Transosteal Implant vs. Eposteal vs. Endosteal (3 Types of Dental Implants)

When a tooth and its root are severely damaged due to decay or trauma, such that the tooth has to be extracted, your dentist may recommend that you get dental implants to form the foundation of your replacement tooth through a crown or implant-supported dentures.

Depending on your specific tooth replacement needs, your oral surgeon may recommend one of the three types of dental implants: Endosteal implants, eposteal or sub-periosteal implants, and transosteal.

Here’s a brief description of each type:

endosteal implant design

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Preferred tooth replacement treatment

When you lose your natural teeth, the underlying jaw bone in the gap left behind tends to weaken progressively. This may in turn cause adjacent teeth to shift, reducing your ability to chew and changing the shape of your face so you appear older.

Dental implants are usually the first choice for restoring missing or damaged teeth. The implants are usually made of titanium, because it is readily accepted by the body, plus it’s durable. 

Over the last 30 years, implants have shown high success, ranging from 90 to 95 percent. The short-term and long-term success of the procedure largely depends on fast healing with safe integration into the jaw bone.

However, the success of dental implants can be affected by mechanical and/or biological complications known as peri-implantitis. But first, let’s look at the different types of implant placement procedures you may encounter.

3 Types of Dental Implants

Dental implant placement is usually performed in the dentist’s office, though the nature of each oral surgical procedure is unique depending on the clinical situation and preferences of the patient and oral surgeon.

There are generally three types of implants:

An endosteal implant

It is the most common, and derives its name from the thin film of connective tissue lining the bone’s marrow cavity. These implants are placed directly into the jawbone through a surgical procedure.

The implant is typically made of titanium and shaped like a small screw. Once the implant is placed, it fuses with the surrounding bone through a process called osseointegration.

After the healing period, an artificial tooth (dental crown) is attached to the implant, restoring the appearance and function of the missing tooth.

Sub-periostal or eposteal implant 

It derives its name from the thin layer covering the surface of the bone (periosteum). Instead of being placed within the bone, these implants sit on top of the jawbone but under the periosteum.

They are not very common, but may be used on patients with insufficient healthy jawbone for an endosteal implant placement, yet they don’t want to undergo bone augmentation procedure.

The implant framework is custom-made to match the contours of the jawbone and is placed under the gums. Once the gums heal, artificial teeth are attached to the framework, providing support and stability.

Transosteal implant (blade or staple implants)

It involves the placement of a U-shaped metal plate to the underside of the jawbone, with pins or screws drilled through the bone to secure the plate. The metal plate extends upwards through the gumline to support the replacement tooth.

This type of implant is quite unpopular, but may be used for patients with severe bone resorption or to replace missing teeth in the lower arch.

Transosteal implants are more invasive than other implant types and may be considered when there is limited bone height or volume, like in the lower arch.

What is the right dental implant for me?

The ability to place an endosteal implant largely depends on the health of the patient, as well as the amount of healthy bone in the jaw. If both are in great condition, then an endosteal is preferred. Otherwise, an eposteal implant may be recommended. The final option (transtosteal implant) is rarely used in today’s dentistry because it requires entry of the metal frame to jawbone via the skin along the bottom of the patient’s face, which is to invasive for your comfort.

Stages of Endosteal Implant Placement

An endosteal implant can be placed in one-stage, two-stages, or three-stages, depending on a number of aesthetic and health-related concerns.


This method utilizes a non-submerged single-piece implant with a metal collar designed to protrude through the gum as the bone heals to the implant. After sufficient healing time (3-6 months), an abutment is connected to the implant, after which the crown can be fabricated to replace the missing tooth.


The process is the same as that of a single-stage procedure. But before the abutment is fitted, the dentist will conduct a second surgery, cutting through the gum over the healing cap to examine the stability and proper integration of the implant with the bone.


When the implants are completely healed, the patient may opt for a final restorative procedure, like connecting prosthetic teeth.

Final thoughts

It’s important to note that the choice of implant type depends on various factors, including the patient’s oral health, bone condition, and individual needs. A thorough examination and consultation with a dental professional are necessary to determine the most suitable implant option for each specific case.

Contact your dentist or surgeon right away if you notice anything odd about your recuperation, such as excessive swelling, pain, or bleeding, as it could be a sign of implant infection or peri-implantits.


  • Editorial team

    A team comprising oral health care professionals, researchers, and professional Writers, striving to impart you with the knowledge to improve your oral health, and that of your loved ones. 

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