Dental implants have changed the way in which dentistry is practiced today. Although implants are not for everyone, once evaluated if you are a candidate, it can provide a highly reliable restoration.
The two most important considerations for implant placement are:
General Health and sufficient thickness and length of available bone. If it is determined that you are not a good candidate for an implant, other restorations can be considered, such as a non-metallic fixed bridge or a partial removable denture.
Once it has been determined that you are a good candidate, the next question is what kind of implant to place. There are basically two materials used in implants today: Titanium and Zirconia.
The advantage of titanium is that it has a long, proven track record and there are hundreds of companies with many systems to chose from.
The disadvantage is that it is a metal.
The advantage of zirconia, is that some people consider it more biiocompatible. The disadvantage is that they are very limited and new. They are very large and invasive and they often need to be reshaped with a bur to fit properly, creating the possibility of micro-fractures.
I will be the first in line when zirconia implants become smaller and more patient and doctor friendly.
Implants vary tremendously in size and design.
It was earlier thought that the larger the implant the better. Latest research show that that is not necessarily the case.
There are also implants that are cemented, others that are screwed in and some that are designed to just click into place (something called a cold weld).
In my practice when we feel an implant is the right choice, we have opted for a very small (much less invasive) and well designed titanium implant that is coated with a bio-ceramic material. This implant is placed and allowed to properly integrate, making sure the bone around it “embraces” it (we find that to be the case in over 95% of our cases). Once the implant is solid, we proceed to place an abutment (connecting the implant to the crown) and a crown.
These implants, although a fraction of the size of conventional implants, have a longer life expectancy and because of their small size, allow us to place them most of the time, without the need of additional and costly surgical interventions such as nerve repositioning or sinus lifts. In addition, the post-operative discomfort is significantly reduced when the procedure is not so invasive.