What happens on the day of implant surgery, step by step?
Implant surgery is a planned procedure under local anaesthetic that consists of a few clearly defined steps. The patient information published by Cambridge University Hospitals (CUH), Guy’s and St Thomas’ NHS Foundation Trust, Cleveland Clinic and UMass Memorial Health describes essentially the same sequence:
- Preparation: According to UMass Memorial Health, you may be asked to rinse with an antiseptic solution before the procedure starts. What you can sort out from home beforehand is covered in our guide to preparing for dental implants.
- Local anaesthetic: The area is numbed with an injection. CUH describes this as the usual way implants are placed; sedation or a general anaesthetic is mentioned for cases with many implants.
- Opening the gum: Cleveland Clinic explains that the surgeon makes an incision in the gum; CUH describes the gum being cut and pushed back to expose the bone (for the exception, see below).
- Preparing the implant site: Cleveland Clinic describes a small hole being made in the jawbone with specialised instruments, which is then widened step by step to the width of the implant.
- Placing the implant: The implant is screwed into the prepared site. If a surgical guide was planned, it directs the drilling; how that works is explained in our guide to guided implant surgery.
- Cover screw or healing cap: The implant is either closed with a cover screw and covered by the gum, or fitted with a healing cap that protrudes through the gum. Which option is chosen depends on the type of healing (next section).
- Stitches: The gum is repositioned and stitched. According to CUH the stitches are usually dissolvable but can take several weeks to disappear; Guy’s and St Thomas’ removes stitches 7 to 14 days after treatment.
Is the gum always cut open?
Usually, but not in every case. In the standard approach described by CUH, Guy’s and St Thomas’ and Cleveland Clinic, the gum is lifted so the bone is directly visible. The 2013 consensus statement of the International Team for Implantology (ITI) records that computer-planned, guided implant placement is possible both with and without lifting the gum.
The approach without an incision is only considered when the bone and gum are suitable for it; who it may suit is explained in our guide to flapless implant surgery. Which route is chosen for you is decided by your dentist after the examination and the cone-beam CT (CBCT) scan.
What is the difference between one-stage and two-stage healing?
The difference is whether the implant sits under the gum during the healing months or protrudes into the mouth. According to Leeds Teaching Hospitals, if placement is relatively straightforward a healing cap can be placed on the implant immediately so that it is visible above the gum; if the surgery is more complex, the implant may be covered up to help healing.
| Feature | One-stage (open healing) | Two-stage (closed healing) |
|---|---|---|
| What sits on the implant? | A healing cap that protrudes into the mouth | A cover screw; the gum is stitched over it |
| During healing | The healing cap is visible in the mouth | The implant lies under the gum |
| Second minor procedure | Not needed | Needed (uncovering) |
| When is it more likely? | When placement was relatively straightforward | After more complex surgery, for example with bone grafting |
The healing period is needed in both cases. The Faculty of Dentistry at the University of Toronto gives 3 to 6 months for either approach, Leeds Teaching Hospitals 2 to 6 months, and Cleveland Clinic three to nine months. This is why international patients usually need two trips; how they are planned is explained in our guide to how many days you need in Türkiye for dental implants.
How is the implant uncovered?
With two-stage healing, the implant is exposed in a short procedure once it has bonded with the bone. The University of Toronto describes the sequence: the implant is exposed, the cover screw is removed and replaced with a healing abutment. Mayo Clinic classes this as minor surgery done in an outpatient setting with local anaesthetic, and Leeds Teaching Hospitals calls it more minor than the first operation.
The gum then shapes itself around the healing abutment. The University of Toronto gives 2 to 6 weeks for this, Mayo Clinic at least two weeks before the artificial tooth is attached. After that, impressions or digital scans are taken and the final teeth are made. For travellers this means the uncovering usually falls in the second trip, with several appointments between uncovering and final teeth, so do not plan that trip too tightly.
How long does placing an implant take?
For a single implant the sources give roughly half an hour to an hour; several implants and additional procedures lengthen the appointment:
- CUH: around half an hour for a single implant, longer for several.
- Leeds Teaching Hospitals: the surgery appointment usually takes around 90 minutes.
What do you feel during the surgery?
Because of the anaesthetic you should feel no pain; pressure, vibration and noise are noticeable. UMass Memorial Health describes that patients who are awake can hear the instruments and feel vibration but should not feel pain.
What the anaesthetic injection feels like and how pain develops in the days afterwards is covered in our guide Do dental implants hurt?. According to CUH, intravenous sedation or a general anaesthetic can be used when many implants are placed; more on this in our guide to dental implants under general anaesthesia.
What happens straight after the procedure?
The NHS patient leaflets stress a few points for the first hours:
- Bleeding: According to CUH, bleeding usually stops quickly; if it starts again at home, press a rolled-up clean handkerchief or swab on the area for at least 10 minutes. Gloucestershire Hospitals advises biting firmly on a clean damp cloth for 20 minutes.
- Numbness: Gloucestershire Hospitals advises avoiding hot drinks and hot food until normal sensation has returned to your mouth and lips, and Hull University Teaching Hospitals warns that eating while numb can make you bite your lip or tongue.
- Rest: CUH recommends taking the rest of the day off work.
- Report: Hull University Teaching Hospitals asks patients to contact their dentist or surgeon straight away about altered sensation, bleeding that cannot be stopped or hard, hot swelling.
How swelling, bruising and stitches develop in the days afterwards, and what applies to the flight home, is covered in our guide to the first week after dental implants; what you can eat is in our guide to eating after dental implant surgery.
What does the day of surgery mean for your stay in Türkiye?
For international patients the day of surgery usually falls in the first trip, after the examination and the CBCT scan. The transfer from Istanbul and the accommodation in Sapanca are included in the treatment price, and on treatment days we take you between your accommodation and the clinic. Book your return flight only once your appointments are confirmed. An overview of how a stay is organised is on our page on dental treatment in Türkiye.
How is implant surgery planned at Rönesans?
The day of surgery puts into practice the plan drawn up after the examination and the CBCT scan at our clinic. Whether a surgical guide is used is decided by your dentist after reviewing the scan; not every implant needs one. Bone grafting and sinus lifts are carried out at our clinic, and treatment under general anaesthesia is possible when needed. Before treatment starts you receive a written treatment and cost plan, which also states the make and model of your implants.
Our dentists review your case together, and you are treated by the same dentist throughout. After the procedure you receive an implant card carrying the manufacturer’s official label for each implant, and when you leave, copies of your X-rays and your treatment summary. Questions during the healing months are answered on WhatsApp at +90 532 363 49 54 in English; how follow-up works once you are home is described on our aftercare and follow-up page. All stages of treatment are on our dental implants page.