Tooth loss impacts the lives of millions of American adults. As the aging population continues to grow, more and more older adults are struggling with tooth loss and the demand for tooth replacement options is growing exponentially. Dental implant treatment is the most popular of the many tooth replacement options available. Advances in dental technology have resulted in new techniques and materials that have increased the reliability of implant treatment. For example, visual modeling technology have dramatically improved the way implants are custom-designed and manufactured. These technological advances have led to a rising number of dental implant systems. Selecting the best dental implant system that meets all of your needs can be difficult. Your dentist will help you work through some of the bigger decisions you need to make in choosing the right implant system. Below are more details on dental implant systems to help guide you through selecting the right system for you.
Popular Dental Implant Systems
Today, there is a growing number of dental implant systems available. This is because implant companies are consistently making small changes to the texture, shape, width, and length of their products to constantly improve the success rate of their implants. There are currently over 100 companies producing the various implant components, but 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
A part of choosing the right dental implant system, is determining which implant components are right for you. Fortunately, this is a decision your dentist will help you make when they are developing your implant treatment plan. Your dentist will likely walk you through the implant component options. You will need help deciding:
* the type of crown attachment you want
* between stock or custom abutments
* if you prefer a titanium or zirconia implant post
Each of these decisions is discussed in further detail below.
Crown attachment: Cement-retained vs. screw-retained crowns
When you select your dental implant system, you will need to determine which type of crown attachment you want. An artificial crown can be attached to the implant abutment with either cement or by screwing the crown to the abutment. When deciding if you want a cement-retained or screw-retained crown, you will want to consider:
Retrievability: At one point or another, it may be necessary to temporarily remove a crown. The ability to remove a crown, also known as retrievability, may be important if the implant system includes a number of implants. A screw-retained crown can be easily removed. Cement-retained crowns can be more difficult to retrieve. However, there are implant systems available that use a cement material that allows crowns to be easily removed. If your implant system includes several abutments, having crowns that are cemented in place will be difficult to remove if you need them to be retrieved. Further, crowns that screw in to place are easier to remove for maintenance and cleaning.
Maintaining peri-implant tissues: The health of the gum tissue surrounding the implant is very important to the success of the implant. The cement used to attach crowns can damage the gum tissue that surrounds the implant if it is not removed after the crown has been placed. Fortunately, excess cement can be removed using a variety of techniques, but this can require extra effort and may not always work. On the other hand, a screw-retained crown involves no cement and therefore is not dangerous to the surrounding peri-implant tissue.
Treatment ease: Your dentist will discuss with you their overall treatment plan and the anticipated difficulty of the implant procedure they have planned. Fitting screw-retained crowns can be more difficult than placing cement-retained crowns, especially if there are multiple dental implants being installed. Placing a screw-retained crown requires several more steps than cement-retained crowns to ensure the proper fit and support of the implant.
Abutment type: Stock abutments vs. custom abutments
The second big decision to make when selecting an implant system is determining whether you want stock or custom implant abutments. Stock abutments are mass manufactured in different standard sizes and they offer an effective, versatile, and affordable option for abutments. Custom abutments will be manufactured based on your specific needs and treatment plan offering unparalleled fit that is just right for you. Custom abutments can be made from a variety of materials, but they are most commonly made of titanium, zirconia, or a combination of the two. When deciding on which abutment choice is right for you, you will want to consider several different factors, including:
Versatility: Stock abutments are designed to be versatile. They are produced in various standard sizes to be used for both bone and tissue level implants. They are also user-friendly because they are easy to measure for crown fitting.
Cost: In general, stock abutments are more affordable because they are premade, and commonly used with cement-retained crowns. While the initial price may be lower for stock abutments, they may require more time to ensure proper fit, costing more in total treatment costs. Custom abutments are generally more expensive than stock abutments initially, due to the personalized design and production. However, they offer a more predictable fit and appearance, which can result in lower final treatment costs.
Fit: Due to standardized sizing, sometimes the tissue around the stock abutments does not conform well to the abutment. On the other hand, the biggest benefit of custom abutments is that they can be made into the exact shape needed to provide the best fit for your implant.
Appearance: If an abutment does not offer the best fit it can impact the general appearance of the implant. One of the benefits of custom abutments is the enhanced appearance they offer, with minimal risk of the grey metal abutment showing along the gumline.
Ease of placement: The standard sizing of stock abutments can make the precision of the placement of the crown a challenge, while custom abutments are generally easy to place due to their custom-made design.
Implant post material: Titanium vs. Zirconia implants
Deciding on the implant post material is another big decision your dentist will walk you through as you are deciding on your implant system. Many dentists will suggest titanium alloy implants because the success of titanium integrating with the bone is well-supported by research. Osseointegration, or the process of the implant integrating with the jawbone is critical to the overall success of the implant treatment. Titanium alloy implants have a success rate of 95% or higher. However, it is possible for patients to be allergic or sensitive to the metals used in titanium implants and for these individuals, metal-free implants made from zirconium are available. Zirconia, or ceramic implants, are strong, offer an enhanced appearance, and have shown to successfully fuse with the jawbone. While titanium implants are more commonly recommended by providers, it is worthwhile to consider both implant material options.
Differences between Titanium and Ceramic Implants:
* Long-term evidence: There is a wealth of evidence demonstrating the long-lasting and reliable results of titanium implants. Unfortunately, ceramic implants are newer, and therefore there is not as much evidence to support their long-term success. However, the number of providers who have experience with ceramic implants and are satisfied with the results continues to grow.
* Versatility: Titanium implants are versatile in design, made as either one or two-piece systems, making their surgical placement easier. Just recently, zirconia implants were made available as both one and two-piece system.
Why Does Brand Matter?
While there are countless generic implant components on the market at an affordable price, these implants may need repeated fittings and cost more in the long run. The most well-known implant brands offer research to support their effectiveness. Additionally, these companies offer training and tools to providers to gain experience. Lastly, implants from well-known brands can be easily repaired or replaced wherever you go, if necessary.
Deciding Which Implant System to Use
It can be a time-consuming process deciding on which implant system is right for you. If you are just getting one dental implant, it will be an easier decision to make. If your treatment plan is going to involve multiple implants, choosing the right system will be a bigger decision. The best place to start when deciding on a system is to do a bit of research. The websites of the implant brands your dentist recommends will provide information and evidence on the success of their systems. This research will also help you become familiar with the individual implant components and the overall treatment procedure. However, you should be aware that many dentists work with only one or two implant companies. Dental implant treatment is a big investment and 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 any questions as your work through the research, it is important that you ask your dentist. It is critical that both you and your dentist are confident in the dental implant system you end up with.