Dental Implants

What is dental implantation?

An implant is a titanium post placed in the jawbone that fuses with the bone over time (osseointegration). A connector — the abutment — and the visible tooth, a crown or a prosthesis, are fitted on top of it. Unlike a bridge, the neighbouring healthy teeth are not ground down; unlike a removable denture, the tooth stays fixed and the jawbone keeps receiving load. The structure of an implant, its types and the overall logic of treatment are explained in a separate article.

Who may be suitable for implant treatment?

Implants are considered when one tooth, several teeth or a whole jaw of teeth have been lost; they are also the main alternative for patients who cannot tolerate a removable denture or do not want healthy teeth prepared for a bridge. That does not mean “implants for everyone”: suitability is assessed at the examination, and in some cases preparation comes first — gum treatment, bone augmentation, or bringing a general condition under control.

• Medical history — systemic diseases, current medication, previous radiotherapy to the head and neck
• Oral hygiene and gum condition — untreated periodontitis raises the risk of peri-implant disease
• Bone height and width — measured on 3D CBCT
• Smoking — the main modifiable factor that impairs healing and the long-term outcome
• Diabetes and other systemic conditions — whether they are controlled is decisive
• Bite and bruxism — the load the implant will carry is built into the plan

How is implant treatment planned at Smile?

In our clinic the implant is planned where the future tooth needs it, not simply “wherever there is bone”. Before surgery all the data is combined into one digital plan, and every stage runs under the supervision of the same doctor.

1. 1

   Consultation and clinical examination

   We listen to the complaint, expectations and medical history; examine the teeth, gums and bite; and review any existing X-rays.

2. 2

   3D CBCT — when needed

   Bone height and width, the nerve canal in the lower jaw, the sinus in the upper jaw and possible hidden findings are measured on the slices. Radiation is justified: if a recent scan already exists, it is not repeated.

3. 3

   Digital implant planning

   CBCT data is merged with an intraoral scan and the design of the future tooth; implant length, diameter, angle and the safety distance to the nerve or sinus are set in the software.

4. 4

   Prosthetically driven position

   The implant position is chosen with the crown shape, screw-access position, cleanability and aesthetics in mind; a surgical guide is made when useful.

5. 5

   Surgical stage

   Under local anaesthesia the implant is placed in the planned position — on the day of extraction where appropriate, together with bone grafting or a sinus lift when required.

6. 6

   Healing and osseointegration

   The implant fuses with the bone; the time depends on bone quality, additional procedures and general health. Progress is monitored at review visits.

7. 7

   Prosthetic stage

   A digital impression is taken; the abutment and crown (or bridge, full-arch prosthesis) are made with CAD/CAM and adjusted to the bite.

8. 8

   Long-term maintenance

   Professional hygiene and regular checks of the tissues around the implant — the stage that determines how long the implant lasts.

Why does 3D planning matter?

A conventional X-ray does not show bone width or the exact position of the nerve. Cross-sectional 3D imaging lets us choose the implant size and position in advance, keep a safety margin from the nerve and sinus, and see unexpected findings (a root remnant, signs of inflammation, sinus changes) before surgery. It bases the operation on measurable data rather than estimation — it does not guarantee the outcome, but it makes it more predictable.

Implant placement

The procedure is done under local anaesthesia; sedation can be discussed on request and where indicated. The gum is opened carefully (in some cases through a guide, without an incision), the implant site is prepared in the bone, the implant is placed at the planned depth and angle, and the area is sutured. One implant usually takes less than an hour, though the number of implants and any additional procedures change the time.

An honest answer about pain: during surgery no pain is expected thanks to the anaesthesia, though pressure and vibration may be felt. Once the anaesthesia wears off, discomfort, swelling and minor bruising vary from person to person — for most patients they are managed in the first days with the prescribed medication, cold compresses and soft food.

Healing after implant surgery

The short-term phase is the first days and weeks: suture removal, the swelling going down, keeping the area gently clean, avoiding smoking. The long-term phase is osseointegration and the years that follow: the implant fusing with the bone, fitting the permanent prosthesis and an annual check of the gum and bone. The long-term result depends less on the surgery than on the care afterwards.

