Most implant problems are not surgical failures. They are teeth placed where the bone happened to allow, rather than where the finished tooth needed to be. That decision is made weeks earlier, on a screen.
Every implant here is planned from a scan and a 3D X-ray of your mouth, so it goes where the final tooth asks for it and not the other way round. Where the bone allows it, the implant goes in the same day the old tooth comes out, with a temporary tooth on it from the first moment.
The range runs from one tooth to a whole jaw. Where bone is missing it is rebuilt first — and what was done and what was measured is written into the file and published with the case.
One implant, one tooth, and the teeth either side are left alone. At the front of the mouth the hard part is not the tooth itself — it is the shape of the gum around it. That shape is built first with the temporary tooth and then copied into the final one, which is why the temporary is not “something until the real one is made”.
When not: when the tooth next door already carries a large filling or crown and a bridge solves two problems at once.
A fixed bridge on implants instead of a partial denture that comes in and out. The implants are not one per tooth: usually two carry three teeth. Where they go is decided by the bone that exists and by where the bite lands.
When not: at the back of the mouth where very little bone is left, and the bone has to be rebuilt first.
Four to six implants carry the entire jaw. The back ones often go in at an angle, to find solid bone and avoid a graft. What cannot be saved is removed, the implants go in, and fixed temporary teeth are screwed on within the first day. The final teeth follow a few months later, once bone and gum have settled.
When not: when teeth can still be saved. This is not an upgrade — it is the answer to a jaw that is finished.
In many cases the teeth go on the same day — temporary, fixed, so that you are never without. It is not promised beforehand: it is judged in theatre, from how firmly the implant sits in the bone, and it is measured.
When not: when the measurement is not there. The implant is then covered over and left to heal — a few extra weeks do not compare with work that did not last.
When a tooth has been missing for a while, the bone that held it shrinks away. Rebuilding that bone is not done to make the implant fit; it is done so the bone still supports it in ten years, and so no line ever shows above the tooth as the gum settles.
Four routes cover nearly everything that comes up. Which one is needed is visible on the 3D X-ray before the surgery rather than during it — so you know when we discuss the plan, not afterwards.
And one thing that is not bone at all: where the gum around an implant is thin, it is thickened with a small graft taken from your own palate. It is a minor procedure that decides how the work looks years later.
Above the back teeth of the upper jaw there is a natural air space, the sinus. When the bone beneath it has thinned, its floor is lifted carefully and the space that opens up is filled with bone material.
Where enough bone remains, all of it is done through the same small opening that will receive the implant: one procedure, nothing opened from the side, little swelling.
When very little bone is left, the same space is reached from the side, through a small window. The reason is simple: the area can then be seen and checked by eye, instead of everything being done blind.
The implant goes in either at the same visit or once the area has healed — depending on how firmly it sits at that moment.
Where the bone has narrowed or dropped, bone material is placed and a very thin membrane is laid over it. Gum heals far faster than bone and, without that membrane, would take the space instead. The membrane keeps the space open for as long as it is needed.
The area needs a few quiet months before it is loaded. That is the time that buys the next ten years.
Before an implant is discussed, we look at whether the tooth itself can be kept. For teeth that have lost bone around the root there is a technique that helps the body rebuild the natural tooth's own support.
It does not work everywhere — but where it does it beats any replacement. Extraction is the last option, not the first.
A 3D X-ray, a digital scan, photographs. Nothing is proposed until the anatomy and the finished result have both been looked at.
The final tooth position is decided on screen and the implant position follows from it. That is also where it becomes clear whether bone has to be rebuilt.
A printed guide carries that plan into the mouth. Where stability allows, a temporary tooth is fitted the same day.
A few weeks with the temporary — longer where bone was rebuilt — then the final tooth. From there the clock starts.