The Ihde Method

The difference between the Ihde method and conventional implants

Both approaches work; where they part ways is the bone they rely on

Most articles comparing these two options praise one and run down the other. The truth is duller: both work in the right conditions, and the choice depends on the condition of your mouth. On this page we set the differences out side by side, point by point. As a clinic that does both, we write about where each one comes out ahead and where it falls short.

Short answer

A conventional implant is placed in the upper bone in which the teeth sit, and it gains its anchorage as the bone fuses with its surface, which takes time; that is why there are months of waiting. In the approach that carries Ihde's name, the implant locks into the hard cortical and basal layers deep in the jaw, it is made in one piece, and its anchorage is mechanical from the first day; that is why it can be loaded within the same week. The conventional implant's strengths are its body of evidence and the scope for correction; the other's is that the plan does not change even when the bone has resorbed.

Conventional: anchorage: Biological fusion with the upper bone, over months
Ihde: anchorage: Mechanical locking into deep, hard bone, from day one
Conventional: advantage: Large body of data, angle can be corrected
Ihde: advantage: No graft or waiting needed if the bone has resorbed

Medically reviewed by Bilge Ilgın, Dentist · ImplantologyLast reviewed 2026-09-08

Where the difference begins

It all comes down to the fact that the jawbone is not a single layer. At the top is the alveolar bone, which holds the teeth; this layer depends on the teeth being there, and when a tooth is lost it starts to resorb because it no longer carries any load. Beneath and around it lie the layers known as cortical and basal bone, which are much harder and are not affected by tooth loss. Every difference between the two approaches follows from one question: which layer do they rely on?

A conventional implant is placed in the upper layer. Once it is in, bone cells attach to the implant surface and, over time, the implant becomes part of the bone. This biological fusion takes months, and no load is placed on the implant during that time. In other words, the wait is not a tradition; it is a necessity that comes from the way the anchorage forms.

This works very well in mouths where the upper layer is sufficient. The trouble starts when that layer resorbs: the space the implant needs narrows, and on the conventional route the answer is to add bone first. A graft, months of healing, then the implant, then another wait. The whole process can take as long as a year, and a large part of the cost comes from this stage too.

The other approach takes its anchorage from the deep layer, which does not resorb. It may look like a single change, but it changes three things at once. In a jaw that has lost bone volume, the plan stays the same; because the anchorage is mechanical from the first day, there is no waiting for fusion; and because there is no waiting, a fixed bridge can be loaded within the same week. These are not three separate advantages but three consequences of the same decision.

Now for the other side, because it comes at a price. In this approach the implants are made in one piece: the body and the top part that the tooth attaches to are the same piece. There is no connecting screw and no micron-scale gap at that connection, which is a gain. But the angle cannot be corrected later by changing the top part. A planning error that could be compensated for in a conventional system cannot be compensated for here.

The second price is the body of evidence. Conventional implantology rests on a very large, comparative literature built up over decades. Corticobasal placement and immediate loading have also been studied, published and taught for a long time, but the evidence base is smaller and there are fewer long-term comparative studies. We are not hiding this: it is something you need to know when you make your decision.

Which suits which mouth

The breakdown below is the framework for the assessment made during the examination. We carry out both; the choice depends on the mouth.

The tooth can be saved

If the bone has resorbed: anchorage from the deep layerIn a jaw where the alveolar bone has diminished and a graft has been recommended, taking the anchorage from the layer that does not resorb removes the bone grafting step in most cases. It is the single decision that changes the time and cost the most.
If many teeth are missing: immediate loadingWhen several implants in one jaw work together, the load is shared and a fixed bridge can be carried from the first day. This is where the approach truly belongs.
If there is enough bone: a conventional implantIf the upper layer is sound and there is enough volume, the conventional route is a well-known option, backed by a large body of data and widely used. It can be the preferred choice for a patient who does not mind waiting.
If one tooth is missing: a conventional implantWith a single gap, the advantage of load sharing disappears. A conventional single-tooth implant means less surgery, lower cost and a result that is at least as good.

