What Happens During Dental Implant Treatment?

The visible gap tells only part of the story.

Planning may need to consider, for example:

• whether the relevant tooth is still present or has already been lost,
• how much bone and soft tissue are available,
• whether inflammation is present,
• how healthy the remaining teeth and gums are,
• which medications or general medical conditions need to be considered,
• and what type of restoration is planned for the implant later.

This is why implant treatment can follow different pathways in two patients whose gaps appear similar.

Terms such as immediate implant placement or immediate restoration also describe possible treatment concepts, not a standard that is automatically suitable for everyone.

The starting point is not the operation, but the question of which problem actually needs to be solved.

For one missing tooth, the treatment objective may differ from that for several missing teeth or for a removable denture that needs better stabilisation.

Depending on the situation, planning can include:

• examination of the teeth and gums,
• assessment of the gap and adjacent teeth,
• evaluation of bone and soft tissue,
• medical history concerning diseases and medication,
• radiographic diagnostics,
• and planning of the later prosthetic restoration.

The future crown, bridge or denture should not be considered only at the very end. The implant position is also influenced by the type of prosthetic restoration that should ultimately be functional and maintainable.

Before an implant is placed, other findings may need to be treated first.

An important example is active periodontal disease. The guideline on timing of implant placement notes that untreated periodontal infection in the remaining dentition presents a risk to implant success and should be treated before implant placement.

Other findings can also change the treatment pathway, for example:

• acute inflammation,
• teeth that cannot reasonably be preserved,
• certain bone defects,
• or medical risk factors.

This does not mean that every implant requires a long series of additional treatments first. It simply means that implant placement is not planned in isolation from the rest of the patient's oral and general health.

There are several possibilities.

In selected situations, an implant can be placed immediately after tooth extraction. In other cases, an initial healing period is allowed before the implant is placed later.

The choice depends, among other things, on the local bone and soft-tissue situation, the ability to achieve a stable implant position and possible risk factors.

Immediate implant placement is therefore not a universal shortcut based on the principle “tooth out, implant in”.

The current guideline emphasises careful patient selection. For example, immediate placement should not be performed where extensive bone defects prevent sufficient primary stability.

No.

Bone augmentation is not an automatic phase of every implant treatment.

Whether additional bone procedures are required depends on whether there is sufficient suitable bone at the planned implant site and on the restoration concept being planned.

Sometimes augmentation can be carried out at the same time as implant placement. In other situations, a separate procedure may be necessary.

The decision should not be based solely on whether an image appears to show “little bone”. The specific three-dimensional and clinical situation, together with the planned implant position, is what matters.

During implant placement, an implant bed is prepared in the jawbone and the implant body is inserted.

The procedure is generally performed under local anaesthesia. The exact surgical approach depends on the initial situation and the planned technique.

From the patient's perspective, it is important to distinguish between two things:

Placing the implant does not automatically mean that the final visible tooth is fitted at the same time.

The implant initially functions as an artificial tooth root or anchoring element. Depending on the treatment concept, the prosthetic restoration is provided immediately, early, or only after a healing period.

No.

Computer-assisted or template-guided implant placement is one possible approach within implant dentistry. It can be used when appropriate planning supports it, but it is not a mandatory part of every implant procedure.

Even with digital planning, surgical assessment remains essential.

The course of implant treatment should therefore not be equated with the use of a particular device or navigation method.

An implant can heal in different ways after placement.

With closed or submerged healing, the implant is covered beneath the gum. After the healing period, it is exposed again in a small additional procedure so that the prosthetic phase can continue.

With open or non-submerged healing, a designated component remains accessible through the gum.

Which method is used depends on the implant system, the starting situation and the treatment concept.

For patients, the key point is that a second minor surgical procedure to expose the implant may be necessary, but is not automatically required for every implant.

After implant placement, the tissues must recover and the implant must become biologically integrated with the bone.

This process is called osseointegration.

Healing of the gums and integration into the bone are not the same thing. The gums may already look calm externally while biological healing of the implant within the bone is still continuing.

How long this phase takes cannot sensibly be described with one number for every patient.

