What implant should we use?

implantes-dentales-donostiaWhen fitting a dental implant to provide support for a new tooth, the patient’s particular case must be carefully studied, their mouth inspected, and a scanner taken to show the quantity and quality of the available bone.

We use different implants for different situations. The implant brand used must be of good, recognised quality for guaranteed success. On choosing an implant, we must consider the connection type, the platform width and the implant size.

Connection types

These are the different ways of connecting the screw or implant to the tooth crown.

External connection

 

The head of the implant is compact, flat and ends in a hexagon which fits into a hexagonal space in the neck of the crown.

This is the traditional connection, the one that was first used more than 30 years ago for modern dental implants. While they have always given good results, they do not respond particularly well to the lateral forces of the teeth, and have largely been replaced by internal connection implants.

Internal connection

 

The head of the implant has a tri-lobe cavity into which the neck of the dental crown is inserted. It uniformly distributes the stress transmitted by the crown to the implant, meaning that both the implant and the bone around it become highly resistant to the occlusal forces and mastication.

In both types of connection, the laboratory-produced crown is connected to the implant by means of a screw which can come loose in the event of very intense lateral forces. This loosening, while infrequent, occurs even less often with the internal connection.

Platform types

 

This is the width of the connection between the implant and the crown. Given that implants are always round, platforms too are round and come in three different diameters enabling their adjustment to the available space. The implant platform can be narrow, universal or wide, i.e. 3.5 mm, 4.1 mm or 5.5 mm.

The size of the platform we choose in each case depends on the space between the adjacent teeth and the width of the bone. Generally speaking, the front teeth are replaced with narrow and universal platform implants. Molars, with a universal or wide platform.

Implant size

In principle, the greater the load to be supported by the implant, the bigger that implant should be. We can choose between implants of different lengths and widths.

Length

It has been shown that implants support the greatest part of the load in the first three threads, those closest to the connection. We therefore deduce that length is not an essential factor and that, to withstand a certain load, it is better for an implant to be wider than longer. This said, when the bone is very narrow, and sufficiently dense, we fit narrow and relatively long implants.

Width

This is the essential factor, above all in the area of the molars, where bone height is rather scarce. It is also why we increasingly use short and wide implants.

The professional’s experience is essential when it comes to choosing the implant to fit in a certain area since sometimes, as well as studying the scanner, they may decide to change the kind of implant envisaged as the surgery progresses.