What is a dental implant?
A dental implant is a tiny metal screw, engineered with very high precision technology. It works as an artificial tooth root and has been in use since the 1950s. Dental implants can be of different materials, widths, and lengths and there are currently hundreds of dental implant brands on the market.
How does a dental implant work?
Once an implant has been placed surgically into your jawbone, the surface fuses with the surrounding bone (a process known as osseointegration). You will then undergo a healing period of between three to six months for this to take effect. This makes the dental implant stable and strong enough to support a prosthetic tooth so that your replaced tooth can withstand the forces of biting and chewing comfortably. At the same time, the gingiva around the implant adheres to the implant collar and abutment, to create a seal against any bacteria trying to reach the implant.
When the healing is completed, an abutment is screwed into the dental implant, connecting the implant to the prosthesis. Sometimes, however, it is possible to place the abutment at the same time as your dental implant and have a temporary crown fitted. Once healed, your temporary prosthesis will be replaced with a permanent one, completing your dental implant procedure.
Continue reading to discover:
What is the best dental implant brand?
It is always worth finding out which implant of dental implant your dentist recommends and if they have other options for you, and do some research. Not all brands have invested equally in long-term quality and clinical predictability.
Today, there are several hundreds of dental implant brands available, all with their own characteristics, prices, and predictability level (the probability of a successful treatment outcome). Dentists tend to have one or two different brands in their practices. Each dental implant brand and design has its own surgical material, and technical limitations, and requires specific training. Dentists are thus dependent on their implant brand’s capabilities to treat their cases as well as possible.
One thing to consider when choosing a dental implant is that your needs will evolve with time. For example, you may need to add an additional implant or change out your prosthesis in the future. And if you are not able to go and see your previous dentists, such as in case of an emergency, relocation, or travel, you will need to find a new dentist. In these cases, the use of a popular and more well-established brand will not only make it easier for you to get the same brand when going to see a new dentist but also gives you a wider choice of fitting abutments and prosthetics when needing to change something.
Typically, there are innovative companies that invest a significant portion of their resources into clinical research and have a strong business foundation and then there are copy-cat companies that copy the more innovative companies and spend little time and money into clinical research and present weaker business sustainability.
Innovation is meant to improve the quality of dental implant treatments, whereas copying helps to reduce the cost of the product in order to sell more of them.
Clinical research includes the effort invested into the research, development, production, and testing of a dental implant. It is meant to make sure that the implant is safe, performs over long-term, and provides health benefits that outbalance its costs. To be credible, clinical research must be reviewed and published in an international scientific journal. Click here to check how many times an implant brand is quoted in biomedical literature.
Sustainability is meant to ensure that the manufacturer of the implant is still going to be active in 10 or 20 years from now. When an implant is not available anymore, the dentist faces two challenges if they have to add one or more implants. Identify the implant correctly and have a compatible implant connection for their prosthesis. The choice the patient makes today can spare them troubles in the future.
Sometimes the quality of copycat brands leads to clinical disasters [1]. To minimize risk and improve patients’ chances of dental implant success, clinicians should select products that have documented scientific evidence of their performance[2]. There is an independent foundation testing the quality of dental implants called The CleanImplant Foundation. Check here to see if your dental implant is on their list of trusted implant brands.
“Mimics can be cheap in the short term, but costly in the long term” [3]
An implant treatment generally takes 12 to 18 months to complete and is a significant financial investment. This is why you do not want to have to redo your procedure or experience unnecessary complications if avoidable. With thorough planning and good dental care, and when performed by a qualified and experienced dental practitioner, high-quality dental implants should last you a lifetime.
Dental implants for an event?
Dental implants have the highest documented success rates out of all possible tooth replacement options. Studies show a five-year survival rate of at least 95% and after more than ten years the survival rate is still around 93-95%[4][5][6][7]. This means that in 93 out of 100 cases, no revisions were needed after 10 years from the date of the dental implant procedure. Evidence even supports the longevity of dental implants of up to more than 20 years[8].
However, you should know that every case is unique. Many factors affect the success rate of a dental implant procedure, such as the location of the implant, the level of bone density, the presence of healthy gum, the products used, and the expertise of the dental team to name a few[9]. It is therefore difficult to generalize success rates. Instead, success rates should be determined on a case-to-case basis.