Factors include:

• the implant region,
• bone quality and volume,
• primary stability,
• additional bone procedures,
• general health,
• smoking,
• and the loading concept selected.

The question of healing time is therefore discussed in more detail in a separate guide article.

Not necessarily.

Whether a temporary restoration is possible or necessary during treatment depends on the situation.

For visible gaps, a temporary restoration may be useful for aesthetic or functional reasons. However, it must be taken into account how much load the newly placed implant or treated tissues can tolerate.

A temporary restoration therefore does not automatically mean that the implant can already be loaded in the same way as the later final restoration.

In selected situations, immediate or early restoration may be possible.

This should not be confused with universal immediate loading.

Whether a prosthetic restoration can be attached straight away depends on factors including implant stability, bone, implant position, bite loading and the overall restoration concept.

For other patients, it is more appropriate to allow the implant to heal initially with as little loading as possible.

The fastest option is therefore not automatically the most medically appropriate one.

After sufficient healing, the prosthetic phase begins or is completed.

The implant position is recorded for manufacture of the restoration. Depending on the treatment, this may result in, for example:

• a single implant crown,
• an implant-supported bridge,
• or retention elements for removable dentures.

Depending on the system, a connecting structure called an abutment is located between the implant and the visible restoration.

This makes it clear why “placing an implant” and “receiving a new tooth” are not completely the same treatment step.

More about different types of dental restorations

Colour and shape are not the only considerations before the definitive restoration is placed.

Depending on the type of restoration, the following may be assessed:

• fit,
• contact with adjacent teeth,
• bite,
• ability to clean the restoration,
• soft-tissue condition,
• and aesthetic integration.

Implant-supported restorations should be planned not only to look good, but also to remain as controllable and cleanable as possible over the long term.

Once the final crown or denture has been placed, implant treatment is not “finished forever”.

Implants cannot develop caries, but the tissues around implants can develop inflammatory disease.

Long-term care therefore includes:

• good oral hygiene at home,
• cleaning the spaces specific to the restoration,
• regular dental reviews,
• and individually appropriate professional maintenance.

Long-term care is therefore part of the treatment concept rather than an optional extra after surgery.

Treatment can become more involved if, for example:

• a tooth first needs to be removed,
• inflammation needs treatment,
• bone or soft tissue needs augmentation,
• several implants are planned,
• medical risk factors need to be taken into account,
• or a more complex restoration is required.

Conversely, individual phases can sometimes be combined more closely when the conditions are favourable.

It is therefore not helpful to plan on the basis of blanket statements before examination such as “implant treatment always takes three months” or “everything is finished after six months”.

There is no universal number here either.

Implant treatment includes at least planning, surgical and prosthetic steps, as well as reviews. The number of individual appointments depends on the treatment concept.

A single uncomplicated gap may follow a different pathway from treatment involving bone augmentation or several implants.

The number of appointments alone is therefore not a meaningful measure of quality.

Implant treatment can usually be divided into six areas:

examination and planning → creating the necessary conditions → implant placement → healing → dental restoration → aftercare.

The actual pathway can vary considerably.

Particularly important points are:

• Immediate implant placement is not automatically suitable for everyone.
• Bone augmentation is not required for every implant.
• The implant and the later visible dental restoration are separate treatment steps.
• Immediate restoration or immediate loading is appropriate only when the conditions are suitable.
• Healing time and the number of appointments cannot be set responsibly at one fixed figure for every patient.
• Long-term maintenance is part of implant treatment.

For detailed information about prerequisites, risks, alternatives and implant treatment:

Dental implants at the practice

The medical information in this article is based in particular on patient information from the German Society of Implantology (DGI) and on current DGI/DGZMK/AWMF guidelines concerning timing of implant placement and conventional versus computer-assisted implant insertion.

The guidelines show that timing, healing and computer-assisted procedures depend on the patient's individual starting situation. The pathway is therefore deliberately described here as a flexible patient journey rather than a rigid appointment or technology protocol.

Editorial review date: 9 August 2026. This article does not replace an individual implant assessment or treatment plan.