An implant is not «a screw you put in». It is a pathway with defined phases, and the part that determines success happens before any handpiece is switched on.
Phase 1 — Diagnosis (where everything is decided)
We assess the quantity and quality of available bone, the position of nerves and maxillary sinuses, the state of the gums and neighbouring teeth, and the occlusion. Here a 3D CBCT is irreplaceable: it provides real measurements in three dimensions.
We also assess the person, not only the mouth: smoking, diabetes, medication, periodontal history. These influence healing and must be on the table beforehand, not afterwards.
One non-negotiable point: if there is active periodontitis, it is treated and stabilised first. Placing an implant in an inflamed mouth exposes it to the same process that already cost the tooth.
Phase 2 — Planning
From the 3D file the implant position is planned according to the tooth it will support, not only the bone available. It is reverse reasoning: you start from where the crown must sit.
Phase 3 — Surgery
Performed under local anaesthesia; for those who wish, conscious sedation is assessed. The implant is placed in the bone through a planned procedure. Duration depends on the case, but a single implant generally means one outpatient appointment.
Phase 4 — Osseointegration
This is the phase that cannot be rushed: bone must integrate with the implant surface. It takes some months, with timings varying by site and bone quality. During this period, where indicated, a temporary solution is worn.
Phase 5 — The prosthesis
Only once integration has occurred is the definitive crown made, today often starting from a digital scan. Contacts and bite are checked: an overloaded implant is an implant at risk.
Phase 6 — Maintenance (the phase people forget)
Implants do not decay, but the tissues around them can become inflamed — peri-implantitis is the main cause of late failure. Dedicated home hygiene (correctly sized interdental brushes) and periodic check-ups are needed. A well-placed implant that is poorly maintained does not last.
Sources
- WHO — Oral health fact sheet — tooth loss and the impact of oral diseases.
- European Federation of Periodontology — patients area — periodontal and peri-implant health as prerequisite and maintenance.
- Italian Ministry of Health — Dental health — diagnostic pathway and periodic check-ups.