Why do some dental implants take four to six months, but other types of dental implants can be done in one day? Okay. Let’s address this question because it is a common one and it’s misunderstood a lot.
So a dental implant, no matter where it goes in the body, in general takes somewhere between three to six months on average to integrate to your jaw bone. Biology is biology, whether it’s in me or it’s in you.
Typically, three to six months for integration, really a full year before the dental implant really becomes solid. And that depends on how hard or how soft your bone is.
So where are the rules or dental implant techniques different?
When you’re replacing just a single center front tooth or a one back tooth or maybe just a section of teeth, typically those teeth, you don’t want to go fast on those. You don’t want to put the final teeth on too quickly because there’s only one anchor that’s supporting all of the weight.
So especially if you’ve had to have bone grafting, that’s often done as a separate procedure or maybe in conjunction with the implant or the bone graft and the implant. Things just have to kind of sit.
Imagine if your arm was broken in half. You’d put a cast on your arm to hold those two pieces together, and you certainly wouldn’t want to move it at all or pull them apart because then the bone wouldn’t heal.
Same thing in the mouth.
If you chew on the dental implant, it’s going to move microscopically or maybe a lot…and it’s just not going to take. The bone is going to break (or when referring to our previous example, your arm is not going to heal).
When you have one or two dental implants, especially on one side of the mouth, then the force that’s coming down on it is too high and the implant could go like this (refer to my visual example in my video) when that force happens.
So the difference is, when I do a full arch dental implant replacement (a full set of dental implants in the lower or upper jaw), I’m taking out all of their teeth (or what’s left of them).
Maybe they haven’t had teeth since they were 18 years old and putting in zygomatic dental implants or pterygoid implants or the full lower, the full upper, they’re all going in at once…all one surgery, all bone graft, everything all at once.
How was it that I can put teeth on those right away or within a day, and the other one, I had to wait for four or five months?
That’s because the jaw is shaped like an arch, right? So if I put in 4, 5, maybe 6, 4 to 6 dental implants across this arch and then I link them together with a rigid bridge, all of a sudden it can’t move anymore. It’s very stable.
So it’s like a triple cast or four or five casts preventing movement. Of course, you have to be on a soft diet. But this arch, an arch in general, just as in building and architecture, has a very strong, sturdy method of holding things.
That’s why they build buildings in arches like this. So when you have an arch of dental implants, then teeth can go on right away and you can even chew on them. Yes, it’s a very soft diet, and you still need that three to six months for things to integrate.
Every patient is different…the length of time it takes for dental implants is different, too!
Some situations change how long it takes to get dental implants. Maybe you have osteoporosis or you take some medicines that slow you down or you’re mildly diabetic, then we need to give some more time for the dental implant process.
Or maybe you smoke or vape, which you shouldn’t have dental implants done. And you have a higher risk of failure or take a certain antidepressant, then those scenarios all increase the risk.
But if we’ve got solid implants into medium to hard bone, then you could have teeth right away. So in the back of the mouth, where our force is really high in the back, that’s not an area that you want to put teeth on right away because it’s not protected at all (not protected by the bite). In the front of the mouth, of course, all the time I take out teeth, I put dental implants in and I make the temporary tooth right on it.
And then I say, “Don’t chew on it. Leave it alone. Nothing. Everything you bite and chew goes on your back teeth.” So even though we have the look of a temporary crown, I’ve made it so when you bite down, nothing touches at all. But you have to be diligent and compliant that you’re not chewing on it at all….zero, zilch for that first three to six months.
Four months is usually the magic number.
And that allows us to let the dental implants heal and make it work. Just do your part. But that’s really the main difference. Full arch, harder bone, multiple implants connected to each other on a splinted arch versus single implants, high force. It’s a broken bone with a cast. You’re now picking up the groceries with the broken bone, and it’s just not a good idea, right?
Softer bone, higher risk…harder bone, better. I mean much better for implants. The hardest bone is not good because it doesn’t have any blood in it. It’s kind of like soil that’s not very fertile.
You can’t plant a dry lake bed. And that’s just the opposite, too. We don’t find it too much, maybe 5% of the time. We call that D1 bone. And again, this is very patient specific, very precise choices. How this is done in each case is very unique.
