The Dental-Implant Process: From Assessment to Crown Placement, What Stages Are There?

The Dental-Implant Process: From Assessment to Crown Placement, What Stages Are There?

Direct answer: Implant treatment has nine stages: assessment and imaging, planning and consent, extraction and bone procedures when needed, implant placement, waiting for osseointegration, exposing the implant or connecting an abutment, impressions and crown fabrication, delivery and adjustment, and regular maintenance.[F2] There is no universal number of days for the full course.[F14][F16]

Geographic scope: This guide is specific to Taiwan's healthcare system (National Health Insurance and Taiwan's Medical Care Act). The institutional passages on surgical consent, duties to inform, approved fees, and health-education positioning cite Taiwan law (fact units marked `geo: TW`); clinical evidence on treatment and timing cites international literature (marked `geo: universal`). When care is received in another country, the institutional passages must instead be read under that country's rules. The official English text of Taiwan's Medical Care Act is https://law.moj.gov.tw/ENG/LawClass/LawAll.aspx?pcode=L0020021 .

What this card covers—and what it does not

This site's implant topic is divided into several cards so that the same point is not repeated and you do not find inconsistent advice on different pages.[F29]

• This card covers the process and timing: what happens at each stage, how the literature describes time, and what to ask at that stage.
• How fees are broken down and how to read a quotation: not covered here. In Taiwan, standards for medical fees are approved by the competent authority of the special municipality or county (city),[F6] and the prosthetic denture portion of implant treatment is outside National Health Insurance coverage.[F7] For cost components and ways to verify them, see the implant-cost card (KM-DENTAL-09, linked in the internal citation chain below). This card gives no monetary amount.
• What to eat after surgery and whether coffee is allowed: not covered here; see the post-operative diet card (KM-DENTAL-20).
• What bone-graft material is and whether it has after-effects: not covered here; see the bone-graft basics card (KM-DENTAL-24) and bone-graft complications card (KM-DENTAL-28).
• Failure, regret, and long-term complications: not covered here; see the implant-regret card (KM-DENTAL-07).

The whole line first: the nine-stage framework

This nine-stage framework is a communication structure prepared by this site so that you can tell where you are in the process. It is not an official classification or a clinical guideline.[F2] In practice, some people will skip stages (for example, no extraction, no bone procedure, or no second-stage surgery), and stages may be combined according to the treatment plan.

1. Initial assessment and imaging
2. Treatment plan and surgical consent forms
3. Extraction and extraction-socket/bone procedures, when needed
4. Implant-placement surgery
5. Waiting period for osseointegration
6. Second-stage surgery or connection of a healing abutment, when needed
7. Impressions and fabrication of the superstructure prosthesis
8. Delivery, retention method, and occlusal adjustment
9. Long-term maintenance visits

Stage 1: Initial assessment and imaging

This stage determines whether implant treatment is suitable for you and which plan to use. It usually includes an oral examination, periodontal assessment, questions about medical history, and imaging.

• Why periodontal status comes first: A systematic review and meta-analysis of 102 studies identified periodontitis, diabetes mellitus, smoking, and alcohol consumption as risk indicators for peri-implantitis; periodontitis, obesity, and smoking were risk indicators for peri-implant mucositis. The authors also state clearly that the selected evidence can identify risk indicators only, not causation.[F9] Including an existing periodontal condition in the assessment is therefore part of treatment planning, not an extra sales item.
• What the imaging needs to show: A systematic review of cone-beam computed tomography (CBCT) indications in implant dentistry covers pre-operative assessment of anatomical structures, planning reconstruction with grafts, computer-assisted treatment planning, and post-operative assessment of complications such as injury to neurovascular structures.[F8] The same review says that effective doses vary widely between devices and can be reduced by adjusting exposure settings and limiting the field of view to the area actually needed.[F8] Whether imaging is needed, which type is used, and how large an area is scanned are clinical judgments.
• What you receive at this stage: examination results and an initial direction. If a fixed total price and a fixed completion date appear before the assessment is complete, they are not yet an assessment result; they are numbers without a basis. For how to read a quotation, see the cost card.[F29]

