Dental implants: when to get them, how they work and why they matter

by Dr Nihad Pljevljak | Oct 20, 2025

Losing one or more teeth is a problem that goes far beyond appearance. Impaired chewing, progressive bone loss and changes in facial structure are just some of the consequences that can appear over time. Dental implants are today one of the most advanced and long-lasting solutions for restoring both the function and the appearance of your smile.

What a dental implant is and how it is made

A dental implant is an artificial root made of biocompatible titanium that is surgically placed in the upper or lower jawbone. The complete structure has three key components:

Endosseous screw: the part that bonds with the bone through the process of osseointegration
Abutment: the intermediate connector that links the screw to the prosthesis
Crown: the visible part, which faithfully reproduces a natural tooth

The titanium used to make implants is highly biocompatible: it is well tolerated by the tissues, and bone cells can grow directly on its surface, creating a stable and lasting connection.

When dental implants are needed

The indication for a dental implant is not limited to simply having a missing tooth. The clinical assessment must take many factors into account to decide the best timing and approach.

Clinical situations that call for an implant assessment

An implant may be needed in a number of situations:

Tooth loss through injury: when a tooth is lost in an accident, prompt treatment helps limit bone loss and preserve the shape of the gums.

Failed root canal treatment: root-treated teeth with recurring infections or root fractures that cannot be saved need to be extracted and replaced with an implant.

Missing teeth from birth (agenesis): the congenital absence of teeth, which most often affects the lower second premolars, followed by the upper lateral incisors and upper second premolars, can be resolved for the long term with implants once skeletal growth is complete.

Partial or total tooth loss: missing several teeth or a whole arch is the classic indication for complex implant-supported restorations.

Osseointegration: the science behind success

Osseointegration is the biological process at the heart of the long-term success of dental implants. Described by Professor Per-Ingvar Brånemark in the 1960s, it describes the direct structural connection between living bone and the surface of the implant.

In the conventional protocol the implant is left to heal without load for a few months (usually 3 to 8), during which precise biological stages take place: formation of the blood clot, deposition of immature bone tissue and finally bone maturation, with remodelling along the lines of functional load. Modern implant surfaces, treated chemically and mechanically, have helped to shorten waiting times in many cases.

Innovative surgical techniques in modern implant dentistry

Dental implantology has undergone significant technological change in recent years. Digitally guided surgery is the current standard: using a CBCT scan and three-dimensional planning software, the surgeon can simulate the procedure virtually and produce stereolithographic surgical guides that improve the accuracy of implant placement: on average, the final position of the implant differs from the plan by about 1-1.5 mm, which is why a safety margin is still maintained.

Immediate loading: protocols and indications

Immediate loading makes it possible to fit a temporary prosthesis on the implants within one week of surgery. This technique requires specific conditions: a high degree of primary stability of the implant (assessed, for example, by insertion torque), adequate bone quality and a balanced distribution of biting forces. When these parameters are met, studies show no clinically important difference in failures compared with conventional loading, with the advantage of reducing the cosmetic and functional discomfort of the healing period.

Innovative materials: beyond titanium

Although titanium remains the gold standard, zirconia implants are an emerging alternative, particularly suitable for patients with thin gums or high aesthetic demands in the front of the mouth. Zirconia has a natural white colour that does not cast grey shadows through the gum and has excellent mechanical properties, although it still needs very long-term clinical validation.

Managing complications and bone regeneration

Not all patients have ideal anatomy for implant placement. Guided bone regeneration (GBR) techniques make it possible to rebuild adequate bone volume using resorbable or non-resorbable membranes and bone graft materials.

A sinus lift, using either a lateral or a crestal approach, overcomes the anatomical limit posed by the maxillary sinus in the upper back of the mouth. The use of autologous bone grafts taken from donor sites inside or outside the mouth, or of bone substitutes of animal or synthetic origin, has greatly broadened the treatment options.

Maintenance and lifespan of implants

Long-term implant success depends critically on oral hygiene at home and on regular professional check-ups. Peri-implantitis, an inflammation of the tissues around the implant with loss of supporting bone, is the most feared biological complication and can lead to the loss of the implant itself.

