Different Dental Implant Systems
1. Overview of Dental Implants
Perhaps the most sought-after tooth replacement technology that exists in the dental world today, dental implants are a strong, durable, attractive and comfortable option for replacing anywhere from one to all of a patient’s teeth. Their carefully engineered multi-part structure and surgically installed support pieces give them unparalleled bite strength and chewing capacity, and the strong connection between abutment pieces and implant crowns or other appliances means that, unlike conventional dentures, dental implants will never move or shift around in one’s mouth. A multi-stage process that involves surgery to place the main structural piece, the creation of dental implants takes time and patience, but they also enjoy a 95% success rate and can last a lifetime.
2. Types of Dental Implants
Dental implants can be used to replace single teeth, multiple teeth, or even all of one’s teeth. For this reason, there are various types of dental implants that serve to accommodate these needs. Dental implants can also be made to be either fixed (permanent) or removable, depending on the needs and preferences of the patient.
Generally, implant crowns are used to replace single teeth, implant-supported or retained bridges are used to replace several missing teeth, and implant-supported or retained dentures – both upper and lower – can be used to replace all or most teeth on either the upper or lower arch (or both). While single tooth replacement relies on the full three-part system as described below, implant-retained bridges and dentures can be created using as few as four implants to support and entire arch.
3. Process of Creating a Dental Implant
Dental implants rely on three main parts to lend strength and durability to the crowns, bridges, and dentures that they support. These three parts include the dental implant, the abutment, and the implant crown or other appliance (as discussed above, dental implants can also support and retain both bridges and dentures, either full or partial).
The implant fixture is the small post that lends the deep structural support of the implant; in the first stage of dental implant creation, it is sunk into the jawbone below the gumline and then left to heal and integrate with the bone. This healing process usually lasts two to six months.
Once the dental implant has successfully melded with the jawbone the abutment can be placed. This usually requires the gumline to be opened up again to gain access to the top of the implant fixture onto which it is attached, as the implant fixture remains fully below the gumline. Again, a period of time is required for the soft tissues of the gum to heal following the attachment of the abutment to the dental implant, but this is usually accomplished in weeks rather than months.
Finally, the dental implant or appliance can be placed on the abutment, completing the process.
4. Choosing a Dental Implant Systems
Along with the popularity of dental implants among patients, dentists, and surgeons alike, there has been a tremendous increase in the number of companies that manufacture their own dental implant systems. Wading through the differences in the products they offer can be difficult, particularly because of the high number of variables involved. From materials to sizes to stock components versus custom-made parts, there is a lot to consider in a dental implant system. Below you’ll find a breakdown of the most important aspects of a dental implant system to consider while choosing between dental implant systems:
Materials
The two most commonly used materials in the creation of dental implants are titanium and zirconium. Titanium is the material that has been preferred traditionally, primarily due to its extreme strength as well as its high degree of biocompatibility (i.e. ability to integrate functionally with the tissues of the body). These aspects of titanium continue to make it a preferred choice for many dentists today, though it is used in alloy form – mixed with a small percentage of other metals – to increase its strength.
Increasingly, though, zirconium has also become a popular material in the creation of dental implants. It began to be used as an alternative for those who had allergies or sensitivities to any of the metals present in titanium alloy, but its high degree of biocompatibility and tremendous strength has made it an excellent choice even for those without concerns related to allergies or sensitivities.
While titanium implants are typically created in multiple parts that are then attached together, zirconium implants are made in one piece, allowing for less flexibility and removing the option of removability. While this is not necessarily a disadvantage of this material, it is something to be taken in consideration when thinking through these options.
Size
Just as dental implants can be composed of different materials, they can also come in different sizes. Oral anatomy as well as availability and health of bone tissue both contribute to decisions made in this area. While a baseline of healthy bone mass is needed to create dental implants and, for this reason, not all patients are good candidates for this tooth-replacement technology, smaller or even mini dental implants can be a helpful alternative if bone mass is not adequate to support traditional dental implants.
While bone grafting can help regenerate bone mass in the jawbone prior to the creation of dental implants, simply opting for a smaller system can also remedy this problem. If available bone mass is found to be a problem, talk to your dentist about whether or not mini dental implants might be a good alternative for you.
Removability
Removability is an important factor to take into consideration when choosing a dental implant system. Certain systems and materials are designed to work one way (i.e. one piece zirconium implants are permanent implants only; they cannot be made to be removable). Whether you’re having a single crown or a bridge placed, it’s important to think about whether you’d like to have the option of removing it in the future, either for cleaning or repairs. While many patients prefer the set-it-and-forget-it simplicity of a cemented or permanent crown, it can be beneficial to simply snap it out of place if a repair or replacement is ever needed.
Stock versus custom pieces
Opting for stock versus custom pieces is also a key consideration in choosing a dental implant system, and one that has a real impact on the financial bottom line. Typically, when making the decision between stock or custom abutments, for example, it’s helpful to think about where it will be located in the mouth. Is that particular area of the mouth highly visible? If so, it might be preferable to go with a custom piece, as stock abutments are not designed to blend in seamlessly with one’s unique smile. If the implant is far back in the mouth, however, and aesthetics aren’t as important, it’s perfectly fine to save some money by using a stock piece; this is an aesthetic choice more than a functional one.
Reputation of the company
Finally, it is very important to go with a reputable company rather than to try to cut costs in the purchasing of a dental implant system. Your dentist will likely have companies that they like to work with and the quality of whose products for which they are willing to vouch; it’s important to take all of this input into consideration when choosing a dental implant system.
5. Surgically Guided Implants
Surgically guided implants can be used to plan extensive surgeries in advance with the use of a detailed impression. This requires detailed imagining as well as meticulous impressions to ensure precise understandings of existing anatomy, but this can be helpful in shortening surgical interventions as well as increasingly accurate targeting of quality surgical sites.
6. Preparing for dental implants
Because there is a lot involved in the creation of dental implants, careful planning and decision-making in tandem with your dentist and/or oral surgeon is very important. Following an initial oral examination, it is important to have a candid conversation with your dentist about your expectations and desires regarding the outcomes of this restoration, as well as a frank outlining of your budget and its possible limitations. Your dentist will ask you questions about your preferences surrounding some of the factors listed above, such as removability, size, and stock versus custom pieces and systems.
To gauge bone health and get a baseline of current oral anatomy, she or he will also likely do some imaging, including both X-rays and either dental impressions, CT or CBCT scans, or more advanced digital imaging. The type of imaging done will be determined by need, your own dentist’s training and preferences, and the kinds of costs that you and your insurance are able to support.
Throughout the process, remember that while your dentist or oral surgeon is the expert in creating and placing these systems, only you know what your preferences and limitations are. Don’t be afraid to ask questions at any or every step of the way. Open and honest communication will only improve the outcomes of this detailed process; be sure to participate as fully as you can in it and you’re sure to be even happier with the results.