Saving it is unlikely to hold

One-piece implants in inexperienced handsBecause the angle cannot be corrected, there is no way back from a planning error. The number of cases a clinic has treated with this approach carries more weight than it does with conventional implants.
Early loading in soft boneLoading an implant when the expected mechanical anchorage has not been achieved leads to the implant being lost. That is a failure of judgement, not of the protocol, and it can be prevented.
Underestimating the graft on the conventional routeIn some cases bone grafting really is necessary and gives good results. But it is also true that it stretches treatment to a year and noticeably increases the cost; patients should be told both.
Active infection or uncontrolled systemic diseaseThis applies to both approaches. The infection is treated first, and blood sugar is brought under control first. This common ground has nothing to do with the difference between the two routes.

The two timelines side by side

What the same patient would go through on each route. It is not the number of steps that makes the difference but the waiting time between them.

1
Imaging and planning: the same for both
A CBCT scan is taken and the height, width and density of the bone are measured. This is where the difference starts: on the conventional route the question is whether the upper layer is sufficient, on the other it is where the deep layer lies.
2
Conventional route: bone grafting first, if needed
If there is not enough volume, a graft is placed and months of healing follow. This is the item that adds most to the overall time and cost; in some cases it cannot be avoided.
3
Conventional route: placement and waiting for fusion
The implants are placed, followed by months of waiting. A removable temporary denture is worn during this period. Then the bridgework is made.
4
Other route: preparing the site by compacting the bone
The site is opened not by removing bone but by pressing it sideways, which makes the bone denser. This is one source of the anchorage achieved on the first day.
5
Other route: placement, measurement and loading the same week
The implants are locked into the deep layer, the anchorage is confirmed with a torque reading and, if the expected value is reached, the final bridge is loaded the same week. If it is not reached, that area is not loaded and delivery is postponed.
6
Afterwards: the same for both
Bite adjustment, check-ups and yearly maintenance. The long life of both routes depends on the same thing: regular check-ups and a design that can be kept clean.

Side by side, point by point

The comparison below sums up where the two approaches differ; none of these points decides the matter on its own.

Where the anchorage comes from

Conventional: biological fusion with the upper alveolar bone, which develops over months. Ihde: mechanical locking into the deep cortical and basal layers, present from the first day.

Implant design

Conventional: two pieces, with a connecting screw and a micron-scale gap between them. Ihde: one piece, no connection. The gain is in the connection; the price is that the angle cannot be corrected.

Bone requirements and time

Conventional: if there is not enough volume, a graft and months of waiting; the total can reach a year. Ihde: anchorage from the layer that does not resorb, so a graft does not come into it in most cases; the clinical process fits into a few days.

When you get fixed teeth

Conventional: the fixed bridge comes once fusion is complete, months later, with a removable temporary denture in the meantime. Ihde: the final fixed bridge is fitted on day three, and no other bridge is made later to replace it.

Body of evidence and availability

Conventional: a very large literature, and dentists offering it in every city. Ihde: studied for a long time, but the evidence base is smaller and the number of clinics offering it is limited. This is the conventional implant's clearest advantage.

The risks of each route

A one-sided comparison is no use. Below are the weak points of both.

Conventional route: bone keeps resorbing while you wait

When the graft and fusion periods are added together, the patient spends a year living with a removable denture, and that denture does not stop bone resorption. That is the hidden cost of a long timeline.

Conventional route: the risks of the graft itself

Bone grafting means an extra operation, extra healing and an extra chance of failure. It is done when it is necessary; when it is done unnecessarily, the price the patient pays is high.

Ihde route: a planning error cannot be corrected

This is the price of the one-piece design. A bridge built on an implant placed at the wrong angle sacrifices either the aesthetics or the load distribution.

Ihde route: a smaller evidence base and fewer clinics

There are fewer long-term comparative studies than in conventional implantology, and the number of dentists who use it is limited. If you move, finding a dentist who knows the system can be harder.

Healing and the long term

The first days after surgery are similar; the two routes part ways after that.

