The few months between placing a dental implant and fitting the final tooth are not just waiting time. During that period new bone forms directly against the implant surface, so the implant ends up held by living bone rather than by the tight fit it had on the day it went in. That process is called osseointegration, and it is the reason most implants are still in place a decade later.
Bone in direct contact with the implant
The word joins "osseo", meaning bone, with "integration". It describes bone growing right up to and onto the implant surface, with no layer of soft tissue in between. Implants are usually made of titanium or a titanium alloy, materials that bone tolerates well, and their surfaces are treated to encourage new bone to form against them.
This is different from how a natural tooth is held. A tooth sits in its socket on a thin cushion of ligament fibres. An integrated implant has no ligament, which is one reason it does not move under pressure the way a natural tooth does, and why it cannot drift into a new position like a tooth can.
From a tight fit to a biological bond
The day of placement
The implant is placed into a carefully prepared site in the bone so it sits firmly and does not wobble. This first grip is mechanical, called primary stability. It holds the implant still while healing starts.
The healing weeks
As the bone around the implant remodels, some of that original mechanical grip is replaced by new bone forming on the implant surface. This gradual handover from mechanical to biological stability is the core of osseointegration. Small movements during this time can disrupt it, which is why the implant is protected from heavy biting forces while it heals.
Restoring the tooth
Once your dentist is satisfied that the implant is stable, the crown, bridge or denture that attaches to it is made and fitted. Our guide to the cost of dental implants sets out the stages and what each involves.
How long the healing phase takes
There is no single number that suits everyone. The Cochrane review of implant loading times (Esposito and colleagues, 2013) notes that under the conventional approach, implants are kept free of biting load for 3 to 8 months to allow osseointegration. The time depends on the jaw, the density of the bone, whether a bone graft or sinus lift was needed first, and your general health. Your dentist will give you a timeline based on your own situation and check stability before the final tooth goes on.
Some implants are fitted with a tooth much sooner. In that Cochrane review, trials comparing immediate, early and conventional loading found no convincing evidence of a difference in implant failure, but the evidence was limited and many of the trials had a high or unclear risk of bias. Immediate loading depends on strong primary stability and suitable bone, so it does not suit everyone, as our article on immediate-load dental implants explains.
Smoking and other factors that work against it
Smoking reduces blood flow to healing tissue and is one of the clearest risks you can change. A meta-analysis by Chrcanovic and colleagues (Journal of Dentistry, 2015) pooled 107 studies and found implant failure in 6.35% of implants placed in smokers compared with 3.18% in non-smokers, with more infections and bone loss as well, although the authors cautioned that other factors could not be fully controlled.
Other things that can make integration less predictable include poorly controlled diabetes, some medicines that affect bone, infection at the site, and too much force on the implant too early. Your dentist will ask about your health and medicines before planning treatment, and you should never stop a prescribed medicine without talking to your doctor.
Most implants last, and the bond needs looking after
A systematic review by Howe and colleagues (Journal of Dentistry, 2019) estimated 10-year implant survival at 96.4%. A more cautious analysis in the same paper, allowing for patients lost to follow-up, gave 93.2%, and survival was lower in people aged 65 and over.
Integration is not something that happens once and is then guaranteed. Plaque around an implant can inflame the gum and lead to bone loss around it, a condition called peri-implantitis, which can undermine the support over time. Careful daily cleaning and regular maintenance visits are what protect it. Our guides to cleaning dental implants, implant aftercare and peri-implantitis treatment cover this in detail.
Common questions
How will I know the implant has integrated?
Your dentist checks that the implant is firm and comfortable and usually takes an X-ray before the final tooth is made. An implant that feels loose or sore is assessed before going further.
Can osseointegration fail?
It can, although it is uncommon. Failure is more likely with smoking, infection, poorly controlled health conditions or early overloading, and when it happens it often shows up in the healing months, which is why that period is monitored.
Will I have a gap while it heals?
Not necessarily. Depending on the site, a temporary tooth or denture can often be worn during healing. Your dentist will discuss the options for your case.
Find out whether an implant suits you
Implants are planned and placed at Lumi Dental using 3D X-rays, and implant consults are free. To arrange a visit, see our current deals or read about dental implants at Lumi Dental in Melrose Park.
