Short answer: After the implant screw is placed, the permanent tooth is fitted once the implant has finished integrating with the jawbone (osseointegration). This usually takes about two to three months in the lower jaw and three to six months in the upper jaw. The period may be longer if bone grafting or a sinus lift was performed. Under suitable conditions a temporary tooth can be fitted on the same day; the exact timing is decided by your dentist.
One of the questions most often asked by people planning implant treatment, or who have just had an implant screw placed, is when a "real" tooth will go into their mouth. However, there is no single answer to the question of when the tooth is placed after an implant, because the timing depends on which jaw the implant is in, the quality of the bone, whether additional surgery was performed and the person's general health. As a general framework, in most cases the permanent tooth is fitted after a healing period of several months, allowing the implant to integrate with the bone. In this article we explain the reason for this waiting period, the differences between the lower and upper jaw, the option of immediate loading and how esthetics can be maintained during the waiting period.
What is the integration (osseointegration) process, and why do you have to wait?
Osseointegration is the process in which a direct, solid connection forms between the surface of an implant screw made of titanium or a similar biocompatible material and the jawbone; this integration needs to be complete before the implant can withstand the chewing forces the permanent tooth will carry. On the day it is placed, the implant sits tightly in the bone mechanically; this is called primary stability. What provides real durability, however, is biological stability, achieved as new bone forms around the screw over weeks and months.
During healing, the process roughly unfolds as follows:
- First days: A clot forms at the surgical site and soft tissue healing begins. Swelling and tenderness usually ease within a few days.
- First weeks: The bone around the implant remodels. During this time the initial mechanical tightness decreases somewhat while the new bone has not yet fully matured; this is why it is important not to overload the implant.
- Following months: The newly formed bone matures and fuses firmly to the implant surface.
If heavy chewing forces are placed on the implant before integration is complete, micro-movements can occur between the screw and the bone. This can lead to connective tissue forming instead of bone and to loss of the implant. The waiting period is a precaution taken so that the treatment lasts.
How long are the waiting periods in the lower and upper jaw?
In general, integration is expected to take about two to three months in the lower jaw and about three to six months in the upper jaw; however, these periods are set by the dentist according to the individual and the clinical conditions. The main reason for the difference is the bone structure of the two jaws.
- Lower jaw: The bone is denser and more compact, especially in the front. This allows the implant to hold more firmly from the start and usually to integrate in a shorter time.
- Upper jaw: The bone is more porous and softer, especially toward the back. Integration may therefore take longer to complete.
Situations that can extend the timeline
- Bone grafting: If a graft was placed because of insufficient bone volume, extra time may be needed for the graft to mature.
- Sinus lift: When the floor of the sinus is raised in the back of the upper jaw, the waiting period is usually extended by a few more months.
- Implant placed at the same visit as the extraction: When an implant is placed right after a tooth is extracted, the healing of the extraction socket is also taken into account.
- General health factors: Uncontrolled diabetes, smoking and certain medications that affect bone metabolism can slow healing.
At follow-up appointments, the dentist assesses the implant with a clinical examination and X-rays; at some clinics, implant stability is measured with special devices to decide when to load it.
Is immediate loading possible with implants?
Yes, when certain conditions are met, a temporary tooth can be fitted on the implant on the day it is placed or within a few days; this approach is called immediate loading. However, this option is not suitable for everyone, and the decision is finalized based on findings during surgery.
Immediate loading usually requires the following conditions:
- High primary stability of the implant at the time of placement
- Sufficient bone volume and density
- No active infection in the area
- No severe clenching or grinding habit
- The patient being able to follow the dietary rules during healing
The tooth fitted with immediate loading is temporary and is often adjusted so that it does not touch the opposing teeth; this provides esthetics while limiting the force placed on the implant. During this time the person needs to eat soft foods and avoid biting hard things with that area. The permanent tooth is still made after integration is complete. In some cases where the entire jaw is treated with implants, the implants can be connected with a fixed temporary prosthesis, providing fixed teeth on the same day.
Can you wear a temporary tooth during the waiting period?
Yes, several temporary tooth options can be used during the waiting period, especially in the front of the mouth, for esthetic and social comfort; the choice depends on the position and number of missing teeth and on whether pressure would be placed on the implant. The most important principle here is that the temporary tooth must not put uncontrolled pressure on the healing implant.
- Removable temporary partial denture: A small removable appliance that replaces one or a few teeth. It is a practical solution; it needs to be adjusted so that it does not press on the implant site.
- Temporary tooth on a clear retainer: It can be made by adding tooth-colored material for the missing tooth inside a transparent plate. It may be preferred especially for short-term use.
- Bonded temporary bridge: A temporary bridge bonded to the neighboring teeth can close the gap without touching the implant site.
- Adapting an existing complete denture: For people who wear full dentures, the inner surface of the denture is adjusted with a soft liner material to keep it from pressing on the implants.
In the back of the mouth, where a single missing tooth is not visible, waiting without a temporary tooth is sometimes preferred. You decide together with your dentist which option is suitable.
How is the permanent tooth fitted?
Once integration is complete, a connecting piece (abutment) is placed on the implant, an impression or digital scan is taken, and the permanent crown or bridge made in the laboratory is fitted after try-ins. The process is usually completed in a few visits.
- Uncovering the implant: If the implant has stayed under the gum during healing, it is uncovered with a minor procedure and a healing cap is placed so the gum can take shape. This step is not needed for implants placed with a cap at the first visit.
- Impression: Once the gum has taken shape, the position of the implant is recorded with an impression or an intraoral scanner.
- Try-in: When needed, the fit, color and bite of the crown are tried in.
- Placement: The permanent tooth is secured either with a screw or with cement. The bite is checked and minor adjustments are made if needed.
After the permanent tooth is placed, regular check-ups and good oral hygiene are decisive for keeping the implant healthy for many years. Before missing teeth are replaced with implants, the position of neighboring teeth may need to be corrected; we explained the options for this in our article on missing teeth and clear aligners. You can find answers to other implant questions on our frequently asked questions page.
When should you have an examination in Ankara for the implant process?
If you have a missing tooth or are considering an implant in the future for a tooth that is planned to be extracted, an early assessment of your bone helps plan the treatment timeline more realistically. At our polyclinic in Oran, Çankaya, after an examination and imaging we discuss with you, specifically for your case, the integration period, temporary tooth options and at what stage the permanent tooth can be fitted; the treatment and fee plan is also shared in writing.
Frequently asked questions
Will I be left without a tooth after the implant is placed?
During the waiting period, especially in the front of the mouth, options such as a removable temporary partial denture, a temporary tooth on a clear retainer or a bonded temporary bridge can be used. Under suitable conditions, it is also possible to fit a temporary tooth on the implant on the same day. The option is chosen based on the implant's position and stability.
How do you know the implant has integrated?
At the follow-up appointment, the dentist assesses the implant with a clinical examination and X-rays. At some clinics, implant stability can be measured with special devices. The absence of symptoms such as pain, movement or inflammation is also a positive sign of healing.
Is it possible to shorten the waiting period?
Integration is a biological process and requires a certain amount of time. Quitting smoking, keeping chronic conditions under control and following your dentist's recommendations help healing go smoothly. In suitable cases, a temporary tooth can be fitted early with immediate loading.
What should I eat while the implant heals?
In the first days, lukewarm and soft foods should be preferred, and chewing on the implant side should be avoided. Hard, sticky and very hot foods should be limited during the healing period. It is important to follow the dietary recommendations your dentist gives you.
