone.

iv. Prosthetic Teeth and Follow-up

• After healing, crowns or dentures are attached to the exposed posts.
• The dentist adjusts fitness, comfort, and aesthetics.
• The patient is advised of good oral hygiene and regular dental visits.

3. Zygomatic implants

Zygomatic implant is specially designed for the upper jaw (maxilla). It is anchored in the zygomatic bone (cheekbone), which is dense and strong, providing good support. It is performed in case when there is severe bone loss in maxilla and bone grafting might not be possible. The four steps are mentioned here in detail or better understanding:

i. Initial Consultation

• The dentist examines the oral health of the patient and suggests advanced 3D imaging (CBCT scan) to evaluate the amount of bone loss in the maxilla and structure of the zygoma.

ii. Surgical Procedure

• The procedure is often performed under general anesthesia or deep sedation, particularly if the dentist is considering multiple implant placements.
• The dentist makes an incision in the gum of the upper jaw to expose the maxilla and zygomatic bone. Then, a long implant, usually 30 to 55 mm, is angled and inserted through the upper jaw (maxilla) into the cheekbone (zygoma) for secure anchorage. The dentist typically places 1 or 2 implants per side, depending on the case.

iii. Temporary Prosthesis Placement

• In many cases, a temporary prosthesis (full set of upper teeth) is placed on the same day, which is called immediate loading.
• The implants bond with the zygomatic bone in 3 to 6 months. Meanwhile, the patient is advised to follow a soft diet and receive regular checkups.

iv. Permanent Prosthetic Attachment

• The custom-made permanent prosthetic fits upon the healing. The dentist carefully adjusts the prosthesis for bite alignment and aesthetics.
• The dentist advises the patient on oral hygiene and regular dental visits to monitor implant health and surrounding tissue.

4. Mini Dental Implants

There are three major steps involved in the process of mini dental implants:

i. Evaluation and Planning

• The dentist performs a complete oral examination to check bone density with the help of X-rays or 3D imaging.
• A plan is developed according to the need of the patient, for example, a single tooth, bridge, or denture support.

ii. Implant Placement

iii. Attachment to Abutment and Follow-up

• The implant has a built-in ball-shaped head (abutment). This is where the crown or denture is attached. In many cases, the denture or crown is placed immediately on the same day. Healing time can be a few days or a few weeks.
• The patient needs to be careful in eating soft foods for a few hours. Regular visits and checkups are essential for functioning well.

5. All-on-4 Implants

All-on-4 dental implants are the best option for those who lose most or all of their teeth. This procedure uses just four strategically placed implants in the jaw to support a full arch of fixed, aesthetically good teeth. Cost-effectiveness and minimal invasiveness are alternative options that differentiate this procedure from traditional dentures and full-mouth implants.

Below are steps to replace all-on-4 implants:

i. Initial Consultation

• The dentist evaluates the oral health of the patient by checking bone quality by the help of X-rays or 3D CT scans.
• A plan is developed for prosthetic design and implant placement.

ii. Tooth Extraction

• Local anesthesia or sedation is administered to make the procedure pain-free.
• Any remaining damaged or unhealthy teeth are removed, and the jawbone may be reshaped to prepare for implant placement.

iii. Placement of Four Implants

• Once the healing is complete, the temporary denture is removed, and a custom-made permanent implant is positioned.
• The dentist adjusts fitness and aesthetics.

6. All-on-6 Implants

The steps of All-on-4 implants and All-on-6 implants are the same, but the main difference lies in the number of implants used and the level of support provided.

Below is a clear comparison between the two implants:

Feature	All-on-4 Implants	All-on-6 Implants
No. of Implants Used	4 implants per arch	6 implants per arch
Patients with stronger bone and higher bite need	2 front (vertical) + 2 back (angled)	4 front (vertical) + 2 back (angled or straight)
Support Strength	Strong support, suitable for many patients	Greater support and stability for larger bridges
Bone Requirement	Designed for less bone, often avoids grafting	Requires more bone density
Durability & Load Support	Good for moderate chewing pressure	Better for higher biting force and longevity
Cost	Slightly lower overall cost	Slightly higher due to 2 extra implants
Ideal For	Patients with moderate bone loss	Patients with stronger bone and higher bite need

7. Single-Tooth Implant

A single-tooth implant is a lifelong solution used to replace a missing tooth without affecting surrounding teeth. The dentist surgically places the titanium post into the jawbone that acts as a root. A custom-made crown that mimics the look and function of a natural tooth. This procedure is very helpful in maintaining jawbone health, preserves facial structures, and restores full chewing ability with a natural appearance.