Stage 2: The treatment plan and surgical consent forms

Implant placement is surgery. Article 63 of Taiwan's Medical Care Act requires a medical care institution, before surgery, to explain the reason for the operation, the success rate, possible complications and risks to the patient or the patient's legal representative, spouse, relative, or related person; it must obtain consent and have surgical and anaesthesia consent forms signed before proceeding.[F3] Article 81 of the same Act requires an institution, when treating a patient, to provide information on the condition, treatment plan, procedures, medication, prognosis, and possible adverse reactions.[F4]

In other words, in Taiwan the documents to sign and the information to be given at this stage are expressly set out in law: surgical and anaesthesia consent forms are part of the process, not a formality. Medication, including whether any medication is used before or after surgery, is a prescribing judgment for the physician; the physician should explain medication and possible adverse reactions.[F4] This card gives no medication advice.

This is also when you clarify which route your case will take: whether a tooth will be extracted, whether bone augmentation is needed, when placement is planned, and when loading is planned. Together, those four questions determine the length of the course.[F10][F14][F16]

Stage 3: Extraction and extraction-socket/bone procedures, when needed

If the tooth is still present, extraction and healing add another period of time. The literature classifies timing of implant placement after extraction into four types. A 2009 review including 91 studies classified it as immediate (type 1), early (types 2 and 3), or late (type 4), and summarized that most studies reported survival rates above 95% (a study-level estimate, not an individual prognosis).[F10] Bone-augmentation procedures were effective for bone fill and defect resolution around implants in extraction sites, and were more successful with immediate and early placement than with late placement.[F10] The same review says facial mucosal-margin recession is common with immediate placement, while early placement has a lower frequency of mucosal recession than immediate placement.[F10] This card cites that review for classification and soft-tissue outcomes; for the state of evidence on combinations of placement and loading, it uses the updated 2026 review in Stage 5.[F16][F29]

What this means for you is that “immediate placement” is not a question of being fast; it is a question of conditions and risk trade-offs. Your dentist judges it from your bony-wall conditions, site, and esthetic needs.[F10]

Bone procedures are another line of variables. This card only explains whether they can lengthen the course; see the bone-graft card for details.[F29]

• At the time of extraction, alveolar-ridge preservation may be suggested. An updated 2021 Cochrane systematic review included 16 randomized trials, 524 extraction sites, and 426 adults. It concluded that these techniques may reduce changes in ridge height and width at six months after extraction, but the evidence is very uncertain. For outcomes such as whether additional augmentation is needed at implant placement and implant failure, there is no evidence of a difference because information and long-term data are lacking.[F11]
• If bone width is insufficient, lateral bone augmentation may be needed first. A systematic review and meta-analysis of 25 trials and 553 patients found that, in those study populations, various lateral bone-augmentation approaches made later implant placement feasible. The authors also state that evidence quality ranged from very low to moderate because of bias and imprecision.[F12]

Stage 4: Implant-placement surgery

On the day of surgery, the implant is placed in the planned three-dimensional position. Freehand placement and computer-assisted placement (static guides, dynamic navigation, and robotic systems) are different workflows. In the clinical-studies component of a systematic review and meta-analysis of 45 studies, computer-assisted groups had better coronal, apical, and angular deviations than non-computer-assisted groups.[F13] But the same authors explicitly say that cost-effectiveness, edentulous span, and clinician expertise all need consideration, and conventional methods remain suitable alternatives in straightforward cases.[F13] This study measures the deviation between implant position and the plan, not clinical success rates. It therefore does not conclude that “a guide is always better.”[F13]

What may happen during the week after surgery is the topic of another card. Here there is only one reference point: in a patient-reported study comparing five types of dentoalveolar surgery, healing after straightforward implant placement was comparable to simple extraction; the proportion with complications at one week after surgery was 12.7% in the straightforward-implant group and 20% in the implant-with-bone-augmentation group.[F28] For diet and care details, see the post-operative diet card.[F29]

Stage 5: Waiting for osseointegration (the red-line section of this card)

This is the stage most easily turned into marketing, and why this card refuses to give a universal number of days.

