Dental implants frighten people mostly because so little is explained in advance. A patient knows that “a titanium screw gets put in”, but not how long it takes, whether it hurts, what counts as normal swelling and when to call the surgeon. Below is the whole process step by step with timings, an honest account of pain and complications, and a separate look at what a sinus lift and bone grafting cost in Russia and in Tbilisi.
Implant treatment has four stages: diagnosis with a CT scan, implant placement under local anaesthetic (20 to 40 minutes per implant), healing for 3 to 6 months, and fitting of the crown. Pain after surgery is moderate and is controlled with ordinary painkillers for 2 to 3 days; swelling lasts up to a week. According to published reviews, early failures occur in 0.5 to 5.2 % of cases and late failures in 0.5 to 7.8 %. If there is not enough bone, you will need a bone graft or a sinus lift, which in Moscow adds another 20 000–58 000 ₽ (Russian roubles, roughly 220–640 € at the central bank rate quoted below) or more.
Stages of dental implant treatment: from consultation to crown
The whole path from the first consultation to the permanent crown usually takes 4 to 8 months, yet the active treatment inside it adds up to only a few hours. The rest of the time the bone is fusing with the implant, and all the patient has to do is follow the instructions. The stages with typical timings are below.
| Stage | What happens | How long it takes |
|---|---|---|
| 1. Consultation and CT scan | Examination, CT scan, assessment of bone volume, treatment plan and quote | 1 visit, 1 to 1.5 hours |
| 2. Preparation | Treatment of decay and gum disease, extractions, bone graft or sinus lift if needed | From 1 visit to 4 to 6 months if bone is being built up |
| 3. Implant placement | Local anaesthetic, incision or punch through the gum using a guide, implant placement, sutures | 20 to 40 minutes per implant, 1.5 to 3 hours per arch |
| 4. Healing (osseointegration) | Bone fuses with the implant surface. A temporary crown is fitted for this period, or nothing at all | 3 to 6 months |
| 5. Healing abutment and impressions | The implant is uncovered, a healing abutment is fitted, and 1 to 2 weeks later impressions or a digital scan are taken | 2 visits, 2 to 3 weeks |
| 6. Permanent crown | Try-in and fixing of the crown or bridge on the abutment | 1 to 2 visits |
The guide in stage three is a template printed from your CT scan: the surgeon drills through it at the right angle and to the right depth. More on the procedure in the dental implants section.
How long the surgery and the whole process take
A single implant is placed in 20 to 40 minutes; a full arch on 4 to 6 implants takes 1.5 to 3 hours. The whole process up to the permanent crown lasts 4 to 8 months, because the bone needs time to fuse with the titanium. The exact period depends on the jaw and on bone quality.
The international ITI group, in its 2008 consensus, defines the classic (“conventional”) protocol as fitting the prosthesis after a healing period of 3 to 6 months, the early protocol as loading between 48 hours and 3 months, and the immediate protocol as a crown within the first 48 hours (ITI Consensus, 2009). The bone of the lower jaw is denser, so 3 months is often enough there; in the upper jaw the wait is closer to 6. If a bone graft was done, another 4 to 6 months are added.
Immediate loading is possible with good primary stability and is used most often in the All-on-4 protocol, where a temporary bridge is fitted on 4 implants within the first days. More on the All-on-4 page.
Does implant placement hurt, and how long does it hurt afterwards
There is no pain during the surgery: local anaesthetic switches off sensation completely, so you feel pressure and vibration but not pain. The pain comes afterwards, once the anaesthetic wears off, usually the evening of the same day and for the following 2 to 3 days. For most patients ibuprofen or paracetamol as prescribed by the dentist is enough.
Many people compare the experience with a tooth extraction, and usually in favour of the implant: there is no open socket, the incision is neat and the sutures hold the tissue. Pain is stronger after an open sinus lift and after 4 to 6 implants placed in one session; then the discomfort lasts up to a week. Sedation takes away the fear but is not needed by most patients having 1 or 2 implants; in Tbilisi it is charged separately and written into the quote before the trip. If the pain gets worse rather than better on day 4 or 5, contact the surgeon the same day.
Swelling after dental implants: what is normal and what is not
Swelling of the cheek and gum is normal; it builds up to day 2 or 3 and goes down by day 5 to 7. A small bruise on the cheek, especially in older patients and after a sinus lift, is not a complication either. Cold packs in the first 24 hours (15 minutes at a time with breaks) reduce swelling noticeably.
Also normal: slight oozing of blood in the first hours, a temperature up to 37.5 °C on the first day, numbness of the lip for a few hours after the anaesthetic. What should concern you: swelling that keeps growing after day three, a temperature above 38 °C, pus or an unpleasant taste, numbness that has not gone within 24 hours, bleeding that does not stop after 30 minutes of pressure with a gauze pad. With any of these symptoms contact the clinic; do not wait for the scheduled visit.
What you can eat after implant surgery
Nothing to eat or drink for the first two hours, then soft, cool food: yoghurt, soup at room temperature, purées, cottage cheese. Chew on the other side. For the first 3 to 5 days avoid hot, spicy and hard food, alcohol and smoking, smoking above all, because it reduces the blood supply to the gum and raises the risk of failure.