The prosthesis on the implant

The implant is the post in the bone; the abutment is the connector between implant and crown; the crown (or bridge, full-arch prosthesis) is the visible, chewing tooth. The prosthesis can be screw- or cement-retained, and the material is usually zirconia or metal-ceramic — chosen according to the tooth position, the bite and the aesthetic demands. For front teeth the shape of the gum is part of the plan as well.

Which implant systems are used?

The clinic works with three systems: NeoBiotech (Korea), MegaGen AnyRidge (Korea) and Straumann BLT (Switzerland). All three are long-established, well-documented systems on the international market; they differ in surface and design features, size range, prosthetic components and price. The system is chosen not on a “best brand” basis but according to the clinical situation — bone quality and volume, implant position, type of prosthesis, the likelihood of immediate loading — and the patient’s budget, at the planning stage.

What determines the price of an implant?

The total is not a single number but the sum of a plan. The main factors: the implant system chosen, the number of implants, whether bone grafting or a sinus lift is needed, the type of prosthesis (single zirconia crown, bridge, full-arch prosthesis) and any temporary solutions. The prices below come from the same source as the site’s Prices section; the exact amount and the schedule of stages are given in a written plan after the examination.

How long does implant treatment take?

There is no universal timeline because the routes differ: placing the implant on the day of extraction reduces the number of stages; in the standard protocol several months usually pass between implant placement and the permanent crown for osseointegration; when bone grafting or a sinus lift is needed, the graft has to mature first and the overall time is longer. At the planning stage you receive a specific sequence and an approximate calendar — promises like “a finished tooth in a week” are not made.

What if there is not enough bone?

After a tooth is lost the jawbone gradually resorbs, and in the upper jaw the sinus floor drops. Not every deficit is the same: sometimes a shorter or angled implant is enough, sometimes horizontal bone augmentation (a graft) is needed, and in the back of the upper jaw a sinus lift. The decision is based on the height and width measured on 3D CBCT.

The fully edentulous jaw: implant-based solutions

When all teeth have been lost, fixed or removable full-arch prostheses on implants can be planned as an alternative to a denture — including concepts such as All-on-4, where the posterior implants are tilted to avoid the sinus and the nerve. Which option is suitable depends on bone distribution, the bite and the patient’s ability to keep the prosthesis clean.

Risks and possible complications

Implant treatment is a surgical procedure with a high success rate, but not a zero-risk one. Knowing the possible problems in advance and attending review visits prevents most of them or allows them to be dealt with early.

• Early osseointegration failure — the implant does not fuse with the bone and has to be removed; re-planning is possible after healing
• Peri-implant mucositis and peri-implantitis — inflammation of the tissues around the implant; linked to hygiene, smoking and a history of periodontitis, and must be detected early
• Bone loss around the implant — monitored with follow-up X-rays
• Nerve- and sinus-related complications — reduced by 3D planning and safety margins, but never zero
• Prosthetic and technical problems — a loosened screw, a chipped crown, residual cement; most are repairable

What affects how long implants last?

According to a 2019 systematic review and meta-analysis (Journal of Dentistry), the 10-year survival of modern implants in the included studies was above 96% — in other words, the great majority of implants are still in place after ten years. The individual outcome is influenced by daily hygiene, regular professional cleaning and check-ups, smoking, control of systemic diseases and occlusal load (bruxism). Read more: how long implants last.

Why do the doctor and the plan matter?

In implant treatment the outcome is determined not by the implant brand but by the plan and the doctor who carries it out. In our clinic implant treatment is performed by Dr. Bakhtiyar Aliyev — implantologist and founder of the clinic; diagnostics, 3D CBCT-based digital planning, surgery and the prosthetic stage take place under one doctor, in one clinic. This reduces information loss between stages and makes responsibility clear. About the doctor’s specialisation and way of working: Dr. Bakhtiyar Aliyev.