Most dental implant surgery procedures are performed in the dentist’s office and local anesthesia is usually adequate for these out-patient procedures. As an initial surgical step, the dentist will need to access to bone in the region where the implant will be placed. To do so they’ll first use a scalpel and score incisions in the overlying gum tissue and expose the bone underneath. Once the bone has been accessed, the dentist will use a series of drills, each of increasing diameter, to prepare a hole into which the dental implant will ultimately be placed. Once the hole has been properly shaped, the dentist can go ahead and insert the dental implant into the jawbone. Finally, close the surgical side and wait for 3 months. Once an adequate healing period has elapsed, the implant can have its final dental restoration fabricated and placed. This might be a dental crown, bridge or denture. Despite decades of clinical and scientific research, dental implants do not have a 100% success rate. However, the success rates have improved dramatically since the introduction of dental implant surgery and the dental profession can proudly report success rates well above 90% for most implant patients. Similarly, long-term success rates are in the high 90% range and are likewise improving. When a dental implant has not successfully integrated, it may need to be removed, as it cannot easily be “converted” to osseointegrate. Your dentist will give you best advice about this. A replacement implant can be placed but it may require some months of healing time and possibly bone augmentation.