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Three Types of Dental Implants Explained

Articles on implants often describe three types, named for where the post sits. This guide explains each one and when it is used.

Key points

  • The three types named in most articles are endosteal (in the bone), subperiosteal (on the bone, under the gum) and zygomatic (anchored in the cheekbone).
  • Most patients are offered an endosteal implant, which is the type behind nearly all the long-term research.
  • A systematic review of studies that followed patients for at least ten years found 94.6 percent of implants still in place after 13.4 years.3
  • The type is decided by your scan, gum health, general health and habits, not by preference. Smoking raises the chance that an implant does not bond.12
  • Whatever the type, implants need healing time, careful daily cleaning and regular check-ups.1

When you search for dental implant types, you will often see three names: endosteal, subperiosteal and zygomatic. They describe where the implant is anchored. Most patients are offered the first type, and the other two are used in particular situations where bone is limited. Understanding the difference helps you follow what your dentist proposes. For other ways to describe implants, such as single, bridge and full arch, see our guide to the types of dental implants.

Endosteal implants

"Endosteal" means within the bone. This is the standard implant: a small titanium post, shaped like a screw, placed directly into the jawbone. Over the next few months, the bone bonds to the post, usually in about three to six months, and then a crown, bridge or denture is attached.1

Endosteal implants are the type behind nearly all the research you will read about. A systematic review of studies that followed patients for at least ten years found that 94.6 percent of implants were still in place after 13.4 years on average.3 They need enough bone in height and width, or a bone graft to build it up first, which adds at least four months to the treatment.1

Who they usually suit: people with healthy gums and enough jawbone, or who are willing to have a graft.

Subperiosteal implants

"Subperiosteal" means under the thin tissue that covers the bone. Instead of being placed inside the bone, a custom metal frame rests on the surface of the jawbone beneath the gum, with posts that come through the gum to hold the teeth.

This design was developed for people who do not have enough bone for an endosteal implant and who cannot or do not want a bone graft. It is now used much less than it once was, because bone grafting and shorter or narrower posts have made endosteal implants possible in more cases. If your dentist suggests a subperiosteal design, ask why it is chosen for you, what the alternatives are and what the long-term evidence is.

Who it may suit: a small number of people with very limited bone, assessed case by case.

Zygomatic implants

"Zygomatic" refers to the cheekbone (the zygoma). These are longer posts that are anchored in the cheekbone instead of the upper jawbone. They are used when the upper jaw has lost so much bone that standard implants cannot be placed, and when a graft is not suitable or not wanted.

Zygomatic implants call for a high level of surgical training and careful planning with a 3D scan. They are a specialised option for particular cases and are not routine.

Who it may suit: a few people with severe bone loss in the upper jaw.

Which type is most likely for you?

For most people, the answer is endosteal. Your dentist works it out from:

  • a 3D scan, which shows how much bone you have and where nerves and the sinus lie;
  • your gum health, because untreated gum disease must be treated first;1
  • your general health, because some conditions and medicines affect healing;2
  • your habits, because smoking raises the chance that an implant does not bond and NHS guidance asks patients to stop at least six months beforehand.1

At Orion Dental Clinic, planning uses a 3D scan (CBCT), so the position of an implant is worked out from your own bone. If you need more bone, a graft may be advised, and our article on bone grafts for dental implants explains the options.

A note on the evidence

Almost all the long-term research is on endosteal implants, so the success figures you read apply to that type. For subperiosteal and zygomatic designs the evidence is smaller, which is one reason they are kept for cases where other options are not suitable. If your dentist proposes one, it is reasonable to ask what the results have been for that design, how often they place it, and what the plan would be if it had to be removed.

Another point is maintenance. Whatever the type, the gum around an implant can become inflamed, and a systematic review found that on average 43 percent of patients had inflamed gum around an implant and 22 percent had the more serious form that destroys bone, with wide differences between studies.4 Daily cleaning and regular check-ups are the main defence.

What every type needs from you

Whatever the design, all implants need:

  • healing time, which NHS guidance puts at three to six months before the final tooth is fitted;1
  • careful daily cleaning, including around the implant;
  • regular check-ups, which NHS guidance puts at every three to six months;1
  • honest conversations about risks. A small number of implants do not bond to the bone and have to be removed, and the risk is higher in smokers.2

Questions to ask your dentist

  • Which type do you recommend for my mouth, and why?
  • Have you placed this type before, and how often?
  • What are the alternatives, including doing nothing?
  • What would happen if the implant did not bond?
  • How long would my treatment take?