The maintenance protocol includes:

A baseline X-ray when the prosthesis is completed, with further X-rays when clinical findings call for them
Professional cleaning at intervals tailored to your risk, generally at least every 5-6 months
Gentle probing of the tissues around the implant to check for bleeding and probing depth
Bite check to make sure there is no overloading

A systematic review of prospective studies reports average implant survival of around 96% at 10 years (around 93% in a more cautious analysis that accounts for patients lost to follow-up).

The importance of surgical skill and clinical experience

Specialist training and continuing education are essential for anyone working in dental implantology. Implant procedures require in-depth anatomical knowledge, advanced diagnostic skills and refined technical expertise.

Dr Nihad Pljevljak, a dentist and surgeon with a PhD in Oral and Dental Diseases from Sapienza University of Rome, is a point of reference for dental implants in the EUR area. Registered with the Rome Order of Physicians and Dentists (Ordine dei Medici Chirurghi e Odontoiatri di Roma), Dr Pljevljak has developed over more than ten years of clinical practice a personalised approach that combines the latest technological innovations with scientifically validated clinical protocols.

Nea Bios Dental Clinic, located at Via Cesare Pavese 135 in the heart of EUR, is equipped with advanced diagnostic technology, including high-resolution CBCT and digital intraoral scanning systems. Dr Pljevljak's experience in treating complex cases and the trust placed in him by many patients, including public figures, reflect the clinic's clinical excellence.

For more information, see also: /en/dental-implants-rome/

Costs and investing in your oral health

Dental implants are a significant investment, but they should be considered in the light of their long-term benefits. Unlike traditional bridges, which require healthy neighbouring teeth to be filed down, or removable dentures, which need replacing periodically, implants offer a long-lasting solution that preserves the remaining teeth.

The cost covers not only the surgery but also:

Advanced three-dimensional diagnostics
Digital planning of the procedure
High-quality certified implant components
A custom-made final prosthesis
Clinical follow-up over several years

Why choose implants: the documented benefits

The scientific literature identifies many benefits of dental implants:

Bone preservation: implants transmit chewing forces to the bone just like natural teeth, helping to limit the progressive bone loss that occurs when teeth are missing.

Chewing function: a marked improvement in chewing ability compared with removable dentures, allowing a varied and balanced diet.

Stable prosthesis: no more of the retention and stability problems typical of traditional removable dentures.

Neighbouring teeth preserved: unlike bridges, healthy teeth do not need to be prepared.

Longevity: when properly maintained, implants can last many years, often decades.

Quality of life: many patients report improvements in speech, self-esteem and social relationships.

Towards a personalised future: digital implant dentistry

The combination of artificial intelligence and implant dentistry is opening up new possibilities. Machine-learning algorithms that analyse large numbers of clinical cases to support treatment planning are being studied, while CAD/CAM systems produce custom prostheses in less time and with high precision.

Bioengineering is developing "smart" implant surfaces that release growth factors to speed up osseointegration and antimicrobial peptides to prevent infections around the implant. Research into tissue engineering is exploring ways to regenerate bone and gum tissue ever closer to the original.

The right time to act

Putting off implant treatment has progressive consequences: bone loss makes future procedures more complex and more expensive, neighbouring teeth tend to drift and alter the bite, and the impact on quality of life builds up over time.

An implant assessment does not mean you have to go ahead straight away, but it allows you to understand the options available, plan the best course of treatment and act when conditions are most favourable.

Would you like to find out whether dental implants are the right solution for you? Book a specialist consultation at Nea Bios Dental Clinic in Rome EUR. Dr Nihad Pljevljak and his team are available for a thorough analysis of your case with advanced diagnostic technology. Our reception is open Monday to Friday from 9:00 to 13:00 and 14:00 to 18:00 - call the clinic at Via Cesare Pavese 135 to make your appointment and find out how to get back a complete, functional smile.

Sources

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Tahmaseb A, Wu V, Wismeijer D, et al. The accuracy of static computer-aided implant surgery: A systematic review and meta-analysis. Clin Oral Implants Res. 2018;29(Suppl 16):416-435. PubMed
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