Dental implants are probably the most remarkable innovation in modern dentistry, allowing us to completely replace lost teeth with new restorations that are fully fixed in the bone and look and function like natural teeth.
Dental implants are not uniform–they come in a variety of forms, giving an implant dentist many options in designing the best restoration for each patient. Overall, studies indicate that these designs seem to have comparable success rates, but for individual cases, there are good reasons why one design might be preferred over another.
Most dental implants have been made with titanium because of its strength and its ability to integrate with bone. In general, pure titanium has been preferred, but some implants are made with a titanium alloy.
Recently, advances in material science have made metal-free dental implants possible. These are manufactured using zirconia ceramics, which may be even more compatible with bone growth and certainly look more like natural teeth.
Dental implant width is one of the biggest variables in dental implant design. What are considered “regular” dental implants are 3.5 – 4.5 mm in diameter (about 1/7 to ⅙ inch), while wide implants are greater than 4.5 mm. Mini implants are less than 3 mm in diameter.
Obviously, the implant has to be narrow enough that it will fit inside the available bone, but the wider the implant the more torque it can withstand. But if the implant is too wide, there will not be enough bone around it to support it. Regular dental implants are adequate for most anchoring situations. Mini implants are most often recommended for retaining dentures, rather than supporting restorations, though in some cases they can be effective.
Some dental implants are designed to simply be pressed into the jawbone, but most are designed using a screw-style interface.
Screw-style implants can come in a number of different designs. The two most common designs of thread are the triangular and the trapezoidal threads, although square threads are also available. The difference in design is to alter the forces on the bone and to improve the amount of surface area for contact between the implant and bone.
Dental implants also come with different thread pitches. The thread pitch measures the distance between threads, and can be narrow pitch or wide pitch. Some dentists recommend narrow pitch implants for low bone density.
Some implants are designed to be placed so that the top of the implant is at the level of the bone that anchors it. Other implants are designed so that the top of the implant is at the level of the gum tissue.
Bone-level implants always connect to restorations like a dental crown or dental bridges using a small connector piece called an abutment. Tissue-level implants may connect directly to the restoration, but they may also have an abutment. Some implants are designed with internal connections–abutments or restorations screw into the implant. Others are designed with external connections–the restoration screws or bonds on the outside of the implant.
Platform switching is sometimes used to help improve the health of gum tissue around the implant. This is when an abutment is used that is wider than the implant below it. Single-piece tissue level implants are often designed with a tapered head to create this effect.
Ceramic implants are generally designed so they do not require an abutment.
Another strategy for improving the contact between an implant and bone is to roughen the surface of the implant. This used to be done with a laser etching system, but more recently acid etching is used to create the rough surface.
However, surface roughening has been blamed for poor compatibility with soft tissue around the implant, so many tissue-level implants are designed with smooth collars.
Obviously, there are many design factors that go into the selection of your dental implant. Your implant dentist will factor in all the benefits and limitations of the different factors and will select an implant that is right for you. Dental implant options are not like features on a car that you select based on your preferences, they will be chosen to maximize your implant success.
The key is to find an implant dentist that you trust to make these decisions for you based on their expertise. If you are looking for a skilled, expertly trained, and highly experienced implant specialist in Beverly Hills, please call (310) 275-5325 for an appointment with Nicolas A. Ravon DDS MSD.