Types of Dental Implants

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What are the different types of dental implants, and which one/s should you select if given the choice?

Losing a tooth or two can cause anyone to feel self-conscious, and ashamed to smile or speak confidently. Moreover, it can cause someone to develop bad eating habits, especially when food is difficult to chew, which then leads to secondary health problems. This is what bridges and traditional dentures try to address. However, unlike natural teeth, dentures and bridges are far from durable and stable. They tend to get loose over time and have the tendency to fall off, and they can be fragile. Enter dental implant surgery – the permanent solution to missing teeth.

This guide will talk about everything you need to know about implant dentistry, including the different types of dental implants out there.

A quick look at dental implants

If you are above 45 years of age, and you still have most or all of your teeth, then you’re one of the lucky few. Statistics show that almost 70% of adults between the ages of 35 to 44 years old have lost at least one permanent tooth. And 26% of seniors above 74 years old have lost all of their teeth.

Periodontal disease, tooth decay, gum disease, and trauma from injury are just a few of the reasons why people lose their permanent teeth. However, thanks to modern dentistry, people today no longer have to continue living their lives with missing teeth. A dental implant, which is a relatively new option for tooth replacement, has exploded in popularity in the last couple of decades.

A dental implant is basically a prosthesis. But unlike removable dentures, it is surgically attached to the bone of the jaw or skull to support the dental prosthesis such as bridge, crown, dentures, etc.

As with other dental procedures, the process starts with an individualized treatment plan to address the specific needs of the patient. The surgery is performed by professionals specifically trained and experienced in oral surgery and restorative dentistry.

A dental implant procedure is a surgical procedure that involves an incision of the gums and the insertion of a titanium screw into the bone socket of the missing tooth. The screws or posts will act as anchors for the artificial tooth/teeth. As the gums and jaw bone heals, the implanted metal post will merge with the bone, providing a secured anchor for the artificial tooth/teeth. The new tooth will be attached to the “abutment”. Depending on the type of implant, techniques used, number of implants used, and the individual, the healing process usually takes 6 to 12 weeks.

Types of dental implants

Each type of dental implant has different specifics, from the coating, connector, size, etc. Your dental professional will choose the best one for you based on your needs and the current condition of your oral health and general health history. Here are the different types of dental implants used today.

Endosteal implants

The endosteal implant is the safest and most common type of dental implant today. It is commonly used as an alternative to dental bridges or removable dentures. Moreover, this is also the most effective type and stable type used today and can provide natural-feeling results. This type of dental implant includes threaded screws, bladed types, or cylinder (smooth) screws.

The process

Endosteal implant process starts with drilling into the jaw bone first and inserting the titanium screw that will act as the artificial root. Before proceeding to the next step, the soft tissues and jaw bone around the root must heal completely first, which could take a couple of months.

Before the dental surgeon chooses this type, the patient must have a sufficient amount of jaw bone density and good overall oral health to fully support the endosteal implant. People with naturally narrow jawbone ridge, short, or worn down due to oral health issues or injury are not qualified for this type of dental implant treatment.

Subperiosteal implants

Once used for holding dentures in place of patients with insufficient jaw bone height, subperiosteal implants are rarely used today. Subperiosteal implants are placed on the jawbone within the gum tissue, the metal post that holds the denture exposed through the gums.

The process

The procedure requires two appointments to complete, which makes it far shorter than the endosteal implant. However, since the metal post is held only by the soft gum tissue and doesn’t go deep into the jawbone, but rather just rests on top of the bone, the subperiosteal implant doesn’t have the same stability as the endosteal. Though this still provides ample support than dentures, it is far less stable than the previous dental implant type.

Different types of dental implant methods

The methods refer to how the dental implants are put in. People with weaker jaw or lesser bone density may be able to get their jaw bone augmented through a preparatory process called bone grafting. Over a few months, the transplanted bone will bone and help the jaw bone grow, making it denser and stronger to hold all types of dental implants.

Depending on the jaw bone and overall oral health of the patient, there may be dental implant alternatives that could work well in specific situations. They can be used instead of or in addition to the traditional types of dental implants. Some of the most common types of dental implant methods are:

Single tooth

This method is the best option for people looking to replace a single or a few missing teeth. The single implant is enough to fill in the gap and create a natural and seamless set of teeth.

This process entails two stages, which start a few months after tooth extraction.

For the first appointment, the post is placed into the jaw. The complete healing (osseointegration process), wherein the bone fuses with the implant, take two to five months. The osseointegration process is very important to ensure a secured and stable root for the artificial tooth.

Multiple implants for several teeth

People with several missing teeth adjacent to each other will have larger gaps in spaces in their gums. In some cases, however, this doesn’t always need a full mouth replacement. This is where multiple implants are used.