Dental implants are just like natural teeth and require good daily maintenance. Therefore, your commitment to the care of your implants as well as attending regular dental visits is important to assure the long-term success of your procedure. Read more about how you can limit the risk of complications here.
Four differences between dental implants
Implants can be made up of various materials, be of different sizes and shapes, and have different types of surfaces and connections to the abutment. It is therefore very important for your dentist to choose the right implant for your treatment. Here the access, training, and expertise of your dentist come in as well as their understanding of your needs and expectations.
The material
There are three primary categories of dental implant material currently in use:
Pure titanium is the oldest material available with extensive scientific evidence showing it to be the most biocompatible material for implants. Titanium’s non-ferromagnetic properties make it possible for patients who have dental implants to have safe MRI examinations. It is also highly resistant to corrosion, durable, and lightweight as a dental implant material.
Titanium alloys are a combination of titanium and other metals such as vanadium and aluminum. The biggest benefit of having an alloy dental implant is that it makes the dental implant stronger than when using pure titanium. The alloy also improves the tensile or flexible strength of the dental implant.
Zirconia or ceramic implants are ideal for persons with metal hypersensitivity because they are metal-free. Some persons prefer white zirconia to titanium implants as they can be more esthetically pleasing due to them being less noticeable behind the gingiva than the grey titanium. However, ceramic dental implants are less elastic under pressure than titanium implants, making them more susceptible to breakage.
The surface
During the production of a implant, a variety of treatments can be applied to the surface of the implant.
Many studies [10] have shown that rough, porous surfaces accelerate osseointegration when compared to smooth ones. Osseointegration is when the surface of the implant fuses with the surrounding bone and if this fails then your implant will not hold. By contrast, smooth surfaces seem to be better adapted for soft tissue adhesion on the implant collar. Dental implant production is therefore highly sophisticated and requires outstanding expertise.
The connection
One important feature of the implant is the implant connection to the abutment (Fig. 6). This interface between the implant and the prosthesis must be perfectly fitting to secure long-term performance and hold the dental prosthesis in place. Any micro-gaps could lead to failures (read more).
The implant connection also determines the choice of abutments and prosthetics. Some dental implants have a wider choice of abutments and prosthetics than others. A broader prosthetic choice can be important if, in the future, you would need more implants or a new prosthesis.
The size and shape
The design and size of an implant vary tremendously (Fig. 7) and come with different properties. The optimal size and shape of an implant depend on factors like where in the mouth the implant will be placed, the treatment protocol your dentist will use, and the type of treatment you will have, to name a few. For example, some designs allow dentists to place the abutment on the day of surgery, whereas others require a few months of healing before placing the abutment.
Tip: Each dental implant design and brand requires the dentist to follow specific training and use an instrument kit dedicated to that type of dental implant. This is the reason why a dentist may have lots of experience and be very well-equipped to perform certain dental implant treatments but not all. Therefore, make sure to ask your dentist how often they treat dental conditions similar to yours and perform this type of dental implant treatment.
Dental implants cost too much!
The sales price of implants to dentists varies from EUR 10 to over EUR 450. Despite this significant variance in implant prices, the price of your overall procedure may not reflect it. This means that a low-cost implant can be part of an expensive procedure and a premium implant can be used in a more cost-effective procedure.
There are a number of different factors and variables that influence the cost of your dental implant procedure. Learn more about the variables that influence the overall price of a dental implant procedure here.
In 2020, there are over 400 brands of dental implants represented on the market. The brands are often characterized by quality and pricing and are more easily viewed as a spectrum from discount to premium. Here is an overview of the three implant tiers[2]:
Premium implant fixtures are defined not only in terms of their relatively high price point, above $250 per dental implant when sold to dentists, but additionally on the basis of their innovative features, quality, and well-established companies. The premium segment is dominated by four major companies: Straumann Group, Nobel Biocare (Envista Group), Dentsply Sirona, and Zimmer Biomet. Implant products from Nobel Biocare and Straumann represent the leading dental implant fixtures in the premium market.
These brands provide dentists a one-stop-shop for the implant, prosthesis, and material to place them. Since each company manufactures all components of their respective implant systems, the quality and long-term performance are seen as very good.
