When it comes to replacing missing teeth, you've got some options. The question is which option is right for you?
Types of Dental Implants
More than 60 companies manufacturer dental implants and/or the materials used to create the restorations placed on top of them. As a result, dentists have many options for identifying the right implant treatment for specific patient needs. However, be aware that if you undergo an implant procedure by one dentist, then see a different dentist for a repair, your new dentist may have limited experience with, or may not have access to, the implant components used by the previous dentist.
Dental implants usually are categorized based on the type of procedure used to place them: two-stage or single stage.
Two-Stage Dental Implants: A two-stage dental implant procedure involves surgery to place the implant into the jaw bone and close (stitch) the gum tissue. Several months after healing, a minor surgery is performed to expose the implant and attach a dental implant abutment and temporary restoration.
Endosteal (Endosseous) Implants: These implants are placed in the jaw bone and are the most commonly used dental implants for two-stage dental implant procedures. Placed primarily as an alternative to a bridge or removable denture, endosteal implants include screw types (threaded), cylinder types (smooth) or bladed types.
Single-Stage Dental Implants: A single-stage dental implant procedure involves surgically placing a longer implant into the jaw so it is on the jaw bone, with the top of the implant level with the gum tissue, after which the gum tissue is closed (stitched), leaving the implant head visible. As a result, after several months of healing, the dental implant abutment and temporary restoration can be attached without the need for minor surgery to expose the implant head.
Subperiosteal Implants: These implants are placed on the jaw bone within the gum tissue, with the metal implant post exposed to hold the restoration, and are the most commonly used for single stage dental implant procedures. Subperiosteal implants are primarily used to hold dentures in place in patients with insufficient bone height.
Types of Dental Implant Coatings
Although most dental implants are made of titanium, the dental implant surface which affects the long-term integration and stability of treatment can vary. A porous surface contributes to more bone contact than a machined titanium surface. Other implant surfaces include a grit-blasted or acid-etched and roughened surface, a microgrooved or plasma-sprayed titanium surface, and a plasma-sprayed hydroxyapatite coating.
Types of Dental Implant Connectors
Dental implants also may be categorized based on the shape/type of the implant head. All dental implants require the restoration and abutment to be attached or screwed to the implant head. For this purpose, there are three main connector types:
Internal Hex Connectors: Shaped like a hexagon, an internal hex connector is an opening in the dental implant head into which the restoration/abutment is screwed.
External Hex Connectors: Also shaped like a hexagon, these connectors are atop the dental implant head.
Internal Octagon Connectors: Shaped like an octagon, an internal octagon connector has an opening in the dental implant head into which the restoration/abutment is screwed.
Sizes of Dental Implants
Another way to categorize implants is based on their size (also called platform), which dictates where they generally can be placed in the mouth. However, every case is different, and individual spacing and bone availability needs may dictate the use of a different size implant.
Standard Implant Platform: Standard dental implants range in size from 3.5 mm to 4.2 mm in diameter. These comparatively shorter and narrower implants are most commonly placed toward the front of the mouth.
Wide Implant Platform: Wide platform dental implants range in size from 4.5 mm to 6 mm in diameter and are placed primarily in the back of the mouth.
Mini or Narrow Body Dental Implants: Mini or narrow body dental implants range in size from 2 mm to 3.5 mm in diameter and are placed primarily in patients with insufficient space between their tooth roots to accommodate a larger implant. They also may be placed when the patient has insufficient bone density.
Immediate Implant Placement after Tooth Extraction
Dentists trained to perform implants, crowns and/or oral surgery have begun to immediately place dental implants into locations where teeth have been extracted. When successful, this approach can shed months off the treatment time associated with dental implants because the osseointegration process is accelerated.
Candidacy for this type of early intervention depends upon the anatomy of the tooth extraction area. For example, in many cases the extracted tooth site is wider than the implant, making it impossible to place the implant into the site immediately after extraction. Bone or soft tissue grafting would be required to ensure a secure implant fit and placement.
Who Places Dental Implants?
Periodontists and oral surgeons perform the implant surgical procedure itself. However, an increasing number of general dentists have undergone the education and training necessary to place dental implants in certain cases.
If you are considering implant treatment and seeking a qualified dental professional, ask about the extent of your dentist's training. Training in implants, crowns and/or oral surgery offered by private organizations may be completed over a weekend, but medical organizations such as the American Academy of Periodontology and the American Association of Oral and Maxillofacial Surgeons offer more extensive training. Since dental implant placement is a type of oral surgery, it is important to ensure that your dentist has the experience and training required for this sensitive procedure.
Keep in mind, too, that dentists do not need a specific license by law to perform implant dentistry. A general or restorative dentist may perform the crown and bridge restoration associated with implant treatment, as well as perform the implant placement.