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The Process of “Permanent” Fixed Dental Implant Teeth -5 Steps to Replacing All Your Teeth

Having fixed “permanent” dental implant teeth is a process. This process can vary greatly from as short as one day and can extend up to two years. The average is a few months. Here is a 5 step summary of the process.

Upper Lower Fixed Dental Implants
Upper Lower Fixed Dental Implants

“Permanent” is in quotations because nothing is truly permanent.  Everything can be removed if needed and all dental work (crowns, fillings, root canals) wears out and needs to be replaced. 

I have written on numerous occasions about the wide array of differences you should ask about when having your teeth replaced with fixed bridges vs. overdentures. (Is it an All on Four economy plastic bridge replacement or is it fixed porcelain on a normal amount of dental implants?)

Why does it take so long…or short?  How much bone you have is the number one factor in determining your unique process.  If you don’t have enough bone, then the bone will need to be rebuilt with a bone graft.  If you have plenty of bone, there are many options and the process is much faster. You may have been told you don’t have enough bone.

If you are replacing ALL the teeth in one jaw, I may be able to help you avoid ‘major’ bone grafts. (Major bone grafts are lateral wall sinus bone grafts, onlay block bone grafts, large segment guided bone regeneration, and nerve repositioning.  I routinely perform these grafts when needed and they are not to be avoided)

There truly isn’t ever a one day process because you have 1-5 evaluation and preliminary records appointments before your actual surgery if you want this to turn out right.  Beware of what you see on TV and hear on the radio.

3D Planning --Ramsey Amin DDS
1. Initial Visit: This is where I begin to understand your needs and wants.  Your medical and dental histories are crucially important.  Digital photographs, intra-oral, panoramic and/or 3D x-rays are taken in my office. Molds of your mouth may also be made. I will study your situation carefully between your first and second appointment.

500 W Olive, Burbank_HI RES-62
2. Treatment Consult: This is where I review your options, risks, benefits, timeline and financial commitments.  This is a very important appointment for you to digest all the information. This is usually 30 minutes to an hour.

3. Surgery or Additional information: If your situation allows, your next appointment may be surgery.  This may involve extractions, bone grafting, and/or placing dental implants. If more molds or temporary fixed teeth or dentures are needed 2-4 measurement and analysis appointments may be needed.  If you are having this process done with me, you will ALWAYS have temporary teeth!  You will not be without teeth during the process!

4. Making the teeth: After the steps of the surgery/extractions//bone grafting are done it is time to start making the final teeth!  You and I will choose the specifics of how you want your teeth to look. I will coach you on color, how much teeth/gum you should show when you smile, the length/shape and about 1000 other details.  This process includes digital and real molds, facial analyses and bite measurements. Many of the Prettau dental implant bridges I make involve a digitized version of fixed temporaries to allow you to test drive the real teeth before they are made.

fixed dental implant
5. Deliver the final teeth: The installation or delivery of the final teeth usually takes 1-3 hours.  The teeth may be screwed or cemented into place over custom or prefabricated abutments.  Your bite must be balanced carefully. Post-operative x-rays will be taken. I will train you on how to maintain your teeth and what to look out for.  It is crucially important that you know your part in the long-term maintenance. I want to see your teeth last!

That is the overall process to replace all your teeth.  Keep in mind it will vary greatly in your unique situation. You will be seen for several follow up visits. I personally perform every step of the process from start to finish.

Having one implant dentist in charge, in my opinion, gives you the best result. You don’t have to worry about any sub-contractors!

Ramsey A. Amin, D.D.S.

Diplomate of the American Board of Oral Implantology / Implant Dentistry

Fellow-American Academy of Implant Dentistry

13 thoughts on “The Process of “Permanent” Fixed Dental Implant Teeth -5 Steps to Replacing All Your Teeth