• In its background section, a Cochrane systematic review describes traditional loading this way: to establish osseointegration, implants have traditionally been kept load-free for 3 to 8 months. It classifies loading as immediate (within one week), early (between one week and two months), or conventional (after two months).[F14] Note what this sentence is: it is the review's background description of traditional practice, not a result of that review and not timing advice for any individual case.[F14][F29]
• The same review included 26 randomized trials, 1,217 participants, and 2,120 implants. Across the 26 trials, the mean implant-failure rate was 2.5%, and the review concluded that there was no convincing evidence of a clinically important difference in prosthesis failure, implant failure, or bone loss among different loading times.[F14] The review searched through 2012. On 2026-08-06, this site checked the Cochrane CD003878 version chain one version at a time: the 2013 version is the current latest version and has not been withdrawn.[F14]
• A meta-analysis of single-implant crowns concluded that immediate and conventional loading perform comparably for implant survival and marginal bone loss. The authors expressly limited that conclusion mainly to cases with insertion torque of at least 20 to 45 Ncm or an implant stability quotient of at least 60 to 65, and no need for simultaneous bone augmentation.[F15]
• Updated through 2026: a systematic review published in February 2026 selected 140 studies from 11,427 records (42 randomized controlled trials and 98 controlled clinical trials or cohort studies), encompassing 10,456 implants. It calculated weighted cumulative survival by nine placement-timing × loading-timing combinations and judged six combinations—1A, 1C, 2-3C, 4A, 4B, and 4C—to meet scientific and/or clinical validation thresholds; 1B and 2-3B remain insufficiently documented despite high numerical survival.[F16] This card uses this update in place of the same team's 2018 version.[F16]
• What a professional consensus says: the 2023 ITI Group 5 Consensus Report concluded that Type 1A (immediate placement plus immediate loading), when used in the anterior maxilla under favorable conditions, is considered predictable and is associated with high survival rates. The report also says that, while the procedure is considered clinically viable and associated with esthetic outcomes, surgical, technical, and biological complications can still occur.[F17]

In plain language for patients: whether a tooth can be placed earlier and how much it can be used for biting are questions of conditions, not willingness. The conditions include stability at placement, whether bone augmentation is done at the same time, the site of missing teeth, and the form of the prosthesis.[F15][F16][F17] Giving a certain number of days before assessment is complete is a promise, not an assessment.[F29]

Stage 6: Second-stage surgery or connection of a healing abutment, when needed

Some treatment plans leave the implant below the mucosa during healing, then use a small second procedure to expose it and connect a healing abutment. Other plans bring the implant through the mucosa at placement and do not need a second operation. The literature calls these submerged and non-submerged healing.[F19][F20]

• A systematic review, meta-analysis, and trial-sequential analysis of 11 studies found a higher early implant-failure rate with non-submerged healing. The review records the difference as 2% (the original wording is “a small higher rate (2%)” and does not say whether this is an absolute or relative difference; this card does not convert it). For marginal bone, the authors describe the strength of evidence as low.[F19]
• Another systematic review and meta-analysis of 6 randomized trials found no difference between the approaches in implant or prosthesis failure. Submerged placement had statistically greater marginal-bone loss, but the difference was not clinically relevant. The authors also emphasize that the review was underpowered and that most included trials had high risk of bias.[F20]
• There is currently no active, valid Cochrane conclusion for this question: the Cochrane systematic review of one-stage versus two-stage implant placement was withdrawn in 2018 (its title is marked WITHDRAWN).[F18] Under this site's rules, a withdrawn publication is not used as clinical evidence; it records the evidence gap only. The two non-Cochrane reviews above are therefore the current basis cited in this card.[F18][F29]
• Second-stage surgery can sometimes also address soft tissue. A systematic review of soft-tissue augmentation and correction around submucosally osseointegrated implants during second-stage surgery included 8 prospective studies and 2 case series; all were rated at high risk of bias, and heterogeneity of study designs prevented meta-analysis.[F21] Whether to do this and how to do it are clinical judgments.

