Different Dental Implant Systems
Tooth loss is common and impacts the lives of millions of Americans. With the increasing aging population, even more older adults are struggling with tooth loss, increasing the demand for tooth replacement options. The popularity of dental implant treatment has grown exponentially over the past few years. Approximately three million Americans have dental implants. With the growing demand for implants, dental implant technology has advanced and newer techniques and materials have been designed to increase the reliability of implant treatment. Visual modeling technology and 3D printing are transforming the way implants are custom designed and fitted. Due to these advances and the rising number of implant systems available, selecting the right dental implant system for you can be a challenge. Dentists must consider a number of factors when deciding which implant systems they will offer their patients.
Popular Dental Implant Systems
There are a number of dental implant systems available and this number continues to increase as companies seek to improve current treatment strategies. Dental implant companies are constantly making small changes to the surface texture, shape, width, and length of implants to improve implant success rates. There are at least 100 companies producing the different implant components, however there is a small number of dental implant companies that are well-known and well-respected worldwide. Some of the most well-known companies include Straumann, Zimmer Biomet, Nobel BioCare, MIS, BioHorizon, and Dentsply.
Choosing the Best Dental Implant System Components
Determining which dental implant system components are right for you is a decision your dentist is the most prepared to make. As your dentist is planning your implant treatment, they will likely discuss with you some of the system options that are available. The many decisions about implant systems you will need to make include which type of crown attachment is best, whether you want a stock or custom abutment, and whether you prefer a titanium or zirconia implant post. Each of these options is discussed in detail below.
Crown Attachment: Cementable abutments vs. screw-retained implants
One of the big choices to make when deciding on your dental implant system is deciding on the type of crown attachment you want. Artificial crowns can either be cemented or screwed to the abutment that is on top of the dental implant. There are a number of factors to consider when deciding on the crown attachment for your implant system:
- Retrievability: In some cases, it may be necessary to temporarily remove an implant crown. A screw-retained crown ensures the crown can be easily removed when and if you need to retrieve it. This could be particularly important if there are a number of abutments involved in the implant system. Cementable abutments are less reliable when it comes to retrievability. There are implant systems that use cements that are made specifically to allow crowns to be easily removed. If your implant system requires multiple abutments and crowns having crowns that are cemented in place will be far more difficult to remove if required.
- Maintaining peri-implant tissues: The success of the implant will partially depend on the health of the tissue surrounding the implant. A cement-retained crown can cause damage to the gum tissue around the implant. If excess cement is not removed the damage to the tissue can become more severe. There are a variety of techniques to remove the cement, however these approaches are not always full proof. In comparison, a crown that is screwed into the abutment doesn’t require any cement and therefore does not involve this risk. The crown can be easily removed for maintenance and cleaning of this tissue.
- Treatment ease: Another factor that your dentist will likely consider when deciding on your dental implant system is the number of implants being placed and how challenging the implant procedure will be. Fitting a screw-retained crown is more challenging than a cement-retained crown. This is especially true when multiple dental restorations are being installed. Placing a screw retained crown requires several extra steps to ensure the fit and that the crown does not place too much stress on the implant.
Stock Abutments vs. Custom Abutments
Another big choice to make when deciding on an implant system is whether to use a stock implant abutment or a custom implant abutment. It is important that your dentist thinks through all of the factors that impact the abutment choice.
- Stock abutments: Stock abutments are designed in various standard sizes and can be used for bone level or tissue level implants. Stock abutments are user-friendly and easy to measure with impressions for crown fitting. Stock abutments are commonly more affordable and more often used for cement retained crowns. However, stock abutments are not perfectly suited for all implant treatments. Because stock abutments are standard sizes, sometimes the tissue around the abutment will not conform well to the abutment. If the tissue does not conform, the implant may not have the appearance that is desired. The standard sizes of the stock abutment also make it a challenge to guarantee the exact placement of the crown, as this is determined by the depth of the implant and the height of the abutment. Using a stock abutment may be more affordable, but may require more time for your dentist to make alterations to ensure the correct fit.
- Custom abutments: Custom abutments can be made into precisely the right shape needed to provide the best fit with your gums. Custom abutments can be made from a variety of materials, including titanium or zirconia, or the combination of the two. Because they are custom-made for each individual patient, custom abutments are more expensive than stock abutments. However, with this added expense comes a more predictable fit with the tissues of the mouth and a more predictable appearance. Custom abutments can be made for either screw retained or cement retained crowns. Depending on the amount of work required to make a stock abutment fit properly, custom-made abutments may be the more cost-effective option.
Titanium vs. Zirconia implants
Deciding on the implant material is another choice that you and your dentist will need to make. Most dentists will choose titanium alloy, because the material is proven to successfully integrate with the bone. The fusing of the implant with the bone is critical to the success of the treatment. The success rates for titanium alloy implants is typically 95% or higher. In some rare cases people may be particularly allergic or sensitive to metals used in the titanium alloy. For individuals who may have a possible sensitivity to titanium alloy, metal-free implants made from zirconium are available. Zirconia, or ceramic implants, are strong and fuse well with the jawbone in a similar way to titanium.
Pros of Titanium Dental Implants:
Long-term evidence: Titanium implants have proven successful to last for decades of use. There is not as much evidence to prove this same long-term effectiveness of zirconia. Overall, titanium implants can be expected to provide reliable results supported by years of research and development.
Versatility: Titanium implants offer versatility because they are made as one or two-piece systems, allowing greater flexibility in surgical placement. Zirconium implants are only made as a single piece so implant restorations must be cemented in place. Thus, titanium implants offer a more flexible approach to treatment.
Why Does Brand Matter?
While there are numerous companies that produce generic implant components at a more affordable price, generic implants may cost more in the long run. The well-established companies offer research and proven effectiveness of their dental implant components. Additionally, dentists and technicians will likely have the specific training and tools necessary to use the components from well-established companies. Lastly, if a patient chooses a component from a well-established brand, they can be comfortable knowing that wherever they go, if their implant system needs to be repaired or a component replaced, they will be able to have this work done easily.
Deciding Which Implant System to Use?
Deciding which implant system best fits your oral health needs can be a confusing and time-consuming process. For most single simple implant treatments, it will likely matter less which implant system you decide on. However, if you have a treatment plant that will involve several implants, your choice may become more relevant. When it is time for you to make final choices about your implant system, it may be worthwhile to do a bit of research and review the websites of the dental implant brands your dentist has discussed with you. This will help you become familiar with the implant components you are considering. Your dentist will likely work with just one or two dental implant companies that produce all of the implant components your treatment requires. Because a dental implant treatment is a big investment, it is important that you take your time in choosing the system that you are investing in. If you have questions as your dentist develops your treatment plan, you should be sure they all get answered. Your dentist will want you to feel just as confident in the dental implant system you end up with as they are.