The following are steps involved in replaceing single-tooth implant:

i. Initial Consultation

• The dentist evaluates bone structure by taking X-rays and 3D scans.
• A treatment plan is developed to ensure the best placement for the implant.

ii. Tooth Extraction and Implant Placement

• The remaining tooth is carefully extracted, and the site is cleaned. In case of insufficient bone, grafting may be recommended.

iii. Implant Placement and Osseointegration

• A local anesthesia is administered following small incision in the gum to access the jawbone.
• A hold is drilled into the bone and a titanium implant is screwed into place.
• The gum is sutured and the osseointegration process starts that take 3 to 6 months. During this time, the implant becomes a permanent part of jawbone.

iv. Placement of the Abutment

• Once the osseointegration process is complete, the gum is opened again, and an abutment (small connector piece) is attached to the implant.
• The abutment protrudes from the gum that provides a base for the crown.
• The dentist takes impressions to create a custom crown. The crown is placed on the abutment, completing the restoration.

v. Final Adjustments and Follow-up

• After crown placement, the dentist adjusts the crown and ensures comfort as well as alignment.
• Follow-up visits are scheduled to ensure proper functioning.

8. Implant-Supported Bridge

One of the unique type of replacing the missing teeth is implant-supported bridges that fall under both categories of dental bridges and dental implants. That’s why the name appears in both contexts.

In dental bridge, it typically uses natural teeth on either side of a gap as anchors. The middle tooth (the pontic) is suspended between crowns cemented onto the neighboring teeth. The drawback of this procedure under dental bridge is that the natural teeth must be filed down, bearing the full load.

In contrast, it uses dental implant as the support (anchors) usually, two implants support three or more artificial teeth like a traditional bridge but anchored in bone. The advantages are no damage to healthy teeth, more stability, and bone preservation.

A key difference of implant-supported bridges lies in their support system. Traditional bridges positioned on adjacent natura teeth, often needing to be filed down while in dental implants, rely on implants, preserving the integrity of surrounding teeth and offering a long-lasting solution.

The following are the steps of Implant-supported bridge:

i. Initial Consultation and Planning

• The dentist evaluates oral health with the help of X-rays, 3D scans, and impressions.
• The dentist also simultaneously makes a treatment plan that shows how many implants are needed, their ideal positions, and the types of bridge etc. bone grafting may be suggested if jawbone is weak.

ii. Implant and Abutment placement

• Titanium dental implants are inserted into the jawbone surgically that act as artificial roots to support bridge.
• Soon after the implants placement, the process of osteointegration is initiated in which the implants fuses with the jawbone. This process takes 3 to 6 months to ensure a strong and stable foundation.
• Abutment (connector) is attached to the implants upon the healing completion which support the bridge.

iii. Bridge Fabrication and Placement

• The dentist takes impressions to design a custom bridge that fits perfectly. The prosthetic teeth are fabricated to match the natural look and bite.
• Once the custom bridge is ready, the dentist fixes it securely on to the abutments and completes the restoration.
• The dentist advises the patient on oral hygiene and regular checkups.

9. Implant-Supported Denture

Implant-supported denture is a type of overdenture that is anchored to dental implants instead of resting directly on the gums. The stability, comfort and chewing are comparativly more efficient. It is best for those who have lost most or all their teeth and want a more secure and durable solution. The denture can be removed or fixed based on the number of implants placed.

Detailed steps are explained below:

i. Initial Consultation and Treatment Planning

• The dentist examines the oral health of the patient with the help of X-rays and 3D scans.
• The dentist determines a plan that how many implants will be required (usually 2 to 6 per arch). Bone grafting may be required.

ii. Implant Placement

• Local anesthesia is administered, and dental implants are surgically placed into the jawbone.
• The osseointegration process is started and the implants integrate with the jawbone to form a strong base for the denture. This process takes 3 to 6 months.

iii. Abutment Attachment and Denture Fabrication

• Once the healing process is complete, the abutments (connectors) are attached to the implants for denture support.
• The dentist takes the impression for creation of custom denture that attaches to the implants. The adjustment and fitting are satisfactorily performed to function properly.
• The placement of denture can be performed into two manners: snapped into place which can be removed at any time and screwed-in which is fixed.

iv. Follow-up and Maintenance

• The dentist advises regular dental visits and proper hygiene to maintain the health of the implants and surrounding tissues.

Frequently Asked Questions