Both specialists are qualified to place implants. But their training focuses on very different things — and that difference can determine whether your implant lasts five years or a lifetime. Board-certified periodontist Dr. Chanook David Ahn gives you the honest comparison.
When patients in Costa Mesa search for someone to place their dental implants, two types of specialists come up: periodontists and oral surgeons. Both are fully qualified to place implants. Both completed dental school followed by years of advanced residency training. But the focus of that training is fundamentally different, and understanding that difference is the key to choosing the right provider for your case.
Oral and maxillofacial surgeons complete a 4- to 6-year residency after dental school. Their training is centered on surgical procedures involving the hard and soft tissues of the face, mouth, and jaws. This includes tooth extractions (including complex impacted wisdom teeth), corrective jaw surgery (orthognathic surgery), treatment of facial trauma (fractured jaws, broken facial bones), removal of tumors and pathologic lesions, and reconstructive surgery of the jaws. Many oral surgery programs also include medical school training and a general surgery rotation. The depth and breadth of this training is substantial. Oral surgeons are, in the most direct sense, trained to take teeth out and to operate on the jaws and facial skeleton.
Periodontists complete a 3-year residency focused specifically on the supporting structures of the teeth: the gingival tissue, the periodontal ligament, the cementum, and the alveolar bone. Their training revolves around diagnosing and treating gum disease, managing soft tissue around teeth and implants, performing bone regeneration procedures, and placing dental implants in the context of comprehensive tissue management. Periodontists are trained to keep teeth in — and when teeth are lost, to create the biological environment that allows implants to succeed long-term.
The surgical act of placing an implant — drilling the osteotomy, inserting the titanium fixture into bone — is a procedure both specialists perform routinely. Modern implants achieve excellent survival rates regardless of which specialist places them: a meta-analysis in the Journal of Clinical Periodontology reported a 95.2% survival rate at ten years, and a national study of 158,824 implants found an overall survival rate of 97.79%. The difference between the two specialties is in what happens around the implant. The health of the gum tissue, the quality and quantity of bone, the thickness of the tissue biotype, the management of the peri-implant environment over time — these are the factors that determine whether an implant thrives for decades or develops complications within a few years. And these are precisely the areas in which periodontal training provides the deepest expertise.
Most patients assume that implant failure means the implant falls out. In reality, the most common cause of implant complications is not a mechanical failure of the titanium fixture — it is peri-implantitis, an inflammatory condition affecting the gum tissue and bone surrounding the implant. Peri-implantitis is essentially gum disease around an implant, and it is the leading biological cause of implant loss.
Published research estimates that peri-implantitis affects between 20 and 40 percent of implant patients over time, and approximately 38% of implant failures are attributed directly to peri-implantitis — a statistic that underscores the value of a periodontist's soft tissue expertise in preventing and managing this condition. Peri-implantitis begins with inflammation of the soft tissue around the implant (peri-implant mucositis) and, if untreated, progresses to destruction of the bone supporting the implant. Once significant bone loss occurs around an implant, the prognosis drops dramatically. Periodontists are specifically trained to diagnose peri-implant disease early, treat it effectively, and — most importantly — prevent it from developing in the first place through proper soft tissue management at the time of implant placement.
Beyond disease prevention, soft tissue management is critical for aesthetic outcomes, particularly for implants in the front of the mouth. The appearance of an implant crown is determined as much by the gum tissue framing it as by the crown itself. Proper gum contouring, tissue thickness, and papilla preservation create the natural appearance patients expect. Periodontists bring specialized training in tissue grafting around implants, managing thin tissue biotypes that are prone to recession, and creating the soft tissue architecture that makes an implant look like a natural tooth. When the tissue around an implant recedes — exposing the gray titanium or the implant abutment — the aesthetic result is compromised regardless of how well the implant itself was placed.
The implant itself is only half the equation. A perfectly placed titanium fixture can still fail if the surrounding tissue is not properly managed. Periodontists are the specialists trained to manage the biological environment that determines whether your implant looks natural and lasts a lifetime.
