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I've got my implant. Why wait for the crown?!

One of the most frustrating things for dental implant patients is waiting for healing. After implant placement we wait four to six months before restoring - or putting the abutment and crown on - the implant. Why do we need to wait that long? Bones heal slowly!

Single tooth replacement - implant, abutment, and crown

If you fall and break your arm, your doctor will put you in a cast for 4-6 weeks. That is for a small fracture. If you have a large compound or complex fracture it might be several months. With implants we are introducing a wound into the bone that must heal. Not only must it heal, but it also must "osseointegrate" with a titanium dental implant. Osseointegrate is a fancy word for the process by which your bone attaches to the implant. While this process is usually successful and we can depend on osseointegration to occur consistently, it is also very delicate. One of the worst things for bone healing is movement. That's why you get a cast when you break your arm - to stabilize the fracture so that it cannot move during healing. If it moves during healing, you risk a fibrous union, which basically means you get scar tissue formation between the two bone segments instead of bone formation. This same thing can happen around implants.

If there is any micro-movement during the healing process your body will form "scar tissue" around the implant instead of bone (its not actually scar tissue, but that's a good analogy). Placing a restoration (abutment and crown) on an implant too soon can cause movement, resulting in scar tissue formation around the implant, and implant failure. There are some cases where dentists do try to immediately restore implants. This means you place the implant and some sort of crown on the same day. This is "teeth in a day". This can be done successfully, but there is always an increased risk of failure compared to conventional implant placement.

Personally, I think you should not mess around with your oral health. If there's anything I can do to increase the chance of implant success, I do it. This includes avoiding immediate implant loading. Four to six months can seem like a long time to go without a tooth, but when compared to the time it takes to reconstruct a site after an implant failure it is well worth a little patience to ensure the best outcome. I don't like to play games with your oral health.

Do you have any questions? Any other topics you'd like me to address on this blog? Shoot me an email at and I'll either respond with an email or with another blog post.

Smile Again.

Jonathan Geleris, DDS, FICOI

Disclaimer and disclosures: I'm a dentist who performs dental implant treatments, and general dentistry in Walnut Creek, California. I don't work for any dental companies (other than my practice). Nobody pays me to write this. As much as possible, I hope to present factual information supported by solid science, however, humans are complex, and the science in this field is constantly evolving. Some of what I present may be based on my opinion.

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