Different Dental Implant Systems
Introduction To Dental Implants
Dental implant treatments have become increasingly available and popular in the last several years. Though many people now enjoy better dental health, tooth loss is still a common problem. Because life expectancy has increased and people are remaining active well into (and beyond!) their sixties people expect to be able to eat their favorite foods indefinitely, and smile confidently.
With a population that is aging and on the rise, the demand for dental implants is increasing. The convergence of public awareness of dental treatment options, high treatment success rates, and phenomenal advances in dental implant technology has lead to some great dental implant systems and options.
Different Implant Systems
Dental implants come in various sizes and shapes, all of which have evolved in order to improve effectiveness of treatments and to adhere to current successful surgical techniques. The best dental implant companies continually research how to make subtle enhancing changes to the shape, width, surface texture, and length of implants in order to improve effectivity and success rates.
Dental Implant Systems are considered to be a set of medical components (that have been certified) used to anchor a denture or replace missing teeth by professional dentists and oral surgeons. These systems can be broken down into types of implants and the components that are used for a dental implant procedure.
Types of Implants
There are two main types of dental implants known as Endosteal and Subperiosteal.
- Endosteal: With Endosteal implants, the implants are positioned into the jawbone. Usually constructed of titanium and shaped much like small screws, they are the most common type of implant.
- Subperiosteal: With subperiosteal implants the implants are positioned under the gums but on, or above, the jawbone.
Components and Component Choices
There are many considerations that made when choosing the components that make up dental implant systems. After deciphering which kind of dental implant is best for a particular dental implant scenario, many choices must also be made about the details of the components used with the specific dental implant.
CEMENTABLE ABUTMENTS VS SCREW-RETAINED IMPLANTS:
There are different kinds of implant crowns, such as cement-retained implant crowns and screw-retained implant crowns. In considering which crown might be used in an implant procedure there are actually many factors to be considered including the following:
- Retrievability: In some cases an implant crown will need to be removed. There are certain kinds of dental cements available for implant restorations that are meant to make retrievability easier. Some dentist will use temporary cement, which is good for retrievability, but can mean overall stability is compromised. By comparison, screw-retained implant crowns are generally more predictable if a crown ends up needing to be retrieved: particularly if more abutments are required. In other words, a multi component restoration which is cemented in position will be much harder predictably retrieve.
- Ease of Use: Properly inserting screw-retained implant crowns can be more difficult than placement of the cement-retained crowns. This is often particularly relevant when fitting multiple component restorations. With cement-retained restorations, where often multiple abutments can be required, the procedure for fitting the restoration is quite similar to that of a routine bridge placement. By comparison, placing screw retained restorations usually requires various additional steps.
- Compatibility with Angled Implants: For esthetic reasons, it is not considered possible to make screw holes in certain contours of the implant crowns. It is a small detail, but if the implant angle is slightly off, then it becomes necessary to use an angled, abutment (screw-retained ) - which will increase the cost. In this scenario, it is much wiser to use a cement-retained crown by using either a stock angled abutment or a custom abutment.
STOCK ABUTMENTS
Stock abutments come in standardized sizes and can be used for both tissue level and bone level implants. The stock abutments have been designed to be very “user-friendly”, making it easy for impressions to be taken.
Stock abutments also tend to work well for cement retained restorations and are often a cost effective choice. There are both straight and angled abutments, and these stock abutments are most effectively used when there are tissue level implants not considered within the esthetic zone.
One common issue with stock abutments is the limitations offered by the standard sizing. Often dental tissues conform to the shape and size of the abutment, which is why these stock abutments are not always an ideal choice when being used in the esthetic zone. Another consideration is that when stock abutments are used the final margin in the placement of the crown cannot be controlled, because ultimately this is height of the abutment determined as well as the depth of the implant.
CUSTOM ABUTMENTS
Custom abutments are considered suitable for either tissue level or bone level implants and can be milled or waxed into exactly the right contour and shape in relation to the crest of relevant tissue.
Several different kinds of custom abutments are made from titanium or zirconia; or sometimes a custom abutment will be made of zirconia, but with base of titanium. Another important issue to consider if custom abutments are being considered, is that though they can be more costly they also usually offer superior tissue management and more predictable esthetics.. They can also work with both cemented and screw retained crowns.
Technically custom abutments are generally considered to be more efficient than stock abutments, which ultimately will save money in the long run, both for the dentist and the patient.
TITANIUM IMPLANTS
Because of its proven biocompatibility (meaning it integrates with bone extremely well), most dental implants are constructed of titanium. Bone does not hesitate to grow on titanium dental implant surfaces, and this biocompatibility allows the implants to become completely fixed - immovable. The success rates for titanium alloy implants is incredibly high. At first, often pure titanium was used to make dental implant components, but was soon discovered to be a bit too soft. Companies then went on to develop an alloy; an impressive alloy capable of offering supreme strength, while still maintaining great biocompatible properties. Interestingly there have also actually never been any recorded cases of allergic reaction to titanium, though rarely some people may have a slight allergic reaction or sensitivity to some of the other metals used in the alloy. Though still very rare, nickel sensitivity is the most common sensitive, and some people do have other concerns about and/or issues with having any metal in their mouth or body.
ZIRCONIUM IMPLANTS
Occasionally because of concerns about possible titanium alloy and metal allergy and sensitivity issues, some companies have been able to research and develop zirconium based implants that are considered “metal-free”. Considered a ceramic, zirconium does have trace amounts of the metals yttrium and hafnium both of which improve its function and properties. Like titanium, zirconium osseointegrates with bone well and is very strong.
PROS AND CONS OF IMPLANT MATERIALS
Titanium: With long-term success rates, titanium has proven to be very successful in dental implants procedures. Generally titanium implants are considered more versatile because of the way they can be constructed - into either one piece or two piece systems, which allows dentists a lot of flexibility in both implant treatments and implant placements. Titanium implants also have multiple use options, such as supporting fixed restorations as well as in overdentures. Overall titanium has proven to be a great material for use in dental implants. Titanium implants provide flexibility in approaches to treatment, depending on scenarios and treatment specifics - and therefor might provide better long-term results. However, if someone has genuine aversions and/or concerns about the use of metal implants, zirconium can definitely be a useful alternative.
Zirconium: Because zirconium implants are constructed as a single piece, implant restorations that use zirconium have to be cemented into position. Special care also needs to be given when positioning zirconium implants. And existing bone volume is especially important because there is really no room for error. However, there are advantages of using dental implants made of zirconium. For instance, zirconium is not thermally conductive and it is considered non-corrosive, as well. Additionally the ceramic color and appearance of the zirconium means that there is not a risk for metallic looking material along the gum line.
Overview
The best implant companies have invested heavily in research and development of implant procedures and systems. A lot of scientific research has been conducted regarding surface characteristics of dental implants. When a dental implant is first positioned in the jaw, it will invoke biological responses, which leads to an “information exchange” between the body’s cells and the biomaterials in use.
Acceptance by the body of the dental implant is the ideal. Through research it has been discovered that osteoblastic cells are able adhere faster to rough surfaces than to smooth surfaces; and this is a process that respected dental implant companies have invested in on in order to achieve better osseointegration possibilities.
Deciding which implant system makes the most sense for your dental needs can take some time; and it can also become a learning experience. For most routine dental implant procedures, which implant system get used might influence subtle aspects of the outcome, but likely will not extremely significant; but your choice of implants can be very important if you have a more complex situation. Gathering lots of information and consulting with your dentist is the best place to start.