What is an implant and which are the steps you have to fulfill in order to get this procedure?


An implant is a procedure in which one or more lost teeth are to be replaced, regardless of how they were lost.

Our implant procedures consist of two phases:

  • The first one is surgical, in which the implant is placed in the mouth.
  • A second phase, in which the implant is put to work by a restoration, whether it is a crown or a bridge.

On the surgical part the most important factor is the existence of bone in a sufficient amount to accommodate the implant that you want to place. To evaluate if there is enough bone a clinical exam must be taken with a 3D x-ray exam.

On the clinical test, we evaluate that the patient doesn’t have untreated systemic diseases, suppressed immune system or that he or she is a smoker. If these factors are under control there is no counter indication for the treatment; if they are not, the patient who wants to be a candidate for an implant must get medical control and treat his or her diseases; and if he or she is a smoker he or she must stop this habit for at least 3 months prior to the installation of the implants and for 9 months after the procedure.

For the 3D x-ray exam there is a test specifically designed for the placement of implants; its purpose is so that the surgery can be realized virtually on a computer. This test gives us information about the thickness of the bone, the height, the nerves and arteries on the area where the procedure will be done, so that we can clarify any doubts, resulting in a safer procedure, more predictable and successful. If there is not enough bone, the necessary previsions are taken, such as generating more bone by lifting the maxillary sinus, bone grafts, or some other regenerative techniques.

Time to start smiling again with our quality dental implants in Costa Rica – Contact Us Here –

With this information we proceed to put the implant. This procedure takes from 1 to 2 hours, and it is done under local anesthesia. Patients have been questioned about which procedure is more uncomfortable between implant placement and exodontias. 9% of them refer it is more annoying to have a tooth removed than to have an implant.

Cares to Consider After the Implant is in Place

Amongst the cares you have to take once the implant is in place, we can quote: abstaining from making hard impact exercises for at least 4 days, not eating hot meals for 2 days after the procedure, and following the extra indications about medicaments and the extra indications based on the individual needs of the patient. The healing process is going to take 6 months. During this time the implant must adapt to the bone that surrounds it. From 90% to 95% of the implants that are placed can be used without any trouble. If for any reason the implant does not work, replacing it will be considered.

4 Appointments are Necessary to Finish the Procedure

Once the implant is ready to be used, four appointments are necessary in order to finish the procedure. For this part what matters most is that the implant has been placed correctly from the beginning, on a position from which it can be used without any problem, since there have been times in which, due to poor alignment, the necessary requirements are not fulfilled for the implant to be used.

  • On the first appointment the implant is revealed, the tissue or gum that lies over the implant is removed, and a healing button is placed.
  • On the second appointment the final impression is taken. This impression will give us the necessary information to create the personalized crown.
  • On the third appointment the restorations that will cover the implant are tested to see their color, shape and adjustment.
  • On the fourth appointment we proceed to definitely cement the restoration on the implant.

What kind of restoration can be achieved with our implants?


With our implants you can achieve a great variety of restorations:

  • For example, if you are missing a tooth, it would be ideal to place an implant and on top of it a crown to restore the space.
  • If you are missing three teeth on the side, you can get from 2 to 3 implants and on top of them you can get a bridge, in order to solve the problem.
  • If there is an inferior prosthesis or a set of teeth that has no attachment and is bothering you, you can get two implants and a set of teeth attached to these two implants to stop those annoying movements.
  • There are cases in which a person does not have any teeth at all and does not want to get a movable set of teeth. On such cases the dentist would think of placing from 5 to 8 implants and on designing a set of teeth to be fixed on those implants.

As you can see, most situations when a tooth is missing can be solved with implants. So if you identify yourself with any of the above mentioned cases, it is worth considering getting one or more of our dental implants and start smiling again!

Are all Implants in Costa Rica the Same?


As it happens with all things, there are different qualities of the same product. At Advance Dental Costa Rica we use high quality implants of the following brands: Zimmer Dental, Implant Direct and 3i Biomet. These manufacturers guarantee us their products and the facilities in which they are manufactured fulfilled high standards of sterilization and production, avoiding us infection problems, loss of the implants and complications after the placement of the implants.

Let’s talk on How to Restore Your Teeth Using All on 4, All on 6 and All on 8 Implants

Implants have revolutionized the way to restore lost teeth. Nowadays, it’s very common to hear of them, and probably you or some of your relatives or friends must have used them to restore one or more missing teeth.