A periodontist is the ideal choice for implant placement when the case involves any of the soft tissue or bone management challenges that define periodontal training. This includes a wide range of clinical scenarios that are common among implant patients in Costa Mesa and Orange County.
Oral surgeons bring unique training that makes them the better choice in specific clinical situations. Being honest about this is important — choosing the right specialist means acknowledging the strengths of both.
It is worth noting that the vast majority of implant cases in Costa Mesa do not involve these scenarios. Most patients seeking dental implants need a provider who can manage bone quality, soft tissue health, and the long-term peri-implant environment — precisely the areas where periodontal training excels.
At most dental offices, the implant process is fragmented. A surgeon places the implant, then the patient is sent to a different office — sometimes across town — to have the final crown designed and fabricated by a separate provider. The surgeon and the restorative dentist may never communicate directly, and the implant may be placed without full consideration of what the final tooth needs to look like, how it needs to function, or where it needs to sit for the best aesthetic and functional result.
At The Loft Dental Studio, that fragmentation does not exist. Dr. Chanook David Ahn, a board-certified periodontist, places the implant and manages all soft tissue and bone grafting. Dr. Lu, a prosthodontist (a specialist in designing and fabricating dental restorations), designs and fabricates the final implant crown, bridge, or full-arch restoration. Both specialists work in the same office, collaborate on every case, and plan treatment together from the beginning.
This collaboration means that when Dr. Ahn places your implant, it is positioned with the final tooth already in mind. The angle, depth, and three-dimensional position of the implant are optimized not just for bone support but for the best possible functional and aesthetic outcome with the final restoration. This is called prosthetically driven implant placement, and it is the standard of care endorsed by the leading implant organizations worldwide. When the surgeon and the restorative specialist are in the same office, working on the same treatment plan, the result is a level of precision and coordination that separate offices simply cannot replicate.
One office. Two specialists. Complete implant care. From the initial consultation through implant placement, bone grafting, tissue management, and final restoration — everything happens at The Loft Dental Studio. No referrals. No miscommunication. No compromises.
Rather than debating which specialist is universally "better," the more productive question is which specialist is the right fit for your specific clinical situation. The complexity of your case — the number of implants, the condition of your bone and soft tissue, and the presence of complicating factors — should guide this decision. Dr. Ahn offers the following framework based on his experience placing over 5,000 implants during his career.
For a straightforward single-tooth implant in a patient with adequate bone volume, healthy gums, and no complicating medical history, both a periodontist and an oral surgeon will produce excellent results. The surgical procedure — preparing the osteotomy and placing the implant fixture — is well within the core training of both specialties. At this level of complexity, the more important factor is the individual clinician's experience and case volume rather than their specialty designation. A periodontist who places implants daily will produce outcomes comparable to an oral surgeon who places implants daily.
When the case involves multiple implants, varying bone quality across sites, thin tissue biotypes prone to recession, or a history of periodontal disease, a periodontist's training becomes a distinct advantage. These cases often require simultaneous connective tissue grafting to thicken the tissue around implants, management of the peri-implant soft tissue envelope to prevent future recession, and coordination of bone grafting at some sites while placing implants at others. Periodontists perform these procedures as core competencies of their residency training. The ability to manage bone and soft tissue simultaneously — placing an implant, grafting bone where needed, and grafting tissue to ensure long-term stability — is a workflow that periodontists are specifically trained to execute.
Full-arch implant cases — whether All-on-4, All-on-6, or hybrid approaches — require both surgical expertise for implant placement and prosthetic expertise for designing the final restoration. When a periodontist and a prosthodontist collaborate from the treatment planning phase, the implants are positioned to optimize the final prosthetic outcome rather than being placed in isolation. At The Loft Dental Studio, Dr. Ahn (periodontist) and Dr. Lu (prosthodontist) plan every full-arch case together using 3D CBCT imaging and digital treatment planning. This prosthetically driven approach ensures that implant position, angulation, and depth are determined by the needs of the final teeth — not just by where the bone happens to be. The result is a restoration that looks natural, functions properly, and is maintainable long-term.
