Once the pilot hole has been made then the implantologist will use drill pieces of increasing sizes to slowly made the hole bigger. This allows the implantologist to slowly increase the length and width until they are happy with the size.
During the increasing sizes a thread will be made in the bone so that the implant will be able to be screwed in easily. Some implants can be self-tapping which means that they create there own space to fit.
Once the implantologist is happy they will often place a direction indicator in the pre-made hole this is just to assess what direction that the implant will be. They may also take x-rays with drill pieces in the hole as they are going along this is to make sure that eveything is going as best it can and so that they can measure accurately.
Once they are happy with the size they will then screw in the implant. The implantologist here prefers to use a little wrench a do it by hand as he feels he gets the best results that way. However, some implantologists will use a machine that measures everthing for them.