Our complete guide to dental implants and the dental implants page cover the rest of the process.

What an implant is made of

Every implant has the same basic parts. The post is the root replacement, a small titanium screw that sits in the bone. The abutment is a connector that joins the post to the tooth and passes through the gum. The crown, bridge or denture is the visible part that replaces the tooth or teeth. Titanium is the most widely used material for the post because bone bonds well to it, although other materials exist and your dentist can tell you which they use.

The three types in this guide differ mainly in where and how the post or frame is anchored. The abutment and crown work in much the same way, whichever type you have.

Why the scan matters more than the name

People often ask for a particular type. In practice, the scan decides. A 3D scan shows the height and width of the bone, the position of nerves in the lower jaw and of the sinus in the upper jaw, and the quality of the bone where the post would sit. The dentist plans the position of each implant from that image, so the plan is based on your own anatomy, not on a standard template.

If the bone is thin, a graft may allow a standard post. If the sinus is low, a sinus lift may be discussed. Only when these routes are not suitable would a less usual design come into the conversation. Our article on bone grafts for implants explains these options.

The three types at a glance

Type Where it sits Usual situation Amount of research
Endosteal Inside the jawbone Most patients with healthy gums and enough bone Largest by far
Subperiosteal On the bone, under the gum Very limited bone, assessed case by case Smaller
Zygomatic In the cheekbone Severe bone loss in the upper jaw Smaller

Myths and facts

Myth: zygomatic or subperiosteal implants are the newest and therefore better. They are used in particular situations, and the standard post in the jawbone has by far the largest body of research.

Myth: you can choose the type yourself. The type is decided by your anatomy and your scan, in discussion with your dentist.

Fact: the first step is always an assessment. Without it, no type can be recommended.

Questions to ask if a less usual type is suggested

  • Why is the standard type not suitable for me?
  • How many of these have you placed, and with what results?
  • What is the plan if it has to be removed?
  • Are there alternatives, such as a graft?

Frequently asked questions

Are subperiosteal and zygomatic implants common?

No. Endosteal implants are by far the most common. The other two are used in specific situations with very limited bone.

Can I avoid a bone graft?

Sometimes. Depending on your scan, a different position, size or number of posts may be possible. Your dentist can say what is realistic for you.

Does the type of implant change how long the treatment takes?

It can. Any design that needs a bone graft adds at least four months, and NHS guidance says the whole process could take 6 to 12 months.12

Is a zygomatic implant major surgery?

It is a more complex operation than a standard implant, and your dentist can explain what is involved.

Are subperiosteal implants still used?

Rarely, in a small number of cases.

Are all dental implants made of titanium?

Titanium is the most widely used material for the post. Other materials exist, so ask your dentist what they use and why.

Which type of implant has the most research behind it?

The endosteal implant, a post placed in the jawbone. Almost all the long-term success figures you will read apply to this type.3

About the author

Portrait of Dr Anupam Sinha

Dr Anupam Sinha, BDS, MDS – Orthodontics. BDS (2002), KLE Vishwanath Katti Institute of Dental Sciences, Belgaum. MDS in Orthodontics (2006), SDM College of Dental Sciences, Dharwad. His thesis work won a national research award in 2005, and he holds a certification in aesthetic dentistry. He sees patients at Orion Dental Clinic in Greater Kailash 1, South Delhi. Read the full profile of Dr Anupam Sinha.

Sources

  1. Cambridge University Hospitals NHS Foundation Trust. Dental implants in restorative dentistry (patient information). https://www.cuh.nhs.uk/patient-information/dental-implants-in-restorative-dentistry/
  2. Guy's and St Thomas' NHS Foundation Trust. Dental implants (patient information). https://guysandstthomas.nhs.uk/health-information/dental-implants
  3. Moraschini V, Poubel LA, Ferreira VF, Barboza EdS. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. International Journal of Oral and Maxillofacial Surgery, 2015. https://pubmed.ncbi.nlm.nih.gov/25467739/
  4. Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. Journal of Clinical Periodontology, 2015;42(Suppl 16):S158-S171. https://doi.org/10.1111/jcpe.12334

Medically reviewed by Dr Anupam Sinha, BDS, MDS – Orthodontics, on . General information for patients from Orion Dental Clinic, last updated 23 October 2026. It is not advice for one person, so ask a dentist what suits you. To report an error, contact us.