How dental implant treatment works, step by step

A dental implant replaces a missing tooth with a titanium post placed in the jawbone in place of the root, with a porcelain crown fitted on top. Many people are put off by the word "surgery", but in practice this is a minor procedure in the mouth under local anaesthetic, usually finished within about an hour for one post. What takes time is waiting for the bone to fuse with the post. This article walks through each step so you know what to expect.

Step 1: Examination and scans

The dentist examines your mouth, asks about your medical history and medicines, and takes a panoramic X-ray and a cone-beam CT scan. The CT scan shows the bone in three dimensions: height, width, density, and the distance to the sinus and the nerve canal. This is how the dentist knows whether a post can be placed straight away or whether bone grafting or a sinus lift is needed first.

Step 2: Planning

From the scans and the state of your mouth, the dentist decides:

• The number, size and position of the posts.
• Whether extractions, bone grafting, a sinus lift or gum treatment are needed first.
• The type of crown and how it will be attached (screw-retained or cemented).
• The expected timeline and the cost of each stage.

The plan is explained to you and agreed before anything starts. If you have a medical condition, the dentist may need to consult the doctor treating it. At Asahii Dental Clinic this plan is drawn up on your CT scan by Dr. Tran Van Thang, the clinic's oral surgeon and implantologist, who explains each option and gives clear prices; the plan is written down item by item with its costs, and you confirm it before treatment starts.

Step 3: Preparation

The mouth needs to be clean and stable: scaling, treatment of gum inflammation, fillings or treatment of decayed teeth. Smokers are advised to stop for at least several weeks before and after surgery, because smoking slows healing and raises the risk of the post failing to integrate.

Step 4: Placing the post

Under local anaesthetic, the dentist opens a small flap in the gum, prepares a channel in the bone to the exact size and places the post. Some cases use a 3D-printed surgical guide made from the computer plan so the post goes exactly where it was designed. The gum is stitched. Depending on the case, the post is covered by the gum or fitted with a healing cap that sits above it. The implant system is chosen by the dentist for your bone and the position of the missing tooth and named in the plan; Asahii uses Straumann and Neodent (Switzerland), Megagen AnyRidge and Dio (Korea), Kontact Biotech (France) and Adin.

For front teeth, or whenever appearance matters, a temporary tooth can be fitted so you are not left with a gap.

Step 5: The healing period

After placement, the bone needs time to grow firmly around the surface of the post, a process called osseointegration. This usually takes a few months; the lower jaw is often faster than the upper because its bone is denser. During this time you eat almost normally, avoid chewing hard on the implant site, and attend review appointments so the dentist can check healing. Asahii's Zalo Mini App reminds you of each of these dates automatically, and the X-ray taken at each review is kept in your record for you to look at.

If bone grafting or a sinus lift was needed, the wait is longer; sometimes the graft has to mature before the post can be placed at all.

Step 6: Fitting the tooth

Once the post has integrated, the dentist takes an impression or a digital scan of the implant site and the crown is made. A connector (abutment) is attached to the implant and the crown is fitted to it. The dentist adjusts the bite so the new tooth meets the opposing teeth correctly. After that come regular check-ups of the crown, the gum and the bone around the implant.

Who needs extra care

Implants are not suitable for everyone, or need more preparation, when:

• Diabetes is not well controlled.
• You take or have taken bisphosphonate medicines for osteoporosis, or have had radiotherapy to the head and neck.
• You smoke heavily.
• You have untreated gum disease.
• You have heart disease, a clotting disorder or take anticoagulants: your doctors need to coordinate.
• You grind your teeth heavily: a night guard is needed after the crown is fitted.
• Children and teenagers whose jaws are still growing: treatment usually waits until adulthood.

The dentist will ask about your history in detail before planning; tell them about every condition and medicine, including supplements.

When to see us straight away

After the post is placed, contact the clinic at once if:

• Bleeding does not stop after biting on gauze.
• Swelling increases after the third day, you have a fever, or the pain does not ease with the medicine prescribed.
• Numbness of the lip, chin or tongue continues for many hours after the anaesthetic has worn off.
• The healing cap or temporary tooth comes off.

See also Caring for a dental implant.

Your own plan, the number of visits and the waiting time can only be set after a doctor has examined you and read your CT scan. See our prosthetics and implants page or book an appointment by hotline 0928 888 121, Zalo or the Mini App.