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There are three main types of dental implants, named for where they anchor. Endosteal implants sit inside the jawbone and are by far the most common. Subperiosteal implants rest on top of the bone, and zygomatic implants anchor in the cheekbone. Implants also vary in size and in what they hold.
Most patients never need anything other than the first type. The other two exist for people who have lost a great deal of bone, and they are usually handled by specialists.
At Brilliant Smiles of Maryland in Reisterstown, MD, Dr. Alex Fishman places implants and makes the teeth that go on them in the same office.
The three types are endosteal, subperiosteal and zygomatic. They differ in where the implant is anchored, which depends mostly on how much healthy bone you have.
| Type | Where it anchors | Who it is for | How common |
|---|---|---|---|
| Endosteal | Inside the jawbone | Most patients, including many who need a bone graft first | The standard type |
| Subperiosteal | On top of the jawbone, under the gum | Patients with too little bone who cannot have, or do not want, a graft | Rare today |
| Zygomatic | In the cheekbone | Patients with severe bone loss in the upper jaw | Rare, specialist procedure |
The American Academy of Implant Dentistry describes endosteal implants as the most commonly used type.
Mini implants are sometimes listed as a fourth type. They are really a narrower version of an endosteal implant, with a narrower job. They are covered below.
An endosteal implant is a small titanium post placed in the jawbone where a tooth root used to be. Once the bone heals around it, it can hold a crown, a bridge or a full arch of teeth.
“Endosteal” means “within the bone.” When people talk about a dental implant, this is almost always what they mean.
The process usually looks like this:
At Brilliant Smiles, the implants Dr. Fishman places are endosteal implants. If you do not have quite enough bone, a graft can often build it up first, so a standard implant is still possible. You can read more about dental implants in Reisterstown.
Both are for patients who have lost so much jawbone that a standard implant cannot be anchored, even with grafting. They are uncommon, and they are usually placed by oral surgeons or other specialists.
Subperiosteal implants are a custom metal framework that sits on the bone, under the gum. Posts come through the gum to hold the new teeth. They were more common decades ago. Bone grafting and modern endosteal implants have largely replaced them.
Zygomatic implants are long implants anchored in the cheekbone instead of the upper jaw. They can support a full upper arch when the upper jawbone is too thin for standard implants.
Mini implants are much narrower than standard implants. Their main use is holding a lower denture in place so it stops slipping.
Because they are smaller, they are placed with a less invasive technique and can sometimes fit into narrower bone. The trade-off is that they handle less biting force, so they are generally not the first choice for a single back tooth.
An implant can hold one tooth, a bridge of several teeth, a removable denture or a fixed full arch. For most patients, the choice of restoration matters more day to day than the type of implant underneath.
| What you are replacing | Restoration | Typical number of implants | Can you take it out? |
|---|---|---|---|
| One tooth | Single implant crown | One | No |
| Several teeth in a row | Implant-supported bridge | Usually two or more | No |
| A full arch, removable | Implant-retained (snap-in) denture | Often two to four | Yes, for cleaning |
| A full arch, fixed | Full-arch bridge, such as All-on-4® or All-on-6 | Four or six | No, only your dentist removes it |
A single implant crown replaces one tooth without reshaping the teeth beside it. If you are weighing it against a bridge, our guide to a dental bridge vs. implant compares the two.
A snap-in denture clicks onto attachments on the implants. It is far steadier than a regular denture, and you still take it out to clean it.
A fixed full arch replaces every tooth in one jaw. All-on-4® implants use four implants, and All-on-6 implants use six. You can read about each option on our dental implant restorations page.
Click a photo to see the full before-and-after.
Real Brilliant Smiles of Maryland patients. Individual results vary.
Most dental implants are made of titanium or a titanium alloy. Titanium is strong, light and bonds well with bone, which is why it has been the standard for decades.
Zirconia (ceramic) implants also exist. Some patients ask about them as a metal-free option, but they have a shorter research record and are not offered at every practice.
The tooth you see is a separate piece. Implant crowns are custom made by a dental laboratory and matched to the color and shape of your other teeth.
For most people, a standard endosteal implant is the best choice. It has the longest research record and the widest range of uses. The best implant for you is the one your bone, bite and goals can support.
A few questions usually decide it:
Cost differs a lot between these options. Our guide to what dental implants cost in Maryland sets out general price ranges for each.
Often you can still have one. A bone graft can rebuild the area first, and in the upper back jaw a sinus lift can add height where the bone has thinned.
Bone shrinks after a tooth is lost, so the longer a gap has been there, the more likely a graft is needed. A 3D scan shows exactly how much bone is available before anyone recommends a plan.
Grafting adds healing time and cost, and both are discussed before treatment starts.
Implants are placed by oral surgeons, periodontists and general dentists with advanced implant training. What matters most is the dentist’s training and how regularly they place implants.
Dr. Alex Fishman trained in oral surgery and implant placement during his Advanced General Practice Residency at the University of Maryland. He places implants and restores them in the same office, so you are not sent to a separate surgeon and back. You can read more about Dr. Fishman.
Every implant is placed with local anesthesia, so most patients feel pressure rather than pain. If you feel anxious, we offer nitrous oxide and oral conscious sedation, and IV sedation can be arranged for larger cases.
You can read more about our sedation dentistry options, or see what patients feel at each stage in our guide on whether dental implants hurt.
An exam and a 3D scan answer it. Dr. Fishman checks your bone, gums, bite and health history, then explains which implant and which restoration fit your case.
You leave with a written plan and an estimate. You do not need to decide at that visit.
Whether you need one tooth replaced or a full arch, the team at Brilliant Smiles of Maryland in Reisterstown, MD will explain your options in plain language. We see patients from Reisterstown, Glyndon, Owings Mills and the surrounding area.
Call (410) 833-8380 to find out which type of implant fits your situation.
Endosteal and subperiosteal. Endosteal implants go into the jawbone, and subperiosteal implants rest on top of it. Zygomatic implants, anchored in the cheekbone, are often listed as a third type.
The endosteal implant, a titanium post placed in the jawbone. It is the type almost every patient receives.
For holding a lower denture steady, they can work well. For a single tooth, especially a back tooth, standard implants are generally the stronger choice because they handle more biting force.
No. All-on-4® describes how many implants hold a full arch. Zygomatic describes where an implant anchors. Some full-arch cases with severe upper bone loss combine the two.
Age does not decide the type. Your bone and general health do. Many older adults who already wear dentures choose implant-supported dentures. Our guide to dental implants for seniors covers health and Medicare questions.
No. Many patients have enough bone for an implant without a graft. A 3D scan shows whether you need one.
The implant itself often lasts for decades. Our guide on how long dental implants last explains what the research shows and what helps an implant last.
