Once the gum tissue has been reflected away from the bone, the surgeon can drill on the bone all day without any discomfort, only vibration because there are no nerve endings in the bone. To place an implant, there must be adequate bone to hold the titanium cylinder. Now 3D x-rays are available to accurately measure the amount of bone and to avoid major structures such as nerves and sinuses. An incision is made in the gums, then the gums are pulled back to give the surgeon full visibility of bone. A hole is drilled into the bone and then the titanium implant is screwed right into the bone. The gums are sutured back into place and the implant is left under the gums undisturbed for a number of months. This allows the bone to grow directly around the implant, a process called osseointegration. Finally, once the implant site has fully healed, the implant can be uncovered and restored to a new tooth.