There are a large number of edentulous people worldwide, i.e. with no teeth, which have had to live with removable prostheses. Making their daily life a silent suffering either by taboo, grief or ignorance.

In the United States only, this population totals approximately 40 million people. There are 40 million people who stays in their homes with fear of being judged if a denture is dropped; they are 40 million people who can’t eat their food in a safe and confident way. And there are 40 million people who do not know that there is a solution to be able to solve or improve their dental condition.

At the end of the years 90s, Dr. Paulo Malo, a renowned Portuguese dentist with extensive experience in implants, began searching for solutions to help 3 types of patients to improve their quality of life.

These patients were:

  1. Patients with no teeth
  2. Patients who had lost their molars and were diagnosed as if they have lost their front teeth (incissors)
  3. Patients that needs bone graft to put implants.

For these 3 types of patients, in order to put implants, on many occasions, the following had to be done:

  • Double maxillary sinus elevation: The issue with this procedure is that the cost was high and that it takes a recovery time of about 6 months. After six months the implants were placed. On occasion, if the bone allowed, the implants were temporarily loaded and thereafter from 4 to 6 months, the implants were definitively loaded.
  • On some occasions, the financial means were not enough to place the 6-8 implants that are ideally occupied to rehabilitate a mouth with teeth, and patients could only pay a smaller amount of implants.
  • Patients wanted to have only one surgery intervention and not a multi-step event.

The geniality of Dr. Malo settled in putting the posterior implants in an angular way, in order to be able to extend the teeth in a better way; and in a very methodical way, he collected all the procedure’s detailed information and the patients’ results.

The results were really surprising, since it has been proven that having 4 implants in strategic positions provides the same support as 6 implants with all the benefits and less important that this brings.

I have had the pleasure of meeting in several occasions with Dr. Malo and I have traveled to Portugal on two occasions to train with him in the surgery protocol and rehabilitation of the All
on Four implants.

And I would like to share my opinions on this technique: what are the benefits, their disadvantages and the repercussions of doing All on 4 vs other treatments, what to expect when performing this procedure, what care is recommended, what materials are used and how it is to live with these or other dental restorations.

4 vs 6 vs 8 Implants

In Advance Dental, when we serve an edentulous patient, i.e. without teeth, or a patient who, for various reasons will lose their teeth, we put into action a very specific protocol that we have already created to meet these needs.

On many occasions, patients have already done their research, even visited other professionals and have many questions, fears or misconceptions of what procedure is better for them. And they come already with the intention of doing only an All on 4 dental procedure.

This is where we put into action the protocol based on years of private practice, continuing education and training as a mouth restoration specialist, which leads in a very intuitive and predictable way, to a solution that is created for each specific patient.

Let’s talk about the amount of implants needed to restore an arc, i.e. the top or bottom of a teeth-less person.

The minimum number of implants needed to permanently restore a dental arch, either superior or inferior, is a total of 4, and the most a patient should think of putting are 8 implants.

Remember that these implants are going to be the support for an average of 12 to 14 teeth.

What’s better 4, 6 or 8 implants?

The first thing we need to take into account before answering this questions is the following: Implants are the necessary pillars to hold the missing teeth and as aforementioned, the minimum needed are 4.

Let’s explore the following scenarios for deciding how many dental implants a patient coming to Costa Rica should get:

-Although implants are highly predictable, and with a high success rate, there are times when an implant may lose its integration into the bone or suffer from peri-implantitis; and if there are only 4 implants, the whole restoration can be compromised. On the other hand, if you have 5, 6 or more implants, up to a maximum of 8, in case an event like this happens, the odds that there are problems with the final restoration are diminished.

-When you put all your teeth in 4 implants, all of these will be joined together in one teeth unit, which makes your daily hygiene more time consuming and complex. On the other hand 6 to 8 implants can be restored in shorter units of 3 to 4 teeth, making it easier to clean them.

-Another differences of having a single unit or many, is the possibility of repairing, in case that one of the artificial tooth is fractured, which is unlikely, since the teeth have 7 years guarantee (in units of Bruxzir). In the unfortunate case one of the tooth is accidentally fractured, and if all the teeth are in a single unit, it can be more difficult to repair.

-As we get older, our physical skills are reduced, including our manual dexterity. Having a single teeth unit will eventually make the daily maintenance harder to achieve. It should
also be taken into consideration that according to Dr. Malo’s protocol the all on 4 prosthesis has to be removed once a year, and this costs time and money.

