A plan built around the future teeth
A crown on an implant replaces a tooth without relying on the adjacent teeth. Whether it is indicated is compared with a bridge or another prosthetic solution.
In a visible area, the analysis also covers the gum contour, tissue thickness and the smile line. Bone or gum preparation may be needed; it is discussed before surgery.
After a tooth is lost, the bone that supported it gradually resorbs. The implant transmits chewing forces to the bone again, which helps preserve its volume under the crown. It does not, however, protect the bone absolutely: the gum, hygiene and follow-up remain decisive.
Implant, bridge or denture: comparing
Several solutions can replace a tooth. None is best in every situation: the choice depends on the neighbouring teeth, the bone, your health and your priorities.
| Solution | Strengths | Limits |
|---|---|---|
| Crown on an implant | Does not involve the neighbouring teeth; cleaned like a natural tooth. | Surgery, healing time, lifelong maintenance. |
| Conventional bridge | No surgery; shorter treatment. | The neighbouring teeth are drilled down; cleaning under the bridge needs special aids. |
| Bonded bridge | Very limited preparation of the neighbouring teeth. | Selected indications, mainly at the front; risk of debonding. |
| Removable partial denture | Simple and reversible. | Less stable and less comfortable; clasps sometimes visible. |
| No replacement | No treatment. | The neighbouring and opposing teeth may drift over time. |
If the neighbouring teeth are healthy, an implant avoids drilling them down. If they already have large restorations, a bridge may instead be a logical solution. This choice is made with your dentist.
What the research says
A meta-analysis published in 2019 pooled 18 studies that followed implants for at least 10 years. On average, 96.4% of implants were still in place after 10 years. Taking into account patients lost to follow-up, the cautious estimate was 93.2%, and slightly lower in patients aged 65 and over.
For single crowns on implants, a 2014 review comparing older and newer publications shows an improvement: 5-year crown survival rose to 97.2% in recent studies, and abutment screw loosening fell markedly.
“Survival” does not mean “no problems”. Technical complications (loosening, chipped ceramic) or biological ones (gum inflammation, bone loss) remain possible and are often easier to treat when detected early.
The stages for one tooth
- Consultation and 3D scanExamination, CBCT at the practice if indicated, discussion of the options and a quote.
- PlanningThe position, angle and dimensions of the implant are chosen on the 3D model, around the future crown.
- Extraction and site preparationIf the tooth is still present: extraction, possibly socket preservation or an immediate implant.
- Implant placementUnder local anaesthesia, often in less than an hour, with guided or navigated surgery as appropriate.
- OsseointegrationUsually 3 to 4 months, with a temporary tooth if the situation allows.
- Final crownMade by your dentist if you were referred, followed by regular check-ups.
An implant on the day of extraction?
When the tooth to be replaced is still in the mouth, the implant can sometimes be placed on the day of extraction. The 2023 ITI international consensus considers this approach predictable for a single tooth at the front of the upper jaw, but in carefully selected situations.
The conditions include general health, gum health, the bite, the thickness of the bone on the lip side and the quality of the gum. The implant must be stable as soon as it is placed; a gap of at least 2 mm between the implant and the outer bone wall is recommended.
When these conditions are not met, the site is first allowed to heal, sometimes after socket preservation. Placing an implant immediately also does not mean receiving a final tooth on the same day.
What the assessment must establish
Dr Yousefpour examines the tissues and anatomical structures, then organises the planning with the dentist making the prosthesis. A CBCT (3D scan) is offered when the information it provides is needed. A bone graft or sinus lift may be discussed if bone support is insufficient.
Your general health, oral hygiene, smoking, current medication and your ability to attend follow-up all play a part in the decision. The benefits, risks and alternatives are explained to you.
Making the implant last
Surgery is followed by a phase of healing and check-ups. Cleaning the implant and the crown must remain possible every day; maintenance is organised with your dentist.
In a large Swedish study following patients for 9 years, 14.5% had peri-implantitis with marked bone loss. A history of periodontitis and smoking were associated with a higher risk. A 2021 meta-analysis estimates that the risk of implant failure is about 2.4 times higher in smokers.
The 2023 European guidelines stress prevention from the planning stage, appropriate cleaning and a programme of regular check-ups. Read our article on peri-implantitis
Frequently asked questions
How long does a dental implant last?
In a meta-analysis of 18 studies, about 96% of implants were still in place after 10 years. The crown may need maintenance or replacement over time. Hygiene, not smoking and regular check-ups all matter for how long it lasts.
Is an implant or a bridge better?
It depends on the condition of the neighbouring teeth. If they are healthy, an implant avoids drilling them down. If they already have large restorations, or if surgery is not wanted, a bridge can be a good choice. Both options are compared at the assessment.
Can the implant be placed on the day the tooth is removed?
Yes, in selected cases: the bone wall on the lip side must be intact, the gum of good quality and the implant stable from the moment it is placed. Otherwise, healing is allowed first, sometimes after socket preservation.
How long does surgery for one tooth take?
Placing a single implant under local anaesthesia usually takes less than an hour. An associated graft may make the procedure longer. You go home the same day with your instructions.
Can you be allergic to titanium?
A true titanium allergy is very rare. If you have a history of metal allergies, mention it at the consultation: your situation is assessed and other materials can be discussed.
How often should my implants be checked?
It depends on your risk: often once or twice a year with your dentist or periodontist, sometimes more often if you have a history of periodontitis. European guidelines stress these regular check-ups to detect inflammation early.
Sources
- Howe, Keys, Richards — Journal of Dentistry, 2019 — meta-analysis of 18 studies on 10-year implant survival.
- Pjetursson et al. — Int J Oral Maxillofac Implants, 2014 — trends in survival and complication rates of crowns and bridges on implants.
- Jung et al. — Clinical Oral Implants Research, 2008 — 5-year survival and complications of implant-supported single crowns.
- ITI Consensus Conference, Lisbon 2023 — selection criteria for immediate single-tooth implants in the aesthetic zone.
- Derks — Effectiveness of implant therapy in Sweden, University of Gothenburg, 2015 — 9-year follow-up of implant patients in Sweden (implant loss, peri-implantitis).
- Mustapha, Salame, Chrcanovic — Medicina, 2021 — meta-analysis on smoking and implant failure.
- Herrera et al. — EFP S3 guideline, J Clin Periodontol, 2023 — European guideline on preventing and treating peri-implant diseases.
Implant or bridge: how to choose? · How long does an implant last? · Information and consent
This general information helps you prepare for your consultation. Treatment, its risks and aftercare instructions are adapted to your situation by the surgeon.