All Dental Implants Are Not Created Equal

Posted by in Featured Articles

Although many types of dental implants have been used to replace missing teeth, including blade, subperiosteal and staple implants, the majority of implants used for tooth replacement in the modern era of implant dentistry (over the past 20 years) are root form osseointegrated implants, most commonly made of titanium. Among the root form osseointegrated implants, there are significant differences, including:

  • Implant design elements — implant shape, thread pattern, presence or absence of a machined surfaced implant collar, type and location of abutment connection, superior or central shifting of micro-gap, and presence of macroscopic grooves on the implant body to encourage greater bone anchorage.
  • Implant surface characteristics (microtopograhpy) and surface chemistry, which both influence the rate and percentage of osseointegration measured as bone to implant contact (BIC).
  • Stability of bone to implant anchorage under functional loading.
  •  Scientific documentation to support the product, company replacement warranties, and cost.

Because there has been a rapid evolution as a result of extensive research and development commitments made by the major implant manufacturers, clinicians and patients need to educate themselves about the current technology available to them and how to avoid selecting an outdated technology—or even worse, an implant sold on the “Black Market” that may have been manufactured by a company that is no longer in business. In this article, I review a little history, talk about the latest advancements, and make some recommendations.

Read More

Dental Implant Complications in the Esthetic Zone

Posted by in Featured Articles

Esthetic implant complications and failures can be devastating for a patient and the doctor rendering treatment. Although the course of action required to deliver an esthetic implant restoration may, in certain instances, seem straightforward it has been rightfully suggested that the delivery of esthetic implant restorations be considered a complex treatment modality requiring advanced training and experience.

Providing acceptable esthetics for patients who desire implant replacements requires in depth knowledge of biologic mechanisms, superior patient management skills, and highly developed diagnostic acumen. Therefore, it is imperative that clinicians who want to provide esthetic implant therapy qualify themselves by obtaining additional education and experience specific to this advanced treatment modality.  That’s why all of our Sclar Center training courses include both functional and esthetic considerations, and we offer a comprehensive Esthetic Implant Site Development Course.

Read More

In Demand: All-on-4® Full Arch Immediate Function

Posted by in Featured Articles

Treatment options for implant reconstruction of edentulous patients or those with terminal dentition include locator or bar/clip overdenture, fixed patient removable restorations retained by precision milled bars and superstructures or telescopic copings, and fixed emergence and hybrid implant prosthesis. Nevertheless, years of experience have taught me that the majority of these patients want a fixed implant restoration and hesitate to embark on a lengthy process that includes bone grafting and/or multiple staged procedures. Even though the All-on-4 procedure provides a life changing, graftless solution for many of these patients, I am a strong advocate for educating patients about all of their treatment options during the consultation process.

In order to do so, clinicians must be able to perform a focused patient evaluation early in the consultation to quickly determine if an immediate load fixed implant restoration is a viable option or if several procedures will be required to satisfy the patient’s treatment goals.

Read More