If a patient has an adequate amount of bone, and does not need bone grafting, the recommended number of implants I advise in order to prevent an implant from presenting problems in the future due to different conditions, are 6 implants at the top and 5 at the bottom. This guarantees us to have an adequate number of implants, a good distribution of forces and to have one or several extra implants, in case they can be needed in the future.

What is the ideal treatment for a patient who has no teeth and why?

In my opinion, for a patient who has no teeth, and a perfect bone condition without the need for bone grafting, putting 8 implants that supports 4 independent bridges would be ideal. The hygiene is easier and do not require so much skills. In the case an implant fails, there are others that can still support the bridges.

When is the All on Four Implants procedure recommended?

After evaluating hundreds of patients and seeing their results, my recommendations for a restoration on all on four implants is when the patient does not have the desire or cannot do a bone graft to be able to place more than 4 implants. It is an excellent choice for patients who have a limited budget. As we have seen, it has its advantages but it also has its drawbacks.

These types of restorations are predictable and the results have high levels of success, however, we always like to give our patients a presentation an explanation of all the treatment options available in order for them to be able to choose the one that is most beneficial for them, according to their needs and budget.

As you have been able to read there is not only one implant option that can be applied to all patients. The ideal thing to do is to make a consultation where we can talk about the issues of post-treatment maintenance, expectations of the restoration, economic scopes, ease of solving problems in case of complications, and all other issues that may occur, both the patient and the Prosthodontist, when planning your case.

What is the cost of implants in Costa Rica compared to the United States?


The cost of an implant with abutment and standard crown in the United Sates costs an average of $4,500, and in Costa Rica it starts from an average of $1,300. The final cost of a dental implant varies depending on the quality of the materials used, oral health, type of anesthesia and other treatments performed in conjunction, such as bone graft if required by the patient.

For patients traveling from abroad, one of the most appealing features of getting dental implants done at our office in San Jose, Costa Rica is the fact that their cost is going to be about 50% less than what the same implant would cost in the United States. The final investment done by our patients here is not as much as one might expect due to the fact that our costs here are lower, therefore our prices are lower and our patients end up having done the same procedure they would get in the US, with FDA approved materials. This all translates into more affordable implants and the same high quality procedure done at our Clinic. In a nutshell, implants in Costa Rica are much more cheaper than in the USA and with a top notch quality.

About Dr. Eugenio Brenes (Director and Prosthodontist at Advance Dental)


Dr. Eugenio J. Brenes at Advance Dental Costa Rica has his specialty from Loma Linda University, where for four years he learned the correct way of planning and patient assessment to be used with candidates for implants, and the proper way to install these implants in order to get successful and predictable results on such procedures. This education, added to the backup of a team that puts you as the priority, makes Advance Dental Costa Rica the ideal place for you to get your implant treatment done. Please contact us for more information on our dental implants in Costa Rica.

Important points to consider if you are thinking on getting an implant at our clinic:

  • Our Director, Dr. Eugenio Brenes is a US trained dentist with a vast experience in all major dental procedures. Dr. Brenes specializes Prosthodontics and Oral Rehabilitations and is currently the Head of Dental Surgery at CIMA Hospital in Costa Rica.
  • At our clinic we only use high quality implants of the best brand: Zimmer Dental. A titanium, American and FDA approved implant. These implants are manufactured under very high standards of sterilization, minimizing complications after the implants are placed.
  • Prior to the colocation of the implant, a clinical exam must be taken with a 3D x-ray exam. The dentist must make sure there is enough bone for placing the implant, this exam also gives the doctor other vital information that will guarantee a more predictable and successful dental procedure.
  • After the implant is placed, four appointments are necessary to finish the procedure. In order for the implant to be used, it is critical that the dentist is 100% sure that the implant has been placed correctly from the beginning, on a perfectly aligned position from which it can be used without any problem.
  • On appointment number one, the implant is revealed and a healing button is placed.
  • On appointment number two, in order to create a personalized crown we proceed to take a final impression.
  • On appointment number three, we make sure the restoration(s) that will be placed on the implant(s) matches the correct color, shape and adjustment.
  • On appointment number four, the doctor proceeds to cement the restoration on the implant in a permanent way.

So what are you waiting for, come to our beautiful Costa Rica and get your high quality implants at an affordable price!

Feel free to contact us and tell us about your dental needs.

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Before and After Photos


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