  1. Yes I just had my permenate hybrid full upper denture put in, I have several issues 1. The pink plastic used for gum line I don’t like the feeling under my lip feels like coated braided cord I want it smoothed out it kind of burns . 2. On Right side feels like a gap along gum line The pink material needs to be built up more up under my own natural gum line to the implant gum I’m getting air and poping in between both gums very annoying. 3. Need screw holes smoothed out more feel rough. 4. I’m feeling Two posts the second screw on left side I can see and feel the post and third screw in the middle feel that one more two gaps in between those posts feels odd not comfortable, my tongue wants to feel those two posts. Also their super white ugh I picked the color wished I would of took one color down my dentist even told me but I didn’t listen . *Also on right side the last tooth feels bowed out more then left side wants to rub on my inner cheek very annoying. right side of my upper implant teeth sit a slight bit over my lower denture and on left side upper implant teeth sit normal on lower denture. I will soon be getting a new snap on denture on bottom ,once, I get these new upper implant teeth to feel right in my mouth. Please can you tell me can those all be corrected that I’ve mentioned above ? My dentist says I’m picky because I wanted the eye teeth on the new implants to not be so pointy she said I was being picky it hurt my feelings as I’m paying over 20k these are the teeth I’m going to be looking at for the next 30 yrs if I’m lucky please Doctor can these issues be corrected I’ve had them in my mouth not even 2 weeks and my temps felt so much better ! Help need advice 🙁

      1. My staff informed me that you may have inadvertently replied somehow to our office rather than to your blog post. Please cut and paste your message back into the actual blog. Replying to emails does not post the question.

  2. Dear Dr,

    I just want to know if it is possible to convert a fixed bridge implant supported appliance in to a snap on denture.

    I have a full upper fixed fridge that attached to a set of implants with screws. I would like to get ride of that. It is too costly to resurface and maintain. I would to remove it and use the implant to support a snap on denture. Is it possible

    Let me know. Thanks

    1. hello anonymous,

      The short answer is yes.

      It sounds like you have a fixed hybrid bridge which is the most basic of all fixed Bridges. I absolutely do not like fixed hybrid Bridges because they break all the time. A hybrid means that you have plastic denture teeth fused onto a metal base. Rather than convert your current implant bridge to an overdenture, I would suggest you converted to a solid zirconia fixed bridge such as the Prettau dental implant bridge. If designed correctly, they do not chip or break at all. They do not stain and look like brand-new for years to come. You will not be happy with an overdenture if you have been used to a fixed bridge. The problem is your bridge requires way too much maintenance and is way too fragile. That is why I do not do these types of Bridges although they are less costly in the short-term they do not last in the long-term.

      Find an expert in your area to do this so that you have it done right the first time.


      Ramsey Amin DDS

  3. Hello there, I have some questions for you regarding zirconia implants for a entire mouth of no teeth and some gum tissue removed from the mouth. My dear mother, had a awful case of periodontal disease and had remaining teeth and some gum tissue taken away by a dental surgeon. she also had bone grafting simultaneously. Now she has no teeth, absolutely none, and has been wearing temporary dentures a few hours per day but doesn’t eat with them. She eats only food she can break down without teeth. Very soon the next step is she’s supposed to have a full mouth of titanium implants placed in her mouth. I am very concerned with this because I know there’s much information on titanium implants and dangers(galvanic electricity) etc. Also, please address the amount of years is average in this type of situation for implants longevity, being that she’s only 60 yrs of age, that should be taken into consideration. She refrains from smoking, doesn’t take any medication, and has a healthy diet, now has raw green drinks daily since teeth removal. Shes absolutely terrified of complications we’ve been reading about (teeth falling out, pain) etc. She’s very young to have mouthful of titanium implants, having just turned 60 yrs old and looks more like 50 yrs old. I’m not sure if you have experience with such a serious case of dental issues as outlined here, but I would be very interested to know if you have a referral in Michigan or your expert opinion in general. Could you take over at this point with the oral surgery and grafting having been completed July 29, 2014? Do you have an estimate based on this paticular situation of what you charge? All advice and information is welcome and desired. Thank you for your time and attention.

    1. Hello Lisa,

      Happy Easter. Sorry for a bit of a delayed reply. It has been a very busy week.

      I have mentioned before on many occasions over the last 6 or 7 years that zirconia is not a good material to make the actual dental implants out of. Zirconia is excellent as an abutment or the final bridge or crown, but is not a good material as a dental implant inserted in the bone. The implants have to be made of 1 single piece and have no ability to redirect angulation with a removable abutment. This means that once the implants are placed, you are stuck with the position that they are in. Almost every complex full mouth dental restoration requires custom abutments in order to make all of the implants angled the same direction for the teeth to fit properly. Zirconia implants lack this ability.

      Titanium dental implants and zirconia dental implants are not poisonous and do not cause medical problems. Titanium dental implants have a long track record of success over the last 40-50 years. I have placed in my own family members. As of 2015 I would not do this in another human being as of yet. There are not enough long-term studies to support it and I don’t use my patients as guinea pigs. Do not believe everything you read on the Internet.

