How Long Does a Single Dental Implant Take, Start to Finish?

You lost a tooth, or you are about to, and someone mentioned an implant. One of the first things you want to know is how long you will be living with a gap.

So, how long does a dental implant take? For one tooth, it is usually several months from the first visit to the final crown. Most of that time is healing, not appointments. Let me walk you through each stage and the reason it takes as long as it does.

How long does a dental implant take, stage by stage?

There are five stages, and not everyone needs all of them:

1. Exam and 3D scan. The scan is a cone beam CT (CBCT), and it measures the bone where the implant would go.

2. Extraction and socket healing, if the tooth is still there.

3. A bone graft, only if the scan shows too little bone to hold an implant.

4. Placing the implant, then a healing period while the bone bonds to it.

5. The abutment and the crown, which turn the implant into a tooth you can chew with.

Planning and placement are single appointments. The months come from stages 2 to 4, when your body is doing the work and no appointment can speed it up.

Why does the socket need time to heal after an extraction?

An empty socket repairs itself in a set order. A review prepared for the International Team for Implantology (ITI) consensus conference lays out the stages (Chen, Wilson and Hämmerle, 2004).

A blood clot forms first, and over the next four to five days soft repair tissue replaces it. By about two weeks, firmer connective tissue has taken over. New bone then grows in from the base and walls of the socket, and by about six weeks it almost fills the space.

While that happens, the ridge that held the tooth gets narrower. Part of the bone around a tooth is there to anchor the ligament that holds the root. Once the tooth is gone, the body breaks that layer down. With no root passing chewing force into it, the rest of the ridge thins too.

One study in the same review followed 46 premolar and molar sockets for a year. The ridge lost about half its width, and two thirds of that loss came in the first three months.

So waiting has a cost as well as a benefit. The gum closes and new bone forms, but the ridge keeps shrinking. The review concluded that placing the implant four to eight weeks after the extraction appears to be the best timing. By then the gum has healed, and not too much bone has been lost.

Our tooth extraction post covers the extraction itself. What happens when you lose a tooth explains why a gap left for years is harder to fill.

Can the implant go in the same day the tooth comes out?

Sometimes. Placing the implant in the fresh socket at the extraction visit is called immediate placement. Whether it suits your tooth depends on three things.

• No active infection. The same 2004 review notes that waiting lets an infection at the site clear before the implant goes in.

• A thick enough outer wall of bone. The thickness of the wall on the lip or cheek side is the biggest factor in how much the site shrinks. A review of front teeth in Periodontology 2000 reports the numbers (Chappuis, Araújo and Buser, 2017). Walls 1 mm thick or less lost about 7.5 mm of bone height as they healed, and thicker walls lost about 1.1 mm. The authors consider immediate placement only where little of that shrinking is expected.

• Enough bone beyond the root tip to hold the implant firmly on the day it goes in. Until the bone bonds to it, that grip is all that keeps it still.

The scan shows some of this, and the rest becomes clear only once the tooth is out. So it is safer to plan around the usual wait until the extraction shows whether your socket qualifies.

When is a bone graft needed, and how much time does it add?

The 3D scan shows how wide and tall the bone is. It also shows how close the site sits to the nerve in the lower jaw, or to the sinus above the upper back teeth. If there is not enough bone to surround the implant, a graft builds it up.

Small gaps sometimes need nothing extra. The 2004 review looked at the space left between the implant and the socket wall. Where it was 2 mm or less, bone filled it on its own around a rough-surfaced implant.

Wider gaps, or a socket missing one of its walls, needed a graft at the same visit as the implant. A larger graft done as its own step has to heal before the implant goes in, which adds a separate wait.

Why does the implant take months to heal before the crown?

On the day it goes in, the implant is held by the grip of its threads in the bone. Over the following weeks, the bone touching it remodels, and new bone grows onto the roughened titanium. That bond is called osseointegration, and it is what lets an implant carry chewing force the way a root does.

Biting hard on the implant before that bond forms can move it. An implant that keeps moving tends to heal with soft tissue around it instead of bone, and then it cannot hold a tooth.

Guidelines set in the 1980s allowed three to six months for this bond before the implant carried a tooth. A 2009 review of front-tooth implants for the next ITI consensus conference describes those waits being challenged (Grütter and Belser, 2009). Its recommendations define early loading, when the implant first carries a tooth, as one week to two months after placement. They also note that the implant surfaces in use by then showed adequate bone contact at three weeks. Which timing suits your implant depends on how firmly it sat on the day, and on the bone around it.

What happens after the implant has healed?

The crown attaches to the implant through a connector called an abutment. Sometimes a small healing cap sits through the gum from the day of surgery. Other times the implant heals under the gum, and a short second visit uncovers it.

Next, an impression or a digital scan records where the implant sits, and the lab makes your crown. At the final visit the crown goes on, and we check how it meets your other teeth when you bite.

How is your own timeline decided?

At Advanced Dental Care of Stafford, a 3D scan is a standard part of assessing an implant case. Some cases also get a printed surgical guide made from that plan, and some do not. Our digital implant planning page explains which cases a guide helps most.

After the exam you get the plan written down. Ask us to walk you through the stages your case needs and the order they come in. Ask, too, what will fill the gap while the implant heals, since the answer depends on where the tooth is. If the surgery visit worries you, we offer nitrous oxide, oral sedation and IV sedation, and our sedation page compares them.

The dental implants page covers who is a candidate and what bone has to do with it. Our implant services overview shows the full-arch and implant-supported denture options as well. To find out what your own timeline looks like, call us at (540) 288-2800 or send a message through our contact page.