From day 5 to 7, once the dentist allows it, your diet goes back to normal, except for very hard food on the surgical side until the crown is fitted. You can brush your teeth from day one, going around the surgical site with a soft brush, and rinse with an antiseptic as prescribed. During the healing period there is one restriction: no cracking nuts or hard bread on the temporary crown.
Contraindications to implants: absolute and relative
There are few absolute contraindications and they are rare: conditions in which the surgery is dangerous or the bone is known not to integrate. Relative ones are more common, but they mean “stabilise first, then place”, not a refusal. Age in itself is not a contraindication.
| Absolute (implants are not placed) | Relative (preparation or the surgeon’s judgement needed) |
|---|---|
| Severe blood clotting disorders | Anticoagulant therapy (adjusted with the cardiologist) |
| Uncontrolled diabetes | Controlled diabetes with normal HbA1c |
| Recent heart attack or stroke, unstable angina | Hypertension controlled with medication |
| Ongoing chemotherapy or radiotherapy to the jaw area | Osteoporosis, bisphosphonate therapy (risk assessment, sometimes refusal) |
| Severe psychiatric illness that prevents the patient from following instructions | Smoking (higher risk, but not a ban) |
| Autoimmune connective tissue disease in the active phase, immunodeficiency | Periodontitis, decay, poor hygiene (treatment first) |
| Age before jaw growth is complete (roughly under 18) | Pregnancy and breastfeeding (postpone), bruxism, bone deficiency (grafting) |
Before implant surgery you will have a full blood count, blood glucose, a coagulation panel, and HIV and hepatitis tests. It is better to list every chronic condition, even the “unimportant” ones: the surgeon is not deciding “whether to place or not” but how to prepare you so that the risk is minimal. Our patients’ plans are checked before the trip by Dr Ketevan Mamulashvili, a prosthodontist.
Consequences and complications of implants: how common they are
According to a 2025 scoping review in the journal Frontiers in Oral Health, early failures (the implant does not integrate before the crown is fitted) account for 0.5 to 5.2 %, and late failures (loss of an already integrated implant under load) for 0.5 to 7.8 % (Frontiers in Oral Health, 2025). In other words, 19 implants out of 20 work without problems, and most complications are reversible.
Early problems, in the first weeks: sutures coming apart, inflammation, insufficient primary stability. They are treated and, if necessary, the implant is replaced after 2 to 3 months. Rare surgical complications: injury to the lower jaw nerve with prolonged numbness of the lip, and perforation of the sinus floor in the upper jaw. The risk of both is cut sharply by a CT scan and a surgical guide, which is why we do not work from a panoramic X-ray alone.
The main late complication is peri-implantitis, inflammation of the bone around the implant, the counterpart of periodontitis. It develops over years, is linked to smoking, poor hygiene and untreated periodontitis of neighbouring teeth, and the same review names it the most frequent cause of late losses. Prevention: a toothbrush, a water flosser and a professional cleaning once or twice a year.
Dental implant rejection: symptoms
Rejection in the strict sense is not an allergy to titanium, such cases are isolated, but a failure to integrate: the bone has not formed a bond with the implant surface. Its signs can be noticed even before seeing the dentist: a mobile implant or healing abutment, pain on pressure a month after surgery, a gum that does not heal, discharge.
In the early period, the warning signs are: pain that increases after day 5; swelling and redness that have not gone within a week; pus or a bad smell; a temperature above 38 °C on day 3 or 4; the edge of the implant becoming exposed. In the late period, with the crown in place: bleeding and redness of the gum around the crown, gum recession exposing metal, mobility. Any of these signs calls for an X-ray. A failed implant is removed, the bone heals for 2 to 3 months, and then a new one is placed, usually wider or in the neighbouring position.
Sinus lift and bone grafting: prices in Russia and in Tbilisi
If the bone lacks height or width, it is built up: in the upper jaw this is a sinus lift (the floor of the maxillary sinus is raised and the space is filled with bone material); in other cases it is a bone graft. In Moscow a closed sinus lift costs from 20 000 to 57 000 ₽, an open one from 40 000 to 58 000 ₽ and above, often without the cost of the bone material. Below are the prices from the three named sources.
| Source | Closed sinus lift | Open sinus lift | Bone graft | Note |
|---|---|---|---|---|
| Startsmile, price summary for 14 Moscow clinics (checked 29.10.2026) | 10 000–57 000 ₽, in price lists “from” 15 000–81 450 ₽ | not listed | not listed | Aggregator, “from” prices |
| Prime Smile (Praim Smail), Moscow (price list on the website, 29.10.2026) | from 34 800 ₽ | from 49 800 ₽ | from 28 500 ₽ | CT scan 4 700 ₽ extra |
| Dantistoff, Moscow (updated 10.07.2025) | from 20 000 ₽ | from 40 000 ₽ | not listed | Total depends on the volume of grafting |
| Dental Luxury Clinic, Moscow (2026) | not listed | 58 000 ₽ | not listed | Excluding the cost of bone materials |
| Tbilisi, Dental Tourism Georgia | Fixed sum in a written quote before the trip, based on your CT scan | Bone material and membrane included in the quoted sum | ||
In Tbilisi a sinus lift and bone grafting are not part of the base implant price and are quoted separately, but from your CT scan and before the trip, in writing. You know the total before you buy your tickets. For comparison, the base prices: an implant with a zirconia crown (NTA®) 629 € (£540 / $730), with Straumann® 1 258 € (£1,080 / $1,450), All-on-4 for one arch 3 890 € (£3,340 / $4,500). At the Central Bank of Russia rate for 29 October 2026, 90.17 ₽ to the euro (Central Bank of Russia data), that is roughly 56 700 ₽, 113 400 ₽ and 350 800 ₽. The full price list is on the prices page.
