Different Dental Implant Systems
Millions of American adults are impacted by tooth loss. The aging population continues to grow, meaning even more older adults are struggling with tooth loss. Consequently, the demand for tooth replacement options has grown exponentially over the past few years. Of the many tooth replacement options, dental implants are one of the most popular choices. With advances in dental implant technology newer techniques and materials have been designed to increase the reliability of implant treatment. Transformations in visual modeling technology have dramatically improved the way implants are custom-designed. Due to these advances there is a rising number of implant systems available. With so many options to choose from, selecting the best dental implant system for you can be difficult. Your dentist will work with you and will help you work through some of the bigger decisions you need to make in choosing the right implant system for you. Below is more information to guide you through selecting a dental implant system.
Popular Dental Implant Systems
There is an increasing number of dental implant systems available. To improve the success rate of their implants, implant production companies are consistently making small changes to the texture, shape, width, and length of their products. While there are over 100 companies producing the various implant components, there is only a small number of well-known and well-respected companies, including Straumann, Zimmer Biomet, Nobel BioCare, MIS, BioHorizon, and Dentsply.
Choosing the Best Implant Components
Determining which dental implant components are right for you is a decision your dentist should help you make. When they are planning your implant treatment, your dentist will likely discuss with you the implant component options that are available. The many decisions you will need to make include deciding:
- which type of crown attachment you prefer
- between a stock or custom abutment
- whether you prefer a titanium or zirconia implant post
Each of these decisions is discussed in more detail below.
Decision 1: Cement-retained vs. screw-retained crowns
One of the big decisions involved in selecting a dental implant system is deciding on the type of crown attachment you want. Artificial crowns can be attached to the abutment on the top of the dental implant with either cement or by screwing the crown to the abutment. When deciding which type of crown attachment is best for your implant system, there are a number of factors to consider, including:
- Retrievability: It may be necessary at some point, to temporarily remove a crown. If you need to retrieve a crown for whatever reason, a screw-retained crown can be easily removed. Retrievability may be particularly important if there are a number of abutments in the implant system. Cemented crowns are more difficult to retrieve. There are implant systems available that use cement materials that allow crowns to be easily removed. If your implant system involves several abutments and crowns, having crowns cemented in place will be challenging to remove if retrieval is necessary. Further, crowns that screw in can be easily removed for maintenance and cleaning.
- Maintaining peri-implant tissues: The success of an implant depends on the health of the gum tissue surrounding the implant. Cement-retained crowns can damage the gum tissue that surrounds the implant. After a crown is placed, excess cement that is not removed can damage gum tissue. Excess cement can be removed using a variety of techniques; however, these approaches are not always effective. On the other hand, a crown that is screwed into the abutment involves no cement and therefore is not potentially dangerous to the gum tissue.
- Treatment ease: Your dentist will also want to consider the number of implants being placed and the overall difficulty of the implant procedure. Fitting screw-retained crowns is more challenging than placing cement-retained crowns. The installation of multiple dental implants increases the difficulty of placing screw-retained crowns. This is because placing a screw-retained crown requires several additional steps to ensure the fit and the proper support of the implant.
Decision 2: Stock Abutments vs. Custom Abutments
The second major decision when selecting an implant system is determining whether to use a stock implant abutment or a custom implant abutment. There are many factors to consider when making the abutment choice. A few of these factors are detailed below.
- Stock abutments: Stock abutments are designed to be versatile. Produced in various standard sizes, stock abutments can be used for bone or tissue level implants. Additionally, they are relatively user-friendly because they are easier to measure for crown fitting. In general, stock abutments are more affordable because they are premade, and commonly used with cement-retained crowns. Despite all of these benefits, stock abutments are not ideal for all implant treatment plans. Due to their standard sizing, sometimes the tissue around the stock abutments does not conform well to the abutment, impacting the general appearance of the implant. The standard sizing can also make the precision of the placement of the crown a challenge, as the placement is determined by the depth of the implant and the height of the abutment. The price of the abutment may be lower if a stock abutment is used, however they may require more time for your dentist to ensure proper fit, costing more in total treatment costs.
- Custom abutments: The biggest benefit of custom abutments is that they can be made into the exact right shape you need to provide the best fit for your implant. While custom abutments can be made from a variety of materials, they are most commonly made of titanium, zirconia, or a combination of the two. Custom abutments are more expensive than stock abutments upfront, due to the personalized design and production. However, they offer a more predictable fit and appearance, which may result in lower costs in the end depending on the amount of work required to make a stock abutment fit properly. Custom abutments are made for both screw-retained or cement-retained crowns.
Decision 3: Titanium vs. Zirconia implants
The third major decision to make with your implant system is deciding on the implant post material. Most dentists will suggest you use a titanium alloy implant, because it is well-supported by research that titanium successfully integrates with the bone. The implant fusing with the bone is critical to the overall success of the treatment. Titanium alloy implants have a success rate of 95% or higher. It is rare, but possible to be allergic or sensitive to metals used in the titanium alloy. For individuals who may have an allergy or sensitivity to titanium alloy, metal-free implants made from zirconium are available. Implants made from zirconia, or ceramic, are strong and also have shown to fuse well with the jawbone. While titanium implants are more common, it is good to discuss both implant options with your provider. Pros of Titanium Dental Implants: Long-term evidence: Due to their popularity, there is a wealth of evidence demonstrating that titanium implants are long-lasting and provide reliable results for decades. Unfortunately, zirconia implants are newer, and therefore there is not as much evidence to support their long-term effectiveness. Versatility: Titanium implants are versatile in design, made as either one or two-piece systems. This versatility makes surgical placement easier. Zirconium implants are only made as a one piece system. Overall, titanium implants offer a more flexible approach to treatment and more ease with implant placement.
Why Does Brand Matter?
While there are many generic implant components available at a more affordable price, these generic implants may cost more in the long run with repeated fittings and issues. The well-known brands offer research to support the effectiveness of their implant components. Additionally, the well-established companies offer dentists training and tools to gain expertise in using their components. Lastly, selecting implant components from a well-established brand, means that wherever you go, you should be able to have your implant system repaired or replaced if necessary.
Deciding Which Implant System to Use
Deciding which implant system is right for you can be a time-consuming process. For a single implant treatment, it will matter less which implant system you select. However, if your treatment plan involves multiple implants, choosing the right system is a bigger decision. When it is time for you to start deciding, the best place to start is to do a bit of research. You can review the websites and the evidence provided for the implant brands your dentist has discussed with you. This step will also help you become more familiar with the implant components and the overall procedure. It is common for a dentist to just work with one or two implant companies that produce all of the implant components. Dental implant treatment is a big investment. It is important that you take your time in deciding which system is the right fit for you and your oral health needs. If you have questions as your dentist develops your treatment plan, it is important that you ask. It is essential that both you and your dentist are confident in the dental implant system you end up and the investment you make.