A periodontist is a dental specialist who has completed three additional years of post-dental school education focused on the structures that support the teeth, including the gums and the underlying jawbone. This specialized training makes them qualified to perform dental implant surgery. Periodontists are experts in diagnosing and treating conditions that affect the health of the tissues surrounding teeth and implants. Their expertise ensures that the foundation for the implant—the bone and gum tissue—is healthy, stable, and prepared for long-term success.
Defining the Periodontal Specialty
A periodontist’s specialty training centers on the intricate biology of the hard and soft tissues of the mouth. This deep knowledge of periodontal anatomy is directly transferable to implant placement. Their education includes advanced coursework in periodontics, the study of gum disease, and the surgical techniques required to manage and regenerate bone and soft tissue.
The periodontist’s primary concern is to create a stable, biologically sound site for the implant. They are skilled in treating periodontitis, a chronic inflammatory disease that destroys supporting bone. Their ability to manage pre-existing disease and prevent post-operative complications like peri-implantitis (a condition similar to gum disease affecting implants) is a unique strength. Training encompasses a detailed understanding of how the jawbone integrates with the titanium implant surface, a process known as osseointegration.
The Periodontist’s Role in Implant Surgery
The periodontist’s surgical role often begins with preparing the jawbone before the implant is even placed. If a patient has experienced bone loss due to tooth extraction or long-standing periodontal disease, the periodontist performs augmentation procedures to rebuild the necessary bone volume. These preparatory surgeries can include bone grafting, where material—such as the patient’s own bone, donor bone, or synthetic substitutes—is placed to stimulate new bone formation in a process called guided bone regeneration.
Another common preparatory procedure is a sinus lift, which elevates the floor of the maxillary sinus to create sufficient vertical bone height in the upper jaw for implant anchorage. The periodontist then uses surgical precision to place the titanium implant post directly into the jawbone, carefully positioning it to optimize its load-bearing capacity. This placement is often guided by pre-surgical 3D imaging and planning, ensuring the implant avoids sensitive anatomical structures like nerves.
Beyond the hard tissue, periodontists are masters of soft tissue management. They utilize techniques such as soft tissue grafting, including connective tissue grafts or pedicle grafts, to thicken the gum tissue around the implant. A strong, thick band of keratinized gum tissue provides a seal around the implant abutment, offering protection against bacterial invasion and contributing to a natural-looking emergence profile for the final crown. This attention to gum architecture is central to the periodontist’s approach to implant therapy.
Other Specialists Who Place Implants
While periodontists specialize in the foundation of the implant, other dental specialists also place them, each with a different primary focus. Oral and Maxillofacial Surgeons (OMS) are trained extensively in surgical procedures involving the entire facial region, including complex extractions and major reconstructive jaw surgery. An OMS often handles implant placement in cases requiring extensive bone manipulation or those complicated by severe trauma or pathology. Their training focuses heavily on the surgical phase and hospital-based operating room procedures.
Prosthodontists are the third specialty commonly involved in implant treatment, though their expertise lies primarily in the design and fitting of the final tooth restoration. They specialize in complex dental reconstructions, ensuring the replacement tooth or bridge functions correctly and looks aesthetic. While some prosthodontists complete surgical training to place implants, their foundational specialty is the prosthetic phase, which involves attaching the crown or denture to the integrated implant. The patient’s specific needs and the complexity of the restoration plan often determine which specialist is best suited for the surgical placement.