      You had one sentence that said it all “Shes absolutely terrified of complications we’ve been reading about “

      You need to see a very skilled and experienced dental implant specialist. I would suggest you see a single provider and consider replacing all teeth with the Prettau dental implant bridge which is all zirconia placed over titanium dental implants. Galvanic reactions do not occur in these types of teeth restorations.

      I would to be more than happy to take over her situation. Given that you live in Michigan, you may want to consider finding somebody closer to home. Attached are some articles to help you

      Prettau Dental Implant Full Mouth Bridge

      case planning for Prettau bridge

      How to Choose an Implant Dentist

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  4. Hi Dr.Ramsey Amin,
    .I came across your blog as I was trying to get more knowledge through the net. A year ago, part of my upper tooth (No. 26) was cracked, and I went to a good dentist who made a root canal treatment, put a temporary filling in order to go for a crown by another dentist. Here is my mistake, I left that tooth untreated for a whole year, the filling wore and got off in few days and I continued chewing on the uncovered tooth. Of course, It was crazy but it happened. Then my tooth started to crack more which made me go to the same dentist. When he checked he said that it was vertically cracked to the level of under the gum and nothing can be done to save it, and I have to extract it. I thought of a bridge (onlays…etc) but the before and after teeth are still in good condition. besides, I hear that bridges won’t stop gum from receding with time. I’m afraid to go for a implant for three reasons:

    1- I’m afraid of having a metal thing inside my mouth. I’m afraid of infections and the effect of metal on health.

    2- I’m afraid to lose hair as I read on internet, some patients claim they started losing hair after implant, while nothing seem sure. I already suffer from moderate hair loss, and I don’t want things to get worse. Many claims that any implant will cause Auto-immune state.

    3- I’m afraid of the success of that operation and which dentist in my country can do it.

    I also read about zirconium implants which are white and they say are metal-free. I would really like to know what do you think of everything I mentioned. What do you suggest?

    I will appreciate your reply so it can help me take decision. Thank you so much in advance.


    1. Hello Dan,

      Titanium dental implants have a long history of success. They also have 100s of thousands of articles to document through scientific research, all of the problems and positive things about dental implants. They have been around since 1965 in the titanium form. Zirconium dental implants have not been around for very long at all and I would not suggest them to be used for the actual screw as of 2015. Zirconia is excellent as and abutments and as a final crown material I would not suggested as the implant screw that goes into the bone.

      The titanium alloy is bio inert. This means that your body really cannot see it at all. There is no immune response that can cause an autoimmune states, hair loss, infections from being sensitized to it. I have placed dental implants in my own family and would place one in my own mouth. I don’t know of this skill, training, judgment and experience of a dentist in your country, but I would suggest you do your due diligence and find somebody very good.

      Here’s some information:
      How Long Have Dental Implants Been Around?
      Solid Zirconia Custom Dental Implant Crowns and Abutments Instead of Metal

      Good luck,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  5. How much is the total cost of Fixed Permanent dental implant teeth for the upper jaw,, from the consultation, procedure, bone grafting ,sinus lift up to after result check ups?
    Thank you and God Bless.

    1. Hi Marilou,

      Specifically a Prettau Dental Implant Full Mouth Bridge is what I am referring to. It ranges from $28 -$37,000 per jaw. It is precisely fabricated by a computer out of a solid piece of zirconia from my design. This allows the bridge to be virtually unbreakable and beautiful at the same time. There is no plastic “All on four” types of acrylic. This is an all inclusive cost using usually six implants.

      I hope this helps!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  6. When replacing multiple teeth (3) (using an implant supported partial), are abutments mandatory (at $700 each)? Is it possible to use screws to screw the appliance directly into the implant? Or is my dentist trying to upsell me?

    1. Hi Lucas,

      Your dentist is NOT trying to up sell you. Dental implant crowns and bridges require abutments UNLESS you have one-piece implants.

      Most implants have two pieces and require an abutment. Even if you have screw retained implant teeth, an abutment has to be used to connect the interface of parts.

      That interface can be casted or luted to the teeth. There are also some cad/cam options too.

      I hope this helps!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

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About Ramsey Amin, DDS

Dr. Ramsey Amin has extensive experience in surgical and restorative implant dentistry. As one of only less than 400 Diplomates of the American Board of Oral Implantology/ Implant Dentistry (ABOI/ID) he is considered an expert, and board-certified in dental implants. He is a former instructor at the UCLA School of Dentistry.