After 33 years in private practice in periodontics, dental implants, and bone regeneration, I am constantly looking for ways to tweak the treatment protocols to achieve faster treatment turnaround times while maintaining ideal functional and esthetic outcomes for our patients; all with a success rate that approaches 98%. My partner and I have many implant systems in our office to accommodate the needs and desires of our restorative colleagues. Most recently though, we have been attracted to implants with 3 specific design features that help us to realize our treatment goals.
1. Tapered implant body (roughened surface to the top) with an aggressive thread design. This allows for maximum initial stability which is especially important in our Teeth in a Day and All on 4 immediate implant placement and restoration cases.
2. “Platform switch” design for connection of the permanent abutment to the implant. This has been proven to help preserve crestal bone which, in turn, helps to maintain the overlying soft tissue levels thereby enhancing the esthetic outcome.
3. Internal conical connection of the permanent abutment to the implant. This connection has also been proven to eliminate or significantly reduce micromovement of the abutment. Abutment micromovement due to poor fit or inherent engineering design can contribute to bacterial invasion. The inflammatory infiltrate which ensues may contribute to bone loss and soft tissue alteration.
Three examples of implant fixtures which incorporate these design features are listed below:
Nobel Biocare NobelReplace CC
Astra Tech OsseoSpeed TX
Straumann Bone Level Tapered
We all have great outcomes in the past with traditional implant design. However, we work so hard to re-build bone and soft tissue so that our patients have beautiful results which mimic natural teeth. Doesn’t it make sense to try to preserve these structures? What do you think?
Photo Credits: NobelBiocare, Dentsply, Straumann