Placing the final prosthetic crown onto a dental implant is generally a non-surgical and painless procedure. This final step occurs only after the titanium implant post has fully fused with the jawbone (osseointegration) and the connecting piece, known as the abutment, is secured. The appointment focuses on fitting the custom-made tooth replacement and adjusting the bite. Patients typically feel no sensation that would be described as pain because the procedure is far less invasive than the initial surgical placement of the implant post.
The Painless Nature of Crown Placement
The primary reason this stage is painless is rooted in the biology of the dental implant system itself. Unlike a natural tooth, which contains a pulp chamber filled with nerves and blood vessels, the dental implant is a piece of inert metal. The implant fixture integrated into the jawbone and the abutment above it contain no nerve tissue. Since there are no nerves within the implant or the crown, the mechanical act of attaching the crown cannot transmit pain signals to the brain. Any sensation felt is typically limited to the soft tissues surrounding the implant.
In many cases, local anesthesia is not required for the crown placement appointment. If the dentist needs to gently manipulate the gum tissue to fully seat the crown, a small amount of topical anesthetic may be used for comfort. This step is a secure, mechanical attachment, not a surgical intervention.
The Steps of the Final Appointment
The final appointment is dedicated to the precise fit and function of the new tooth. The dentist first ensures the abutment, which connects the implant and the crown, is securely fastened. A final X-ray may be taken to confirm the abutment’s position and the health of the surrounding bone.
The custom-fabricated crown is then tried in to check its fit against the abutment and the adjacent teeth. The dentist evaluates the contact points with neighboring teeth and the overall appearance. The most time-intensive part of the appointment is often the adjustment of the occlusion, or the bite.
The patient bites down using articulating paper to identify any high spots on the new crown. These high spots, which can cause excessive force, are polished down until the bite feels natural and even with the surrounding teeth. The crown is then permanently secured, either by cementing it onto the abutment or by screwing it directly into the implant and covering the screw access hole with filling material.
Distinguishing Crown Placement from Implant Surgery
The anxiety many patients feel is often a carryover from the initial surgical phase of the implant process. The actual implant surgery involves making an incision, drilling a precise space into the jawbone, and placing the titanium post. This procedure requires local anesthesia and involves a significant recovery period, often with stitches and temporary swelling.
In sharp contrast, placing the final crown involves none of these surgical elements. There is no cutting, drilling into the bone, or suturing required for this restorative step. The entire process is performed above the gumline, focusing only on the prosthetic components.
The difference in patient experience is substantial. The surgical phase is an invasive procedure requiring a multi-month healing period for osseointegration to occur. The final crown placement is a non-invasive, mechanical seating of the restoration, typically completed in one short appointment without the need for significant recovery time or strong pain management.
Managing Post-Placement Pressure and Sensitivity
While the crown placement itself does not cause pain, it is common to experience minor, transient sensations afterward. The most frequent sensation is a feeling of pressure or mild soreness in the gum tissue surrounding the new tooth. This occurs because the gums, which had been healing around a smaller temporary cap, are gently pressed by the slightly wider final crown as it is seated.
This minor irritation, sometimes compounded by the use of temporary retraction cords during the procedure, is typically very short-lived. The surrounding soft tissue needs a few days to fully adapt to the new contour of the permanent crown.
If the bite adjustment (occlusion) is slightly off, the implant may feel like it is hitting first or harder than the other teeth. This issue is usually resolved with a quick follow-up visit for a minor polish. For any mild post-placement tenderness, over-the-counter pain relievers are sufficient to manage the temporary discomfort, which typically resolves completely within a few days.