Which Type of Dental Implant Is Right for You? Understanding the 3 Options

The three types of dental implants are endosteal, subperiosteal and zygomatic. Endosteal implants, the most common type are titanium posts placed directly into the jawbone and are appropriate for most patients with adequate bone volume. Subperiosteal implants are placed under the gum tissue above the jaw bone and are used when the height of the jaw bone is not enough to place a regular implant and grafting does not seem to be a viable alternative. Zygomatic implants are used in patients who have significant bone loss in the upper jawbones but are not candidates for placement and the implant is secured into the cheekbone.

Key Takeaways

• There are three kinds of dental implants: endosteal, subperiosteal and zygomatic.
• For most patients with good bone volume at the implant site, the most commonly used and recommended type of implant is endosteal implants.
• Subperiosteal implants are reserved for cases where the bone height is not sufficient to accept an endosteal implant and bone grafting is not an option; less frequently used today because of the development of bone grafting techniques.
• A zygomatic implant is a highly specialized implant that is used for patients who have a significant deficiency in their maxillary (upper) jawbone.

When patients research dental implants, they encounter the term "types of implants" without a clear explanation of what that means or which type might apply to them. The distinction matters, not because patients need to select their own implant type but because understanding why different options exist helps explain treatment recommendations that might otherwise seem unnecessarily complex.

The three types represent three different anatomical approaches to the same fundamental goal: providing a stable anchor for a crown, bridge or denture. Which type is appropriate depends entirely on the patient's available bone, its volume, density and location.

Why There Isn't One Implant That Works for Everyone

The titanium post in a dental implant functions as an artificial root. For that root to be stable and durable, it needs to be anchored in sufficient bone that can integrate with the titanium through osseointegration, the biological process where bone grows directly onto and into the implant surface.

When the bone that would receive an implant has been compromised, by tooth loss, gum disease, infection or congenital absence, the standard placement pathway may not be viable. The three implant types represent the available solutions across the spectrum of available bone.

Understanding the Three Types of Dental Implants Through Real Patient Situations

Endosteal Implants: When the Jawbone Can Support an Implant

Endosteal implants are the baseline, what most people mean when they say "dental implant." A titanium post is surgically placed into the jawbone below the gum line. Over three to six months, the bone integrates with the implant surface. After the integration is confirmed, an abutment and crown is placed in order to complete the restoration.

Who they work for- Patients with adequate bone volume and density at the implant site. This includes most patients who pursue implants relatively soon after tooth loss or who have undergone bone grafting to rebuild volume at a site that initially didn't have enough.

Why they're the standard- Osseointegration with endosteal implants has decades of clinical evidence behind it. Long-term success rates above 95% make them one of the most reliably successful procedures in all of dentistry.

Subperiosteal Implants: When Bone Height Is Limited

Subperiosteal implants take a different approach. Rather than being placed inside the jawbone, a custom metal framework is placed on top of the jawbone, beneath the gum tissue. Posts from the framework protrude through the gum to support a restoration.

Who they work for- Patients who cannot receive endosteal implants due to inadequate bone height and for whom bone augmentation isn't a viable path, either due to health factors, patient preference or the extent of bone loss.

Why they're less common today- Advances in bone grafting, including sinus lifts, ridge augmentation and socket preservation, have made it possible to rebuild bone in most patients who previously would have been candidates for subperiosteal implants.

Zygomatic Implants: When Traditional Placement Isn't Possible

Zygomatic implants represent the most specialized option in dental implant surgery. Rather than anchoring in the maxillary (upper) jawbone, these longer implants travel at an angle through the sinus area and anchor in the zygomatic bone, the cheekbone.

Who they work for- Patients with severe maxillary bone loss, particularly the upper posterior quadrants, who need implant-supported restoration and for whom extensive grafting either isn't feasible or hasn't been successful. Zygomatic implants are used as part of full-arch implant solutions (similar to All-on-4 or All-on-6 concepts) in complex cases.

Why they require specialized expertise- The surgical anatomy involved, approaching the zygomatic bone while avoiding sinus structures, orbital contents, and other anatomy, requires advanced training beyond standard implant placement.

Why Most Patients Will Never Need All Three Options

The three types form a spectrum from routine to specialized. The vast majority of patients considering dental implants, whether for a single missing tooth or multiple teeth, are candidates for endosteal implants with or without bone grafting as a preliminary step.

Subperiosteal and zygomatic implants exist to serve patients at the more complex end of the bone volume spectrum. A patient who is told they "might not be a candidate for implants" due to bone loss has more options than they realize, including bone grafting to enable endosteal placement, subperiosteal implants when grafting isn't suitable or zygomatic implants for severe upper jaw cases. What isn't possible is "no options at all."

Conclusion

The three types of dental implants, endosteal, subperiosteal and zygomatic, represent different solutions to the same clinical challenge: providing a stable, durable anchor for tooth replacement when natural teeth are missing. Most patients receive endosteal implants. The other two types exist to serve patients whose anatomy makes the standard approach impossible.

At Clove Dental, we evaluate each patient's specific bone anatomy and goals before recommending any implant approach.

FAQs

Which type of dental implant is most commonly placed?

Endosteal implants are by far the most common, they represent the vast majority of all dental implants placed worldwide. Subperiosteal implants are rare in modern practice and zygomatic implants are a specialized procedure performed in a small percentage of complex cases.

Can I choose which type of dental implant I receive?

The implant type is determined by your available bone anatomy, not by patient preference. A patient without adequate bone for endosteal placement can't receive one by preference alone.

What if I don't have enough bone for a standard dental implant?

Options depend on the extent of bone loss and its location. Bone grafting, including socket preservation, ridge augmentation or sinus lift, can rebuild volume in many cases and enable standard endosteal placement. For cases where grafting isn't viable, subperiosteal or zygomatic implants may be considered.

How long do dental implants last?

Endosteal implants, with appropriate care and maintenance, are designed to last a lifetime, the implant post itself typically doesn't need replacement. Subperiosteal and zygomatic implants have less long-term data than endosteal implants but have been used successfully for decades in appropriate patients.