The three types of dental implants are endosteal, subperiosteal, and zygomatic. Each is designed for a different jawbone situation, from healthy bone that can hold a screw-like post to severely deteriorated bone that requires anchoring into the cheekbone. Which type you’re a candidate for depends almost entirely on how much jawbone you have left.
Endosteal Implants: The Most Common Type
Endosteal implants are small titanium screws placed directly into your jawbone. They’re by far the most widely used type, and they have the strongest track record for long-term success. Once the screw integrates with the bone, a connector piece and artificial tooth (or teeth) are attached on top. A single endosteal implant can support one crown, or several implants can anchor a bridge or full denture.
The catch is that your jawbone needs to be large enough and dense enough to hold the screw securely. The bone at the implant site generally needs to be at least 3.5 to 4.5 millimeters wide and around 12 millimeters tall. If you’ve been missing teeth for a long time, the bone in that area may have shrunk below those thresholds. In that case, your dentist might recommend bone grafting to build the area back up before placing the implant, which adds months to the overall timeline.
Cost for endosteal implants typically runs $1,000 to $3,000 per implant. That’s the implant post itself, and doesn’t include the connector (called an abutment) or the crown on top, which add to the total.
Subperiosteal Implants: For Severe Bone Loss
Subperiosteal implants sit on top of the jawbone, just beneath the gum tissue, rather than being screwed into it. A custom metal framework rests on the bone’s surface, and posts protrude through the gums to hold the replacement teeth. This design was created specifically for people whose jawbone has deteriorated too much to support a traditional screw-type implant.
The primary candidates are people with severe bone loss, classified clinically as advanced horizontal and vertical atrophy. This includes elderly patients or those with systemic health conditions who can’t undergo or don’t want bone grafting surgery. Subperiosteal implants are actually the only implant technique that can rehabilitate very narrow bone ridges without sacrificing any remaining vertical bone height, which makes them uniquely useful in certain cases.
Because they require custom fabrication of the framework (often designed using a CT scan of your jaw), subperiosteal implants are more expensive than standard endosteal implants. Expect to pay roughly $1,500 to $4,000 per implant. They’re also less commonly offered, so you may need to seek out a prosthodontist or oral surgeon with specific experience in this technique.
Zygomatic Implants: Anchored in the Cheekbone
Zygomatic implants are the longest of the three types, and they bypass the jawbone entirely. Instead of anchoring into your upper jaw, these implants extend upward into the zygomatic bone, your cheekbone. They were originally developed for patients with extreme upper jaw atrophy or those who had lost significant bone after tumor removal, trauma, or congenital conditions like cleft palate.
The main appeal is avoiding bone grafting altogether. Rather than spending months rebuilding the jaw with grafts before placing conventional implants, zygomatic implants use the dense cheekbone as an anchor point. The original technique combined one zygomatic implant on each side with two to four conventional implants in the front of the mouth, all splinted together to support a full upper bridge. Newer approaches sometimes use four zygomatic implants without any conventional ones.
These implants are not considered minimally invasive. The surgery requires larger incisions and more bone exposure than standard implant placement, and it involves important structures in the middle of the face. Limited mouth opening (less than 30 millimeters), active sinus infections, or abnormalities in the cheekbone itself can rule you out as a candidate. Zygomatic implants only apply to the upper jaw, since the cheekbone connection doesn’t exist for lower teeth.
They’re also the most expensive option, ranging from $2,000 to $4,500 per implant, and a full rehabilitation typically involves multiple implants plus the prosthetic teeth on top.
Titanium vs. Zirconia: The Material Choice
Regardless of which type you receive, the implant post is made from one of two materials: titanium or zirconia (a ceramic). Titanium has decades of clinical data behind it, with a 95.7% success rate at 10-year follow-up across more than 45,000 documented cases. It integrates exceptionally well with bone, achieving 65 to 85% direct bone-to-implant contact, and it’s flexible enough to resist fracture under heavy biting forces.
Zirconia is the newer alternative, showing 92.3% success rates at 7 years. Its biggest advantages are aesthetic (it’s white, so no gray showing through thin gums) and biological. Zirconia surfaces accumulate 47% less bacterial plaque than titanium, and no cases of zirconia hypersensitivity have been documented. On the other hand, it’s more rigid and more prone to fracture under extreme force, which makes it a poor choice for people who grind their teeth. It also lacks long-term data beyond 15 years.
Titanium allergy is rare, affecting about 0.6% of the population, but if you’ve had reactions to metal jewelry or other metal implants, zirconia may be worth discussing. For most people, titanium remains the standard recommendation.
How Long the Healing Process Takes
After any implant is placed, your bone needs time to grow around and lock onto the implant surface, a process called osseointegration. This initial healing phase takes roughly 8 to 12 weeks, at which point the area around the implant is typically replaced by mature, dense bone in direct contact with the implant surface.
In practice, the full timeline from implant placement to final tooth is often longer than those 8 to 12 weeks. If you need bone grafting before an endosteal implant, that graft needs 3 to 6 months to heal before the implant can even be placed. After osseointegration, you’ll still need appointments for the abutment and crown fabrication. For a straightforward single-tooth endosteal implant with no grafting, expect roughly 3 to 6 months total. For zygomatic or subperiosteal implants, the timeline varies more and depends on how many implants are placed and whether you’re getting a temporary prosthesis during healing.
Which Type Is Right for You
The decision tree is fairly straightforward. If you have adequate jawbone density and volume, endosteal implants are the default choice: they’re the most studied, most widely available, and least expensive. If your jawbone has deteriorated significantly and you can’t or won’t undergo grafting, subperiosteal implants offer a way to anchor teeth without drilling into bone. If you’ve lost substantial bone in the upper jaw specifically, whether from long-term tooth loss, failed previous implants, surgical removal of a tumor, or trauma, zygomatic implants provide anchorage in the cheekbone where jawbone no longer exists.
Your starting point is a CT scan. A prosthodontist or oral surgeon will measure your available bone dimensions and map the anatomy to determine which approach gives you the most stable, long-lasting result.