Stage 7: Impressions and fabrication of the superstructure prosthesis

Only after the implant is stable does the prosthetic stage begin. There are two routes for impressions: conventional impressions and intraoral scanning.

• A 2025 systematic review and meta-analysis used data from 7 clinical studies and 151 partially dentate patients. It concluded that digital impressions had significantly lower deviation than conventional impressions, but no significant difference in angular displacement. The authors also report very high heterogeneity across studies (I² from 80% to 97%), which limits certainty in the pooled findings, and urge caution with long-span or angulated implant cases.[F22]
• From the patient perspective, a systematic review and meta-analysis of 12 studies found digital scanning more time-efficient and preferred by patients for comfort, anxiety, nausea, and perceived time.[F23]

At this stage, ask “how many visits will there be in total, and what happens at each one?” Try-ins, adjustments, and remakes at the laboratory all take calendar time. The choice of impression method is a clinical judgment; this card does not recommend any technology or equipment.[F29]

Stage 8: Delivery, retention method, and occlusal adjustment

There are two ways to fix a superstructure prosthesis to an implant: screw retention and cement retention. The direction of the literature is not fully consistent, and that is worth stating honestly.

• A systematic review of 73 publications calculated five-year survival rates of 96.03% (95% CI 93.85%–97.43%) for cement-retained and 95.55% (95% CI 92.96%–97.19%) for screw-retained reconstructions, with no statistical difference. Its conclusion was that screw-retained reconstructions had fewer technical and biological complications overall.[F24]
• A 2024 systematic review and meta-analysis focused on all-ceramic crowns on zirconia abutments (8 studies for qualitative synthesis and 6 for quantitative synthesis). It found no statistically significant difference in marginal bone level for screw retention, comparatively fewer biological complications, and comparatively more technical complications.[F25]

In other words, both retention methods have trade-offs. The choice follows site, angle, and repairability; it is not a question of which is “more premium.”[F24][F25] Delivery day usually also includes occlusal adjustment and imaging confirmation. If your bite feels strange, say so then rather than enduring it at home.

Stage 9: Long-term maintenance visits

Placement is not the endpoint.

• A 2021 systematic review and meta-analysis included 5 trials, 1,570 implants, and 617 patients. It concluded that supportive peri-implant therapy can significantly reduce rates of peri-implantitis and marginal bone loss (the included evidence contains retrospective designs, so this is associative evidence). The same review says evidence for reducing peri-implant mucositis remains limited.[F26]
• A 2016 systematic review and meta-analysis (13 trials in qualitative analysis and 10 in quantitative analysis) concluded that implant therapy cannot end with “placement and restoration” and must include peri-implant maintenance therapy. The authors suggested a minimum recall interval of 5 to 6 months while emphasizing that it must be adjusted to the patient's risk profile.[F27] The interval should still be set by your dentist according to your risk; this card does not promise a universal frequency.[F27][F29]
• Why maintenance needs attention: population-level estimates put the prevalence of peri-implant mucositis and peri-implantitis among implant patients at 46% and 21%, respectively.[F9] These are population figures, not your individual probability, but they show why maintenance is part of treatment.

Why nobody can tell you in advance “how many months in total”

Putting the nine stages together shows that course length depends on these switches:[F29]

1. Whether extraction is needed and, after extraction, which placement-timing type is used.[F10]
2. Whether bone augmentation is needed, how much is needed, and when it is performed.[F11][F12]
3. Which loading plan is used for the osseointegration waiting period and whether that plan has conditions.[F14][F15][F16]
4. Whether second-stage surgery is needed.[F19][F20]
5. The complexity of the superstructure prosthesis and the number of try-ins.[F22][F23]

The literature can provide the description “traditionally load-free for 3 to 8 months” and classifications and survival estimates for different loading plans.[F14][F16] It cannot provide “your case will be completed on this calendar date.” This site therefore gives no general promise of a total number of treatment days and does not accept study-level survival rates as an individual result.[F29]

Risk factors (conditions that can make the process longer or more complex)

Implant treatment is a surgical procedure with medical risks and contraindications. A dentist must assess whether any of the following applies to you in light of your individual circumstances.