The popularity of premium implant is largely due to the prevalence of oral surgeons and periodontists. These users tend to perform more dental implant procedures per year, thereby necessitating a larger volume of dental implant fixture purchases. As such, these dentists typically buy premium implants in bulk at a discounted price, further facilitating premium implant fixture sales.
Dental implant fixtures priced in the range of $150 to $200 sold to dentists are more of a value item. Value implants are attracting a growing market of consumers due to the ‘value’ their products deliver. With a lower price point relative to premium products, these brands promise a quality product and prove to be attractive especially to general practitioners who are introducing implants to their practice.
These brands are mostly focusing on implant production and offer often ‘compatible’ prosthetic solutions from third-party manufacturers. The risk of using compatible vs original solutions is that the long-term performance is not always well-researched and therefore the risk of micro-motions occurring is higher which could lead to failures.
A number of national and regional brands compete in this second category, such as Alpha-Bio Tec, Anthogyr, BioHorizon, Bredent, BTI, Camlog, Global D, Implant Direct, Medentis, MegaGen, MIS, Neoss, Phibo, Southern Implants, Sweden & Martina.
Often discount brands present a price that aligns quite closely with a value product; however, they then proceed to offer a discount close to 50%, below $100 per implant. The discount brands are an emerging segment with an influx of companies coming from South Korea, Israel, and Argentina. Known brands are Osstem, Champion Implant, AB Dental, Often. Discount implants are some imitations of more premium products with quality levels varying significantly.
With the rise of General Practitioners placing implants, discount implants become a more acceptable option, especially in less aesthetic and complicated cases.
[1] Karl M, Irastorza-Landa A. In Vitro Characterization of Original and Nonoriginal Implant Abutments. The International Journal of Oral & Maxillofacial Implants. 2018;33(6):1229-39.
[2] iData. US market report suite for dental implant fixtures and final abutments. iData Research Inc. 2017 Jun.
[3] Duddeck DU, Albrektsson T, Wennerberg A, Larsson C, Beuer F. On the Cleanliness of Different Oral Implant Systems: A Pilot Study. J Clin Med. 2019 Aug 22;8(9).
[4] Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A (October 2012). “A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years”. Clinical Oral Implants Research. 23 Suppl 6: 22–38. doi:10.1111/j.1600-0501.2012.02546.x. PMID 23062125.
[5] Simonis P, Dufour T, Tenenbaum H (July 2010). “Long-term implant survival and success: a 10-16-year follow-up of non-submerged dental implants”. Clinical Oral Implants Research. 21 (7): 772–7. doi:10.1111/j.1600-0501.2010.01912.x. PMID 20636731.
[6] Pjetursson BE, Brägger U, Lang NP, Zwahlen M. Comparison Survival and Complication Rates of Tooth-Supported Fixed Dental Prostheses (FDPs) and Implant-Supported FDPs and Single Crowns (SCs). Clin Oral Implants Res. 2007 Jun;18 Suppl 3:97-113. doi: 10.1111/j.1600-0501.2007.01439.x.
[7] Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Review of the Survival Rate and the Incidence of Biological, Technical, and Aesthetic Complications of Single Crowns on Implants Reported in Longitudinal Studies With a Mean Follow-up of 5 Years. Clin Oral Implants Res. 2012 Oct;23 Suppl 6:2-21.
[8] Chappuis V, Buser R, Brägger U, Bornstein MM, Salvi GE, Buser D (December 2013). “Long-term outcomes of dental implants with a titanium plasma-sprayed surface: a 20-year prospective case series study in partially edentulous patients”. Clinical Implant Dentistry and Related Research. 15 (6): 780–90. doi:10.1111/cid.12056. PMID 23506385.
[9] Raikar et al. “Factors Affecting the Survival Rate of Dental Implants: A Retrospective Study.” J Int Soc Prev Community Dent. 2017 Nov-Dec; 7(6): 351–355. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774056/
[10] Novaes, AB., de Souza, S., de Barros, R., Pereira, K., Iezzi, G, PIatelli, A., “Influence of Implant Surfaces on Osseointegration” Braz Dent J (2010) 21(6): 471-481 Retrieved from: http://www.scielo.br/pdf/bdj/v21n6/v21n6a01.pdf