It’s not just a cookbook catchall, although I do know of colleagues whose every patients get the same thing over and over. And there are some clinics that advertise this concept….everybody gets the same thing, regardless of who you are!! This is crazy! You’re all the same, apparently. That’s not the case. ( a little humor. 😂)
Thank you for this blog! And for your time. When do you know for sure an allograph block bone transplant has failed? My doctor says it’s failing because my immune system is so robust it’s rejecting the new bone. I have no pain, no swelling, no sign of infection, a small bit of the bone is peeking out from under some sort of synthetic flap sewn into my gums and cheek and he says it is loosening, but I can’t tell. The scan was normal. He said to go back to a regular diet after 3 weeks, which I didn’t do but I did chew on that side once with soft food. He wants to remove it in 2 weeks of there us no improvement. It seems like the gum is having a slow time growing over the bone. I think he is being too hasty. It’s been 5 weeks since surgery. Thank you for any help you can offer. I left a similar comment earlier and would be happy if could leave a reply on this question, thank you!
If it is truly a block bone graft then exposure of the graft is not going to do well. Part of it may take but the part that is exposed will fail.
A block bone graft must remain covered. It is possible that he will just lose a corner of the graft and not lose the entire thing. The best thing to do is to surgically remove the exposed part and let the gum grow over it and see how it does before removing the entire graft and starting over
The rules are different for a block bone graft versus a particulate bone graft that is typically done for a common socket bone graft.
Dear Dr Amin- Didn’t know which comment site is active, so am leaving my remarks here. Husband at age close to 80 is considering implants to address new issue of upper left unilateral free end saddle and periodontist suggested removing the failed 3 unit bridge ( 3 extractions) at that location and then doing bone graft at the same time. and 4 to six months later 2 implants followed later by crowns. He is diabetic and hypertensive ( controlled) also on cholesterol meds. He is trying to decide if at his age whether to do all of the professional suggestions or to ask for precision removeable partial , or simply do nothing. He is mainly concerned with the long time line
to completion of the treatment plan and addressing the issue of being able to properly care for the implants as he ages. Thank you for your informative website.
Occasionally, older patients express concern that their age may prevent them from enjoying the benefits of dental implants. However, health is more of a determining factor than age. If you’re healthy enough to have a tooth extracted, you’re probably healthy enough to receive dental implants. Age is rarely a consideration in dental implant treatment. I have implanted patients as young as 16 years, and as old as 94. Certain chronic diseases may contraindicate implant treatment.
Age is not a factor! The time to have implants is when you are healthy. I placed an implant into my mom at age 80 and she will age with all her teeth ❤️
Thank you for your reply, I can tell from your response that you simply love what you do ! You and your mom are lucky — you are blessed with your skills to help her and she will be able to enjoy the implants. Husband was mainly concerned if the diabetes – even if controlled—would slow down the healing as it would be multiple upper extractions followed by the bone graph . I suspect he is concerned about infection. Your website and blog are well presented and quite informative – I am sure you have helped countless people make a decision regarding their dental future. Blessings to you in the future.
You are very kind. I am happy to help
As long as the hemoglobin A1c number is seven or below he should have no real problem.
As you can imagine I have place thousands of implants on diabetics. It’s important to have a good glucose control for proper healing
Hello Dr. Amin,
I’m a 69-year old retiree in FL (used to live in So. Cal. many years ago). Your website has become a GO-TO website for anything about dental implants! Thank you very much!
I’m seriously thinking about having upper and lower implants done very soon. And I’ve seen several implant centers within a 60-mile radius in my area. One particular center which I’m leaning towards to using, categorically states (also published in their website) that I will have my PERMANENT teeth made of “Prettau2 Dispersive Zirconia” within 7 days after date of surgery. Of course they say that not everybody can qualify. The entire process takes 7 days excluding pre-op meeting. First day is surgery plus all necessary digital scans; next day following surgery, TEMPORARY teeth are installed – the reason this is done on the day following surgery is to provide their in-house lab, time to customize the temporary teeth which will become the prototype for the PERMANENT zirconia teeth; and 3-5 days later, the PERMANENT Prettau2 Dispersive zirconia teeth are installed. About 4 months of healing and soft diet come after.
They have an in-house lab equipped with the “latest digital computer-aided technology”.