The first week: similar for both
Swelling peaks on the second and third days, then goes down. Soft food, cold compresses and the medicines you are given. During this period there is no noticeable difference that the patient would feel between the two routes.
The first months: this is where the real difference lies
On the conventional route the patient waits with a removable temporary denture. On the other, they live with the final fixed bridge fitted on day three, and the bite is adjusted at check-ups if needed. In terms of daily life, the gap between the two is large.
The permanent bridge: conventional route only
On the conventional route, it is made as a separate stage once fusion is complete, replacing the temporary denture, and needs to be discussed from the start. On the other route there is no such stage: the bridge fitted on day three is the final bridge.
The long term: the same rules for both
At least one check-up a year, interdental cleaning and a review of the bite. Peri-implantitis progresses silently with both approaches and leads to bone loss.

Message us right away if

You are not sure which route suits you. Send us the panoramic X-ray or CBCT scan you already have. If you have enough bone volume, we tell you so; in cases where a conventional implant is the better fit, we say that plainly in writing too.
You have been advised to have a graft. It is a decision worth getting a second opinion on, because it is the item that adds most to both the time and the cost. A CBCT scan shows whether the anchorage can be taken from the deep layer.
Treatment has started on one route and a problem has come up. An assessment can be made with your records: which system, which areas, on what date. With unfinished treatment, the priority is finding the cause.
You have a fever, spreading swelling or difficulty swallowing. This is not the time to debate methods. See a dentist the same day; if you are struggling to swallow, go straight to A&E.

How the costs of each route are made up

We do not give figures, but the costs of the two routes are made up of different items, and a comparison only means something when it is done item by item.

Bone grafting: On the conventional route, a graft comes in if there is not enough volume: materials, extra appointments and months of waiting. On the other route, because the anchorage comes from the layer that does not resorb, this item does not arise at all in most cases. This is the biggest difference between the two routes.
Number of appointments and travel: A plan spread over months means travelling back and forth four or five times. For patients coming from another city or from abroad, this item can be bigger than the difference between the quotes.
Number of implants: In plans that rely on load sharing, the number is usually kept higher. This makes the implant item larger while strengthening the supporting framework.
Bridgework: On the conventional route, the temporary denture and the permanent bridge are separate items; on the other, the final fixed bridge fitted on day three is a single item. On both routes it is the largest part of the total in most plans, and the first line to look at when comparing quotes.

Frequently asked questions

Which is better?

There is no answer that holds for everyone, and wherever there is one, someone is selling you something. If you have enough bone volume, a conventional implant is a well-known and widely used route. If the bone has resorbed and a graft has been recommended, taking the anchorage from the deep layer changes the time and cost significantly. The decision is made after a CBCT scan.

Is a conventional implant safer?

The body of data behind it is larger; that is true, and it is an important advantage. But to call one 'safer' you would need to compare the two in the same mouth. In practice, what decides it is which route suits your bone and how experienced the dentist is with that route.

My bone has resorbed. Is a conventional implant out of the question?

No, it is possible, but bone has to be added first: a graft, months of healing, then the implant, then another wait. The whole process can take as long as a year. If the anchorage can be taken from the deep layer, these steps are not needed in most cases.

Is a one-piece implant more durable than a conventional one?

Because there is no connecting screw and no gap at that connection, the problems that arise at that point are eliminated. On the other hand, the angle cannot be corrected later. So the comparison should not be about durability but about which risk you are trading for which.

Can you use both in the same mouth?

In some cases, yes; the condition of the bone can vary from one area to another. In a plan like this, keeping a record of the systems used is especially important, because any future procedure depends on knowing which system is in which area.

I had a conventional implant and a problem came up. Can I switch to the other route?

In most cases it is possible. First, the condition of the existing implants and the remaining bone is assessed, and the area affected by the loss is given time to heal. If the bone loss is advanced, taking the anchorage from the deep layer is an advantage here.

How big is the price difference?

It would be wrong to give a single percentage, because the items are different. On the conventional route, if a graft is needed the total rises noticeably; if not, the two routes come close to each other. Compare them on the basis of the finished treatment, item by item.

Sources

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