For people with several missing teeth, or a whole row of missing teeth, you don’t need individual dental implants for every missing tooth. Instead, you can have a more efficient approach called the all-on-4 and a dental bridge.

All-on-4 (or 5 or 6)

This method is used for patients who have lost all or most of their teeth due to gum disease, tooth decay, etc. It is called all-on-4, since as many as four implants are used to hold an entire set of teeth for the upper or lower jaw. Depending on the bone density, some people may get five to six screws. This method allows patients to get dental implants without the use of bone grafting by using a temporary set of teeth on the same day or soon after the procedure.

The surgical procedure is done by inserting the titanium screws into the jawbone to replace the root of the missing tooth. Once done, a crown is then connected, making a realistic and functional artificial set of teeth.

Dental bridge

A dental bridge is used to support multiple artificial teeth in a row. For example, say you have three missing teeth in a row. Your periodontist will place two implants to hold the end pieces. The crowns will then support the middle tooth using a bridge.

Immediate Load Dental Implants (a.k.a. Teeth in a Day)

Teeth in a day method is exactly what it sounds like – it allows patients to walk out of their dentists’ clinic with a full set of teeth, all without the delay of waiting for months for healing. It is a great way to get your smile (and confidence) back as soon as possible.

It is important to note though that the teeth you get from the first appointment are temporary. This means you will need to visit your dentist again as soon as the implant heals completely and your bone has made merged with the metal post for stable and strong support.

Mini implants

A less invasive method of dental implant is called mini implants. Mini dental implants have the same structure as traditional implants but smaller.

Mini implants are smaller and far narrower in terms of diameter (less than 3mm in diameter) and include a ball-shaped endure that protrudes from the jawbone. This method is typically used for people without the bone in the jaw to hold full-sized implants.

These implants are inserted using a less-invasive method. Unlike traditional implants that are placed under the gums, the tooth-pick-sized screws of mini implants are put over the gum surface when placed into the bone.

Since the placement of the mini screws is less involved, the procedure requires less time. The implants can be placed in a single visit using local anesthesia and don’t need sutures. Traditional implants require several months of healing period and require at least two appointments.

Dental implant coatings, connectors, and sizes

More and more dental supply manufacturers are making different types of dental implants, using different materials. This gives dentists and periodontists more options for finding the best type, treatment method, and specific material for their patient’s needs.

Dental implant coatings

While most implants are made of titanium, the outer surface can use various coatings.

Coatings can provide a certain level of roughness on the surface of the metal, which can assist in seamless healing and stronger fusion with the bone. A porous surface can bone better to the bone than a machined titanium surface.

Some of the surfaces options available include:

  • Grit-blasted or acid-etched roughened surface
  • Microgroove or plasma-sprayed surface
  • Plasma-sprayed hydroxyapatite coating
  • Zirconia

Zirconia is a transition metal; it’s white and ceramic in color and look, making it distinct compared to titanium and other colored metals.

Dental implant connectors

All dental implants require screws or implants to be in the jaw and attached to the abutment. The connector is what holds the titanium screw and artificial tooth together. Here are the different types of dental implant connectors.

  • Internal hex connector – this hexagon-shaped connector is used as the opening in the implant heat where the restoration/abutment is screwed.
  • External hex connector – also hexagon-shaped, this type sits atop of the implant head rather than inside.
  • Internal octagon connector – this octagon-shaped connector has its opening in the implant head where the restoration/abutment is screwed.

Dental implant sizing

Periodontists decide on implant size based on what they think their patient needs. Since each patient is different, they consider many factors, from bone availability, individual spacing, etc. There are three sizes for implants today:

  • Standard platform – shorter and narrower dental implant to match the size of the front teeth. Size ranges from 3.5mm to 4.2mm in diameter.
  • Wide platform – this size of implant is usually used on the backside of the mouth. Size ranges from 4.5mm to 6mm in diameter.
  • Mini or narrowed body – patients with enough space between their existing teeth can have a narrow or mini implant. This is also used for patients with insufficient jawbone density or as a temporary support while the larger implants heal.

The takeaway

The world of restorative dentistry has gone a long way. Dental implants today make artificial teeth virtually indistinguishable from natural teeth. Thanks to the structural and functional innovation of dental implants, missing teeth can have permanent and amazing-looking solutions.

Dr Febin Mary George - Editor

With more than 10 years as a dental surgeon, Dr Febin Mary George is passionate about educating consumers around the world to help look after their teeth.

She completed her Bachelor of Surgery at the Century Institute of Dental Science and Research Centre in 2010.

Alongside editing the International Journal of Dental Clinics she has also written for major publications including Thrive Global.