Which Dental Implant is Best for Replacement of Teeth Depends on Many Factors:
- Does the patient have any metal allergies or biocompatibility concerns with titanium?
- Is it a front tooth or a molar tooth implant?
- Is one tooth being replaced or is the implant for a full mouth of implants or All on 4 dental implants?
- Are there TMJ pain Issues and does the person clench or grind their teeth?
- Are the teeth tall or short? Big or Small?
- Are there metals in the mouth such as gold crowns, amalgam silver fillings, partial dentures?
- What kind of implant surgery is being done. Immediate implant placement on the same day as tooth removal. Implant surgery after a tooth has been missing for a significant period of time (3+months)
Can you get a Tooth Replaced?
Of Course with a new tooth implantation called a dental implant. The magic or invention of tooth replacement with teeth implants by Dr. Branemark was the surgical implantation of a titanium root form into bone resulted in growth and attachment of jawbone around the titanium implant root. We also know zirconia will also integrate into human jawbone as well.
What kind of teeth implants are available? How to know which is best for your implant case.
Zirconia Metal Free vs Titanium Tooth Implants
Internal vs External Dental Implant Connection. What makes tooth Implants different
Teeth implants basically come in two different kinds of materials. Metal-free zirconia and titanium. Implants also come in many different sizes and shapes. Implants technically mimic the replacement of tooth root. Implant teeth connect to implants by connecting to a part called an abutment. A major difference in teeth implants is that some connect to abutments in an area down and inside the implants whereas others connect on the outside and on top of the implant. These two different kinds of implants are called “internal” and “external” hex respectively. Hex because the parts typically connect by way of a hexagonal shaped fit. The hex is used to prevent rotation of the abutment about the implant. Dentists refer to this as an anti-rotational feature. Most implants today are “internal” because the design allows the implant dentist to more easily make implant teeth that look better because there is more room to create a beautiful implant tooth that emerges from further below the gum line. An internal implant also makes a smoother transition between abutment and implant.
One Piece Implants:
Some implant teeth are one piece implants where the implant directly makes the connection with the crown. In this case, the implant comes directly out of the bone and gum and into the mouth as one piece. In this case, it is necessary to drill the part sticking up into the mouth to customize its shape to facilitate a proper shape for fitting of an implant crown. A one piece implant creates a major disadvantage in two ways: 1) the implant is sticking up into the mouth after placement where the patient can hit it and cause implant failure prior to implant osseointegration or healing. 2) many teeth make a turn into the mouth where the root transitions to the crown. A one piece implant is always straight and makes it much more difficult for the implant dentist to create a nice looking crown.
Glued Two Piece Implants:
Some implants require an abutment to be glued to the implant. This glues connection is still used by many zirconia implant systems. The glue leaves another dental material and a new opportunity for biocompatibility issues. Additionally, a glued abutment needs to finished in the patients mouth. That means the dentist may need to drill the abutment in the mouth. A glued implant cannot ever be removed without drilling the abutment out of the implant. Such a removal can destroy the implant and result in a need to remove the implant.
So What Kind of Implant is Best? Here are some good rules of thumb when choosing an implant
The Best dental implant is the tooth implant that will perform the best in the given situation. A highly qualified implant specialist is the best person to determine what implant is best in a specific situation. But generally:
- Zirconia implants may be more biocompatible than titanium implants and gum tissue grows better around zirconia than titanium.
- When using titanium implants, use a pure titanium implant rather than a titanium alloy. Alloys increase the chance of metal allergies.
- Glued abutments make getting ideal results much more difficult and is outdated and old-school. Modern day implants should not need glued abutments. In most cases a two piece system is best.
- one piece implants fail at too high of a rate and getting cosmetic results is too difficult and not predictable.
- internal connections lead to better results than external connection implants.
- Metal-free zirconia implants look better for front teeth implants or any tooth visible in the smile zone. Zirconia are the cosmetic implants.
- cases where people have small and short teeth are better done with titanium over zirconia implants
- cases where people grind their teeth are better treated with titanium implants
- people with allergies and who are sensitive are better off with metal free zirconia implants because they are more biocompatible.
- complex full mouth implant bridges such as All on 4 are better done with titanium implants.
- dentures with implants are better done with titanium implants
- front teeth implants should be longer and not as wide
- back teeth implants should be wider and not as long.
- implant length should closely mimic the approximate length of the surrounding natural teeth
- never buy a generic implant. Often these companies go out of business making finding future implant parts difficult if not impossible.
- always use implants from a financially stable company because if the company sell out or goes out of business, you may not be able to get replacement parts. The implant will be unserviceable and un useable.
- implants with deeper grooves and more taper are better same day all on 4 implants.
All on 4 Video
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