Patient guide · For patients
How does implant treatment in İzmir proceed? First exam, 3D planning, surgery, healing, prosthesis and maintenance, step by step, with the evidence.
Before deciding on an implant, most patients have the same question in mind: "How exactly does this process work, and how long does it take?" Implant treatment in İzmir is a sequence of stages, from the first examination to the day the prosthesis is fitted, and each stage shapes the next. This article walks through those stages in order, together with what the literature says about each.
One Anatomy. Two Surgical Philosophies.
After tooth loss the jaw loses width as well as height. When the ridge is too narrow for a standard implant, two different paths can be taken; both are documented in the literature.
Thin alveolar ridge: schematic bucco-lingual cross-section. Ridge width ≈ 5 mm.
Standard-diameter implant + guided bone regeneration (GBR)
Narrow-diameter implant (3.3 mm), no augmentation
| Augmentation-driven path | Anatomy-driven path | |
|---|---|---|
| Implant diameter | Standard (≈4 mm) | Narrow (3.3–3.5 mm) |
| Additional procedure | Graft + membrane | None |
| Surgical field | Crest + cheek side | Crest only |
| Timing | Same session or staged | Same session |
Two philosophies, one goal:
Minimally invasive implantology.
The process begins with a conversation. When and why the tooth was lost, the condition of the remaining teeth and gums, general health history (diabetes, medications, smoking) and expectations are clarified at this meeting. An intraoral examination follows: gum pockets are measured, and the neighbouring teeth and the opposing jaw are assessed.
The first image is usually a panoramic X-ray. It gives an overview of the whole jaw: the roots of the teeth, the approximate level of the sinus floor, the course of the lower jaw nerve. If there is active gum disease, implant planning waits until that disease is brought under control, because a history of periodontitis is a recognised risk factor for inflammation around implants later on (Monje 2016).
For patients coming from another city or from abroad, the pre-assessment can start remotely from an existing panoramic X-ray or CBCT scan. This does not replace the examination, but it helps narrow down which options can be discussed in advance.
A panoramic X-ray is two-dimensional; it does not show the width or the internal structure of the bone. That is why, in most cases, cone beam computed tomography (CBCT) is requested for implant planning. The three-dimensional image makes it possible to measure bone height and width to the millimetre, to see the distance to structures such as the sinus and the nerve, and to decide the position and angle of the implant in advance.
A systematic review summarises the indications for CBCT in implant dentistry as anatomical assessment, planning of sites that require grafting, and computer-assisted treatment planning; the same review notes that effective doses vary widely between devices and that limiting the field of view to the region of interest reduces the dose significantly (Bornstein 2014). In practice this means a scan is taken when needed and with a narrow field.
If planning reveals limited bone volume, the options are discussed at this point: short implants, internal sinus lift, angled placement or grafting. These are described in more detail on the minimally invasive implant approaches page. Which route is suitable is decided after the examination and the scan.
Implant surgery is performed under local anaesthesia in the clinic in most cases. For a single implant the procedure usually takes less than an hour; with several implants it takes longer. When planning has been done on the CBCT scan, it may be possible in suitable cases to work without a gum incision or with a small one.
The decision between extracting the tooth and placing the implant in the same session, or waiting for the extraction site to heal, depends on the condition of the bone walls and the presence of infection. A systematic review of placement and loading protocols in partially edentulous patients reports a weighted cumulative survival of 97.7 percent for late placement with conventional loading and classifies the protocols combined with conventional loading as "scientifically and clinically validated" (Gallucci 2018). In other words, the classic route is the well-documented route; accelerated routes depend on specific conditions.
Mild swelling, tenderness and a small bruise may occur in the first days after surgery; these are expected findings. Medication and care instructions, the date for suture removal and the first follow-up appointment are confirmed on the same day.
The integration of the implant with the bone is called osseointegration, and this biological process determines when the prosthesis can be fitted. The Cochrane review defines three approaches: loading within one week of placement (immediate), between one week and two months (early), and after two months (conventional). In the conventional approach, implants are left load-free for 3 to 8 months to establish osseointegration (Esposito 2013).
The same review reports a mean first-year implant failure rate of 2.5 percent across 26 randomised trials and finds no convincing evidence of a clinically important difference in prosthesis failure, implant failure or bone loss between the different loading times (Esposito 2013). This does not mean "same-day teeth for everyone": immediate loading depends on conditions such as sufficient primary stability, suitable bone and balanced chewing forces. Which timing is appropriate for you is decided by weighing the stability measured during surgery together with the plan.
During healing, a temporary tooth or appliance is used in the front of the mouth where appearance matters. In the back, a temporary is often not needed.
Once osseointegration is complete, the prosthetic stage begins. The first step is either fitting a gum-shaping component on the implant or taking the impression directly. The impression can be taken conventionally or digitally with an intraoral scanner. The laboratory then makes the connecting piece between the implant and the crown (the abutment) and the crown itself.
At the try-in appointment, the fit of the crown, its contact with the neighbouring teeth and the bite are checked, and small adjustments are made if needed. At delivery the crown is either screwed on or cemented; the choice depends on the position and the design.
An important record is taken on delivery day: the radiograph and gum-pocket measurements made after the prosthesis is finished are kept as baseline values for comparison in the years ahead. The 2017 World Workshop consensus report recommends obtaining these baseline records once the implant-supported prosthesis is completed (Berglundh 2018).
Implant treatment does not end with the delivery of the prosthesis; it moves into a different phase. A meta-analysis of the effect of maintenance therapy on preventing peri-implant diseases reports that the frequency of peri-implantitis at implant level ranges from 1 to 47 percent across studies, that a history of periodontitis increases the risk, and that the recall interval influences the incidence of peri-implantitis at implant level; the authors suggest a recall every 5 to 6 months, tailored to the patient's risk profile (Monje 2016).
The long-term picture looks like this: a systematic review of ten-year survival reports a summary estimate of 96.4 percent at implant level; in a more cautious analysis that accounts for patients lost to follow-up the figure is 93.2 percent, and the risk of loss is somewhat higher in the over-65 group (Howe 2019). These are literature averages; the individual course depends on bone, gum health, smoking and care habits.
Home care involves cleaning around the implant with interdental brushes or floss. At follow-ups, gum measurements, radiographs where needed and professional cleaning are carried out. The recall frequency is set at the end of treatment according to your risk profile. For general information on the treatments provided at the clinic in Bornova and on periodontology, see the implant dentist in İzmir page.
If bone and gums are healthy and conventional loading is chosen, the process typically takes a few months; reviews define the conventional healing period as 3 to 8 months (Esposito 2013). If a graft or sinus lift is needed the timeline is longer; in suitable cases it can be shorter with immediate loading. The schedule is set after the examination.
In some straightforward cases a panoramic X-ray may be considered sufficient, but in most planning a CBCT scan is requested to see bone width and the distance to the sinus and the nerve (Bornstein 2014). The dose is kept low by limiting the field of view to the region concerned.
The pre-assessment can begin remotely with your existing panoramic X-ray or CBCT scan. The surgical and prosthetic stages usually require two separate visits, with the healing period spent at home in between. The number and spacing of visits are clarified at the examination according to your case.
Which placement and loading route suits you is decided after a clinical examination and three-dimensional imaging. A pre-assessment can start from an existing panoramic X-ray or CBCT scan; the definitive plan only emerges after the examination.
This article is for general information and does not replace an examination or a personal treatment plan.
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