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Most patients come in for an implant consultation having already read a lot. They know the general idea — something titanium goes into the bone, healing happens, a crown gets attached on top. Online research tends to cover the beginning and the end, not much in between. The gaps in that picture are what most of the consultation is actually about.
Dr. Peter Hazim is a prosthodontist in Allen, Texas, practicing since 1999. His specialty training is specifically in complex dental restoration, which means when he’s planning an implant, he’s thinking about how that replacement tooth will fit into the bite and the surrounding dentition, not just whether the post will hold in the bone. What follows is an account of how those consultations actually go.
Why the Consultation Isn’t Just a Scheduling Call
Patients sometimes walk in expecting to set a surgery date. They’ve decided. They want the tooth. They came in thinking it was mostly logistics. We spend a fair amount of that first appointment explaining why it doesn’t work that way.
What’s actually happening is a diagnostic evaluation. The imaging is a big part of it — standard X-rays for some cases, a cone beam CT scan for others. The 3D version gives us bone volume and density information that a flat X-ray can’t show. We’re also reviewing health history, because certain conditions and medications affect how bone responds to titanium, and examining the adjacent teeth and bite. All of that has to happen before anyone can map out what the patient’s specific path actually looks like. Patients who go through the evaluation carefully tend to leave with a clearer, more accurate picture of their case.
When We Find Out the Bone Needs Work First
One thing that surprises nearly everyone: what the jaw does after a tooth has been gone for a while. The bone responds to chewing forces, and when a tooth is missing, the bone in that area gradually loses volume — sometimes significantly over a year or two. When we pull up the scan, patients usually see for the first time what their jaw actually looks like, and sometimes that changes the conversation.
If grafting is needed — rebuilding the bone before the implant can go in — that’s months added to the process. The graft has to consolidate before placement can happen. Patients who came in expecting to be done in four or five months sometimes leave understanding they’re looking at closer to a year. What we hear from those patients later is that knowing early gave them time to plan. Gum disease and active decay get addressed first too, before any implant work starts. The tissue has to be in good shape, and we’re direct about that at the consultation rather than letting patients assume the implant can run parallel to other treatment.
The Surgical Guide — Something Most Patients Haven’t Heard Of
Patients almost never know about this step going in. Before placement day, we build a surgical guide using the 3D imaging from the consultation. Built from that scan, it tells us exactly where the implant goes — angle, depth, position — before we’re in surgery. When the surgery happens, the guide is what we’re working from, not a freehand judgment call about where to drill.
Patients who learn about it for the first time during their consultation tend to find it reassuring. That precision carries through to the crown — placement accuracy influences how the final tooth sits against the opposing arch and how it functions over years of use.
What the Surgery Day Looks Like
The day of placement is the part patients tend to build up most in their heads, and it’s usually the part they’re most surprised by afterward. We use local anesthesia for placement. Sedation is available for patients who want it. We make a small incision to access the bone, use the guide to place the post, and either put a healing cap on or close the tissue, depending on how the case was planned.
Patients are often surprised by how manageable the recovery is. Most handle whatever discomfort there is with over-the-counter medication. What comes after isn’t usually painful — it’s a waiting period. The bone has to grow around the titanium post, which takes three to six months depending on the case. That’s what makes the implant stable for the long run. A temporary tooth during that period isn’t always an option — it depends on the specifics of the case. Patients who understand why the waiting period matters tend to get through it more easily than ones who weren’t told what to expect.
Crown Delivery and What We’re Looking For
Once osseointegration is confirmed, the abutment goes in — the connector piece between the post and the crown. That’s a minor procedure. Then impressions go to the lab, the gum tissue heals around the abutment over a couple of weeks, and the crown comes back for delivery.
This is where Dr. Hazim’s prosthodontic background is most directly relevant. The crown has to match the color and shape of the surrounding teeth, and the bite contact has to be calibrated carefully — how the implant crown presses against the opposing tooth on every chew affects the durability of the restoration over years of function. We review fit carefully before delivery and adjust until the contact is correct.
Maintenance and What We Actually See Over Time
Implants we’ve followed long-term in patients who care for them don’t decay, and they hold up well. The thing to monitor over time is the gum tissue around the implant. Peri-implantitis — tissue inflammation around an implant — is the main long-term risk. It’s preventable, but it requires specific attention at the gumline. We go through the home care routine with each patient at crown delivery because it differs slightly from the routine for natural teeth, and patients who understand the distinction tend to maintain their implants better. We check the tissue health at every visit and flag anything early.
If you’re in Allen or the surrounding area and want to talk through what an implant consultation would involve for your specific situation, reach out to our office.