Implant or bridge
If one tooth is missing and the neighbours are healthy, an implant is usually better: the neighbouring teeth are not ground down, the bone under it does not shrink, and it lasts longer. A bridge makes sense when the neighbouring teeth already have crowns or are badly broken down, when implants are contraindicated, or when the problem has to be solved in two weeks rather than six months.
Honestly about the trip: flying to Tbilisi for a single implant rarely makes sense, as flights and the hotel eat up the saving. The trip pays off from 3 or 4 implants, and with a full arch the price difference becomes decisive. If you are missing one tooth and have a good dentist nearby, have it done at home.
How it works in Tbilisi in 2 to 3 weeks
For single implants about 10 days is enough; for a full arch 2 to 3 weeks, and that is the surgical stage only. Before the trip you send your CT scan and receive a written plan and a fixed price. It includes a CT scan on site, the surgical guide, implants and abutments, surgery under local anaesthetic, permanent crowns or a bridge, airport transfer, a coordinator at every appointment, an implant passport and an aftercare plan.
The permanent bridge for All-on-4 is fitted after the implants have healed; your written plan states whether this happens within one trip or on a second short visit, and what it includes. Brands: Straumann® (Switzerland) and Bredent® (Germany), with B&B Dental® and NTA® in the budget packages. We are a concierge service, not a clinic: we select a partner clinic, arrange the appointments and stay in touch after you return home. The trip day by day is on the your trip page.
Frequently asked questions
How long does the gum take to heal after implant surgery?
The gum closes over in 7 to 14 days; sutures are removed on day 7 to 10 or dissolve by themselves. Swelling and discomfort are gone by the end of the first week. The bone, however, has not yet integrated: osseointegration continues for 3 to 6 months, and during that period the implant must not be loaded with hard food, even if everything looks long healed on the outside.
Can an implant be placed immediately after an extraction?
Yes, this is called immediate implant placement. It is possible if there is no purulent infection in the socket and the bone walls are intact and dense enough for the implant to sit firmly. The surgeon decides during the extraction. If the conditions are not met, the socket is left to heal for 2 to 3 months and the implant is then placed in the usual way.
How long does swelling last after a sinus lift?
After an open sinus lift the cheek swells more and the swelling lasts 5 to 10 days, often with a bruise under the eye. This is normal. For two weeks you must not blow your nose forcefully, sneeze with your mouth closed, dive or fly without the surgeon’s permission. Slight blood-stained discharge from the nose in the first 2 to 3 days is also expected; heavy bleeding is not.
Does an implant have to be removed in peri-implantitis?
Not always. At an early stage, when only the gum is inflamed, professional cleaning, antiseptics and better hygiene are enough. With bone loss, the implant surface is cleaned surgically and sometimes bone is grafted. The implant is removed when it is mobile or less than half of the bone around it remains. The earlier bleeding at the crown is noticed, the simpler the treatment.
Can I have an MRI with implants?
Yes. Titanium is not magnetic, the implants do not heat up or shift in the scanner, and MRI with them is done without restrictions. On head scans there may be slight distortion in the jaw area, which is worth mentioning to the radiologist. Implants also pass airport security without trouble; they are too small to set off the metal detector.
What if the implant fails after Tbilisi and I am already home?
Signs of failure to integrate usually appear in the first weeks, while you are still in Georgia or in contact with the coordinator. The guarantee terms for the implants and the work are written into your plan before the trip, together with how a replacement is handled. The coordinator replies on WhatsApp after you return as well, and X-rays can be sent for the dentist to assess.
The short version
- Four stages: CT scan and plan, surgery under local anaesthetic at 20 to 40 minutes per implant, healing for 3 to 6 months, crown. With a bone graft add 4 to 6 months.
- Moderate pain for 2 to 3 days, swelling for up to a week. Early failures 0.5 to 5.2 %, late failures 0.5 to 7.8 % according to a 2025 review; the main late risk is peri-implantitis, which hygiene prevents.
- A sinus lift in Moscow costs 20 000–58 000 ₽ and above, often without the material. In Tbilisi the sum is named in a written quote before the trip; an implant with a crown from 629 € (£540 / $730, about 56 700 ₽).
Send your CT scan on WhatsApp and the surgeon in Tbilisi will reply with a written plan and a fixed price, including bone grafting if it is needed. Free, with no deposit. A coordinator replies on WhatsApp.
