# Dental Implants

> Dental implants for BDS Oral Surgery — osseointegration, titanium fixtures, patient assessment, surgical principles, peri-implantitis and care.

- Canonical URL: https://prepelephant.com/topics/bds/oral-surgery/dental-implants
- Exam / course: BDS · Subject: Oral Surgery
- Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team
- First published: 2026-10-02
- Last updated: 2026-10-02
- How to cite: "Dental Implants", PrepElephant, https://prepelephant.com/topics/bds/oral-surgery/dental-implants

## Direct answer

A dental implant is a titanium fixture placed in bone to support a replacement tooth, and it works by osseointegration — the direct structural and functional connection between living bone and the implant surface demonstrated by Branemark. Success depends on case selection, atraumatic surgery preserving bone viability, and the patient's hygiene and health; reported survival in suitable, well-maintained patients is high, but implants demand lifelong maintenance and can fail through peri-implantitis.

## What you must remember

- Osseointegration: direct apposition of living bone onto the titanium oxide surface without intervening soft tissue; a fibrous interface instead means biological failure and a mobile implant.
- Components: the fixture or screw in bone, the abutment traversing the mucosa, and the crown; systems are one-stage, healing through the mucosa, or two-stage, submerged and exposed later.
- Material: commercially pure titanium or alloy with roughened surfaces to enlarge bone contact; zirconia offers a metal-free alternative.
- Assessment: bone height, width and quality on the Lekholm and Zarb scale, proximity of the inferior alveolar canal and maxillary sinus on cone beam CT, interocclusal space, and a prosthetically driven rather than surgically convenient plan.
- Systemic and local considerations: uncontrolled diabetes, heavy smoking, untreated periodontitis, poor plaque control, previous jaw radiotherapy and antiresorptive therapy impair healing or raise osteonecrosis risk.
- Surgical principles: asepsis; a precise, gradually sized osteotomy with sharp drills and copious saline irrigation, since bone dies above about 47 degrees; primary stability at insertion; then a healing period before loading, immediate or delayed by protocol.
- Complications: bleeding, nerve injury with lip or chin paraesthesia, sinus communication, early failure with mobility, peri-implant mucositis — reversible soft tissue inflammation — progressing to peri-implantitis with bone loss, and prosthetic screw loosening or fracture.

## Common confusion

Peri-implant mucositis and peri-implantitis are used interchangeably: mucositis is inflammation confined to soft tissue around an integrated implant and is reversible with hygiene, whereas peri-implantitis adds progressive loss of supporting bone and needs active treatment. The second muddle is osseointegration versus ordinary wound healing around a screw: the entire premise is direct bone-to-titanium bonding, which is why overheating the osteotomy or loading an unstable implant destroys the result.

## Exam-focused takeaway

Theory answers should define osseointegration, describe components and materials, list evaluation factors, outline the surgical sequence, and close with complications and prevention. Viva examiners ask who described osseointegration, which temperature kills bone, why irrigation matters, and how an implant fails clinically. During postings, observe placement for the irrigation and drill sequence, watch a maintenance review with probing and radiographs, and note how much depends on the prosthodontic plan made before any incision — implantology is prosthetics delivered through surgery.

## Frequently asked questions

### What is osseointegration?

The direct, functional attachment of living bone to the titanium implant surface without intervening fibrous tissue — the biological basis of implant success, described by Branemark.

### Why must drilling be done with copious irrigation?

Bone necroses above roughly 47 degrees Celsius, and heat rises with dull drills, pressure and speed, so chilled saline and sharp drills protect the cells that will osseointegrate.

### What is the difference between mucositis and peri-implantitis?

Mucositis is reversible soft tissue inflammation around an integrated implant; peri-implantitis adds progressive bone loss and requires active treatment.

### Which patients are unsuitable for implants?

Those with uncontrolled systemic disease, heavy smokers, untreated periodontitis or poor hygiene, recent jaw radiotherapy, and antiresorptive therapy warranting caution — each a risk to weigh, not an absolute bar.

### What is assessed before placement?

Bone height, width and quality on cone beam CT, relations to the inferior alveolar canal and sinus, occlusion and interocclusal space, systemic health, and a prosthetically driven plan.