• History of periodontitis, diabetes mellitus, smoking, alcohol consumption, or obesity: identified in systematic review evidence as risk indicators for peri-implant diseases (association, not causation).[F9]
• Insufficient bone volume or bone width: may require additional bone procedures, for which current evidence quality ranges from very low to moderate.[F11][F12]
• Unfavorable extraction-socket conditions: immediate placement is associated with more common facial mucosal-margin recession.[F10]
• Insufficient primary stability or simultaneous bone augmentation: conclusions from immediate-loading studies have explicit conditions and do not apply to every case.[F15]
• Limits in the level of evidence itself: both reviews comparing submerged and non-submerged healing report inadequate power or inadequate evidence strength,[F19][F20] and the Cochrane version has been withdrawn.[F18]
• Maintenance not kept up: supportive peri-implant therapy is associated with lower rates of peri-implantitis.[F26]

Actual treatment methods and outcomes vary by person and require a dentist's assessment.

Checklist before your appointment (8 questions; ask them during the treatment-plan discussion)

1. How many stages is my case expected to have? Which stages might be omitted (for example, no extraction, no bone augmentation, or no second-stage surgery)?[F2]
2. What type of imaging do I need, and how is the scan range decided?[F8]
3. Does my periodontal condition need treatment first? Is implant placement after that treatment?[F9]
4. If extraction is needed, which placement-timing type will be used, and why?[F10]
5. How long is the osseointegration waiting period expected to be, and what is the basis? What will be in my mouth during that time (a temporary prosthesis or not; can I bite)?[F14][F15][F16]
6. Is second-stage surgery needed? If so, is that another anaesthetic and another healing period?[F19][F20][F21]
7. How many return visits are expected for impressions and try-ins? Is the superstructure screw-retained or cement-retained, and how would it be removed if repair is needed later?[F22][F24][F25]
8. When will the surgical and anaesthesia consent forms be signed? Which complications and risks will be explained? How will medication be arranged?[F3][F4]

How to find a clinic that provides this service

This site lists no clinics and does not recommend, rate or compare any medical institution.

To find a clinic that provides this service, use the following official lookup channels yourself —

they are maintained by the competent authorities and are more current than any list:

>

- The Ministry of Health and Welfare's medical-institution lookup: search by city or county,

township and specialty (dentistry) for institutions that have completed practice registration.

The results show the institution's name, address and registered specialty. This is the first place

to confirm whether a clinic is lawfully registered.

- The National Health Insurance Administration's contracted-institution lookup: check whether a

clinic is under contract with National Health Insurance. This determines which items are covered

and which are self-paid, and therefore what kind of fee explanation you will be given.

>

Both systems are on the respective authorities' official websites; searching for the

medical-institution lookup or the contracted-institution lookup will find them. This site does not

reproduce the URLs, because they change; use whichever entry point the authority currently publishes.

>

In an emergency, do not spend time looking up lists. If your breathing, swallowing or speech is

affected, or swelling is spreading, go to the nearest emergency department.

Chinese labels to look for on the official pages

These official systems, datasets and files are published in Chinese only. The English names above are this site's renderings; on the page itself you will see the following strings, so search for these:

>

- 「醫事機構查詢」

- 「特約醫事機構查詢」

- 「特約院所查詢」

Compliance notice

This is health education information under Article 87 of Taiwan's Medical Care Act.[F5] It is not medical advertising, does not recommend a particular institution, and gives no monetary amount or price range. Implant treatment has risks and contraindications; actual treatment methods and outcomes vary by person and require a dentist's assessment. The nine-stage framework in this card is for communication during care and cannot replace your treating dentist's diagnosis, treatment plan, or post-operative instructions. This card also gives no medication advice.

Every clinical statement in this article is mapped line by line to its cited source (see the sources and evidence chain below). It has not been clinically reviewed by a licensed practitioner. This is health information, not individual advice; assessment by a clinician is required.