Cases that involve extracting impacted wisdom teeth, managing jaw trauma, or performing major reconstructive procedures such as fibula free flap grafts or iliac crest bone harvests fall squarely within oral and maxillofacial surgery training. If your treatment plan includes removing impacted or deeply buried teeth, correcting jaw deformities, or requires surgery under general anesthesia in a hospital setting, an oral surgeon is the appropriate specialist. Dr. Ahn refers patients to trusted oral surgery colleagues when a case requires capabilities beyond the scope of periodontal training, because the right specialist for the right case always produces the best outcome for the patient.
The bottom line on case complexity: Simple cases can go to either specialist. Complex soft tissue and multi-implant cases favor a periodontist. Full-arch cases benefit most from a periodontist-prosthodontist team. Major jaw reconstruction and hospital-based surgery are best handled by an oral surgeon. The right question is not "which specialist is better" — it is "which specialist's training best matches my specific clinical needs."
Dr. Ahn will evaluate your bone, tissue, and overall oral health, then give you an honest recommendation about the best approach for your specific case — including whether a periodontist or oral surgeon is the right fit.
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Both periodontists and oral surgeons are fully qualified to place dental implants. The difference lies in training focus. Oral surgeons spend 4 to 6 years learning extractions, jaw surgery, trauma, and pathology — they are trained to take teeth out. Periodontists spend 3 years focused specifically on the gum tissue and bone that support teeth — they are trained to manage the biology around implants. Since long-term implant success depends heavily on the health of the surrounding soft tissue and bone, a periodontist's training is directly aligned with what keeps implants healthy for decades. Neither specialist is universally "better" — the right choice depends on the specific clinical situation.
Yes. Implant placement is a core part of periodontal residency training, and many periodontists place implants daily in private practice. Periodontal residency programs include extensive surgical training in implant placement, bone grafting, sinus lifts, and soft tissue management around implants. The American Academy of Periodontology recognizes implant placement as a central competency of the specialty. Dr. Ahn places implants regularly and has done so throughout his career since completing his periodontics residency at the VA Greater Los Angeles Healthcare System. He also served as Chief Resident during his general practice residency at Yale-New Haven Hospital.
Legally, yes — any licensed dentist can place dental implants. However, general dentists do not receive formal implant surgical training during dental school. Most learn through weekend continuing education courses rather than multi-year residency programs. For straightforward single-tooth implants in healthy bone, an experienced general dentist may produce acceptable results. For cases involving bone loss, gum disease, sinus proximity, aesthetic zone placement, or any complicating factors, a specialist — periodontist or oral surgeon — provides a higher level of training and expertise that directly impacts outcomes. If you are unsure, an honest consultation with a specialist can help you understand the complexity of your case. See our implant cost guide for more on what to consider.
Both periodontists and oral surgeons perform bone grafting. Periodontists receive extensive training in guided bone regeneration, socket preservation, ridge augmentation, and sinus lifts during their residency. These procedures are core to periodontal training because managing bone levels is fundamental to treating gum disease and placing implants successfully. Dr. Ahn performs bone grafting procedures routinely at Loft Dental, including complex ridge augmentation and sinus lifts, often in conjunction with implant placement in a single surgical appointment to reduce overall treatment time.
Consider the specific clinical situation. If you have a history of gum disease, thin or receding gums, need soft tissue management around the implant, or are placing implants in the aesthetic zone (front teeth), a periodontist's training is directly relevant. If you need hospital-based surgery under general anesthesia, jaw reconstruction, or have a case involving trauma or pathology, an oral surgeon may be the better choice. At Loft Dental, we offer a consultation where Dr. Ahn evaluates your specific situation and gives you an honest recommendation — including referring to an oral surgeon if that would better serve your case. The goal is always the best outcome for you, not the most convenient referral for us.