10 facts about dental implants
Dental implant marketing often emphasizes “simplicity,” underplaying an inherent complexity in the product, procedure — and patient. Prosthetic dentistry is not simple. And patients rarely have simple problems. Potential complications can be far from simple to correct. To ease your learning curve with implant dentistry, following are some core variables that can be managed based on proven research.
1. Implant surface design: Choose implants that have micro-topography and bioactive surfaces that enhance bone contact and have macro-topography (overall shape) that better stabilizes bone profiles with little or no crestal bone loss.
2. Abutment connections: Internal connections have simplified abutment insertion. And if the abutment-implant margin is kept shy of the implant outer surface, a connective tissue zone will develop. The result is improved bone preservation at the crest. Abutments should be torqued to position and have specifically designed abutment screws that support long-term stability.
3. Provisionalization phase: Once thought optional, today this step is a critical diagnostic and management tool used to verify osseointegration, occlusion, esthetics, soft-tissue management, hygiene, prosthetic design and abutment selection.
4. Prosthetic options — screw versus cement: Some companies emphasize a “simpler” and familiar cement-only option. But irretrievability — presence of subgingival cement — can be problematic. Plan your design to minimize complications.
5. Earlier osseointegration and restorative phases: Improved implant surfaces and shapes support primary stability in bone and enhanced osseointegration. Early loading is becoming more feasible — choose cases carefully.
6. Soft- and hard-tissue management: Timely placement of provisionals can influence the support and contour of tissue. Advancements in bone grafting and tissue preservation help preserve soft tissue, maintain anatomical bone contour and improve gingival esthetics.
7. Enhanced marketing: Implant dentistry is aggressively promoted. However, costs remain high for average-income patients. It’s critical that benefits a patient realizes far outlast any corresponding debt.
8. Technological improvements: Zirconia ceramics and CAD/CAM have created an explosion in design, customization and improved esthetics. Zirconium is doing for esthetics what titanium did for osseointegration.
9. Computer-guided implant therapy: You can’t deny the value of 3-D software that helps measure and locate vital structures such as the mandibular nerve, sinus cavities and nasal floor. But most practices still rely primarily on conventional radiography.
10. Long-term studies: Implant companies provide education, solid research and ongoing support to customers (you). Incorporating up-to-date knowledge into the clinical variables you’re managing on a daily basis will enable you to achieve a predictable approach in your decision-making with dental implants.
This article was published in Implant Tribune Canada Edition, Vol. 2, No. 3, May 2015 issue.