Dental implants have been evolving for 40 years now. The best solutions emerge to become dominant, making the most popular implant types at any given time very much alike. Nowadays, titanium implants have taken hold of the market, with its shape resembling the tooth root and its surface microscopically uneven, so as to make it easier for the bone tissue cells to bond with the implant, in turn speeding up the process of full integration. The most significant difference in types of implants is the shape of the screw, type of connection between the abutment and the crown as well as the dimensions.
Get to know your implant
Although you don’t need to become an implant expert, the basic knowledge of how implants work will help you prepare for the procedure and possible setbacks, to better understand what to expect from the implant and to distinguish between standard and premium implants, so you can make decisions about what type of implant you want.
Size and shape
As far as their width, implants range between 3.5 mm and 6 mm, the narrower implants being placed predominantly in front teeth, and wider in back teeth, depending on the available space and the expected load. The length ranges between 6 mm and 16 mm. The surface of the implant may be intentionally grained on a nanometer scale, which serves the purpose of better osseointegration. The shape of this graininess determines whether it will be used for immediate load or not. The more pronounced the screw thread, the easier to achieve better stability, making it more robust for immediate load. Implants may have a more or less smooth surface towards its collar area, so it can better bond with the gum. The surface layer, which is in contact with the jaw, is sometimes made of special material with more bonding properties, or the whole surface can be uniform, with the surface layer covered in micropores.
Cemented and screw retain implants
Cemented implants are widely used, where the abutment is first inserted into the screw that is placed in the jaw and then the crown is cemented on top of the abutment. In case some adjustments are needed, the crown can be removed, with abutment staying on the implant. This solution is reliable, but it also requires making sure that when applying the cement, it does not get in contact with the gums or spills over the side of the implant or into the abutment itself. Latest abutments are designed so as to be aligned with or lower than the gums the whole length of the edge, so that the surplus cement is easily removed.
The alternative is a screw retain implant, where the crown and the abutment are attached, i.e. cemented to one another, and then are screwed in the jaw. In the screwing process, a small access hole is drilled in the crown so as to be able to get to the screw through it, after which the hole is sealed with dental filling material. This solution is more complex and pricey, but it leaves the possibility of temporarily detaching the crown from the implant if need be, which is the reason why it is recommendable for certain patients in specific situations. In any case, it is applicable only if there is enough bone tissue to be able to position the implant in such way that the hole for the screw is in the centre of the crown, or at least close to it. The common issue here is the inclining bone structure, so that the hole becomes visible at a side of the crown, which is aesthetically unacceptable.
Mini implants or TADs (Temporary Anchorage Device) are quite thinner and a bit longer than the standard implants. In our clinic we rarely make use of mini implants because of their relative fragility, potentially causing them to crack 5 years into the placement. We use mini implants as a short-term strategy, where we plant them between two classic implants, mount braces on them, and finally remove them when they have served their purpose.
Implants used in Cvejanović Dental Clinic
Implant Direct is a Swiss implant manufacturer credited with making implants popular over the past decade, since it is the first company to make implants affordable to an average European consumer. The company was founded by Dr Gerald Niznick, an implant dentistry pioneer. Today, Implant Direct has a variety of products, boasting of, among other things, four types of Legacy implants which are widely used in implant procedures. Among them, these exquisite implants cover up to 90% of all patients’ demands, granting a lifetime warranty on any of the products. The company has recently been acquired by the US corporation Danaher.
Another Swiss company, Nobel Biocare is the manufacturer of premium dental implants. This brand sets the bar high when it comes to implant dentistry, and while others are trying to keep up, Nobel stays a step ahead, ever working on and implementing innovations. Nobel Biocare legacy can be traced back to a doctor who has patented the first dental implant in 1978, a Swedish physician by the name of Per-Ingvara Branemarka.
At Cvejanović Clinic, we use Nobel Parallel CC implants. Formerly, we have used other Nobel Biocare implants, like Replace and Activ, but more recently we have realized that we have practically everything we need in one single implant, which is Parallel CC. This implant is applicable even when the bone tissue is of poor quality but still requires an immediate load. It also has a polished collar area which practically locks the collar and makes it impossible for bacteria to penetrate further into the bone, similar to a natural tooth. Unlike the Active implant, which has more aggressive screw threads, Parallel CC’s threads are pronounced enough to bear the immediate load if necessary, without damaging the bone in the process.