All other centers that I’ve seen would put in TEMPORARY teeth (on the day of surgery) and make you wear them during the entire healing process (4+ months).
What is your opinion about having the PERMANENT ZIRCONIA teeth already installed throughout the entire healing time (as opposed to having TEMPORARY plastic teeth)? Is this unnecessarily risky? What are the other risks? This center says that “in less than 5% occurrence” where gap(s) between the gum and arch develop, they will fix the permanent teeth by “adding porcelain material (zirconia) to fill the gap(s)”. They have an UNCONDITIONAL 5-YEAR warranty with no exclusions.
Again, thank you very much!
Good health to you.
Unnecessarily risky! AVOID! I do all of these same things and have the most advanced technology on the planet and as of April 2022 there is no way that I would deliver permanent zirconia to a patient that quickly. There is far too much information to be gleaned from the temporization process. It sounds like this practice is more focused on profit margin then excellence. This is a hard no from me. Check out this article.
Thank you very much, Dr. Amin. I respect and value your opinion. And, I will re-assess and consider other options going forward.
Wow! Nothing else to say. I truly appreciate your taking the time! More success to you. God bless.
Hello Dr. Amin,
I’m a 69-year old retiree in FL (used to live in So. Cal. many years ago). Your website has become my GO-TO website for anything about dental implants! Thank you very much!
I’m seriously thinking about having upper and lower implants done very soon. And I’ve seen several implant centers in my area. One particular center which I’m leaning towards to using, categorically states (also published in their website) that I will have my PERMANENT teeth made of “Prettau2 Dispersive Zirconia” within 7 days after date of surgery. Of course not everybody can qualify but majority will. The entire process takes 7 days excluding pre-op meeting. First day is surgery; next day following surgery, TEMPORARY teeth are installed – the reason this is done on the day following surgery is to provide their lab, time to customize the temporary teeth which will become the prototype for the PERMANENT zirconia teeth; and 3-5 days later, the PERMANENT Prettau2 Dispersive zirconia teeth are installed. About 4 months of healing and soft diet come after.
Similar to your office, they have an in-house lab equipped with the “latest technology”. All other centers would put in TEMPORARY teeth (on the day of surgery) and make you wear them during the entire healing process (4+ months).
What is your opinion about having the PERMANENT ZIRCONIA teeth installed throughout the entire healing process (as opposed to having TEMPORARY plastic teeth)? Is there a difference? What are the possible risks, if any? This center says that “in rare situation, -5%” where gap(s) between the gum and arch develop, they will fix the zirconia by “adding material to fill the gaps (my words)”. They have UNCONDITIONAL 5-year warranty with no exclusions.
Good health to you. Again, thank you very much!
Dear Dr. Amin,
I take tricyclic antidepressant meds. Two of my implants are failing. They support a bridge on the bottom front jaw. Are certain antidepressants better than others vis a vis dental implants? If this is a contributory factor to having implants, then I will change antidepressants. Or, are most antidepressants contraindicated for implants?
Great question 🙋🏻♂️
TCAs do decrease success BUT….it is only a small amount.
If you take a TCA and you smoke/have diabetes/low vitaminD/ cholesterol/osteoporosis etc then it becomes additive.
I would not change your meds. Just re-evaluate and try again.
https://burbankdentalimplants.com/why-do-dental-implants-fail/
**Quitting**, not quoting. Sorry
Dr. Amin, I have contacted your office about zygomatic/pterygoid implants, looks like you’re scheduled out to mid April. I will be out asap, so I’m wondering, In this post you say” maybe you smoke or vape, you shouldn’t have implants”. I vape but I will quit before coming out. Is it because of sinus issues like smokers have or because it affects healing? It’s not good in general and I will quit, just want to ensure I have the best possible procedure which is why I’m coming to you. After quoting, do I need to wait a certain period of time before getting the full arch supports? Top and bottom. Thank you
Nice to meet you! 😊
Quitting as soon as possible is important. How long you previously smoked for definitely is a major factor. Meaning somebody that has smoked for 30 years ideally quits for longer than somebody who has only smoked for three years.
Ideally you have quit for several weeks in advance at the very least. 😀
Vaping and smoking greatly affect healing especially in complex dental surgery. I would advise you to quit altogether. Sometimes you have to transition to a patch if you need.
Looking forward to meeting you! 😊