Making IMPLANT PLACEMENT A REALITY
Ongoing innovation in implant design, surface chemistry, and delivery methods creates a window of opportunity for clinicians to treat more patients and, in the process, build stronger practices
It’s estimated that around 3 million people in the U.S. have dental implants, and another 500,000 implants are placed by dentists, oral surgeons, and implantologists every year. An increasing patient demand for implants, coupled with a growing aging and edentulous population, puts clinicians in a unique position to meet the needs of more patients and, in the process, expand their practice offerings and profitability.
Patients with missing teeth have historically relied on bridgework or dentures to preserve their dental function. But because of difficulty flossing them, bridges can fail as early as 5 years in—making root surfaces below and around the restoration susceptible to decay and further tooth loss. Implants can be a more sensible option for these patients because they preserve the jawbone, will not decay, and function like natural teeth.
Technology Expands Treatment
An influx of technology such as 3D imaging and printing, digital impression-taking, and advanced planning software has simplified treatment planning for implants and, as a result, made implant surgery extremely accurate and predictable. According to the American Academy of Implant Dentistry, computer-guided dental implant surgery has a success rate of 97%. That said, patients with anatomical or financial challenges, including those who lack sufficient bone structure for successful implant placement, may be left out of the implant conversation entirely.
Manufacturers have responded to this challenge with extensive research and development into implants that are shorter and narrower than traditional options, which significantly expands the range of treatment to patients with poor bone quality, resorbed mandibles, or who would otherwise need extensive bone grafting or ridge augmentation procedures. This, along with ongoing innovations in implant surface technology, creates an opportunity for clinicians to treat more individuals who may have previously been deemed poor candidates for implant therapy.
In other words, with the right tools and training, placing implants in-house can become a reality for any clinician. There’s no shortage of implant systems on the market that are designed for both the ideal and nonideal implant patient.
Here's a snapshot of what's available:
Featuring high primary stability, Nobel Biocare’s NobelActive implant is an ideal choice for demanding indications and protocols, such as immediate implant placement in soft bone or extraction sockets. Its expanding tapered body condenses bone gradually, while an apex with drilling blades enables a smaller osteotomy. NobelActive implants feature a unique oxidized TiUnite surface that encourages fast bone formation and long-term implant success.
Featuring an osteoconductive midsection that is structurally similar to cancellous bone, Zimmer Biomet’s Trabecular Metal Dental Implants are made from elemental tantalum and fabricated using a proprietary vapor deposition process. The implant’s 100% open, engineered, and interconnected pore structure supports bony in-growth and vascularization.
Ritter Implants’ Ri-Quadro Spiral implants are designed for soft bone, immediate implantation, and immediate loading. 
They allow for excellent primary stability and can be inserted into smaller-sized preparations. Ri-Quadro Spiral implants can be adjusted during placement in any region—anterior, posterior, upper, or lower jaw.
Straumann BLX implants are manufactured with Swiss precision and Roxolid material, a high-performance alloy with high tensile strength and excellent osseointegration capabilities. The implants are designed for immediate protocols in all bone types and feature one connection and undercontoured prosthetics to deliver esthetics with ease.
Hiossen’s ETIII NH Implant features a bioresorbable apatite nanocoating on its surface that improves bone-to-implant contact and increases osseointegration by over 30%. The super-hydrophilic dry implant also features a corkscrew thread for powerful self-threading, helix cutting edge for enhanced stability, and an innovative design for improved secondary attachment force.
Dentsply Sirona’s new Astra Tech Implant EV features a revised design with a deeper implant thread design apically and a flexible drilling protocol, which make it easier to reach preferred primary stability, as well as enhanced handling capabilities for easy installation. A variety of sizes and lengths—as well as straight, profiled, and conical designs—make early and immediate loading possible.
The Azento system, also from Dentsply Sirona, simplifies single-tooth replacement by providing clinicians with everything needed for their digital implant workflow—a custom treatment plan that includes surgical guides, instruments, drills, a case-specific Astra Tech Implant System or Xive implant, an Atlantis custom healing abutment, and an optimal temporary restoration.
Smaller Size, Bigger Opportunities
As the population of aging adults in the United States steadily increases, clinicians are finding themselves treating an increased number of patients with severely resorbed mandibles, limited available bone, or poor bone quality. While in the past, these patients might never have been considered candidates for implant therapy, recent innovations in implant technology have bent the rules in these patients’ favor.
Short and mini implants that are designed with smaller diameters, shorter lengths, and higher crown-to-implant ratios expand the realm of possibilities for treating these nonideal patients—giving clinicians the opportunity to provide predictable and esthetic results to a greater number of individuals. Here’s a look at some of the latest innovations in short and mini implants.
At 4 mm in length, the Straumann Standard Plus Short (SPS) Implant is the shortest screw-type implant with internal connection on the market. It is indicated for fixed or removable dental restorations in patients with severely resorbed jaw bones. The SPS Implant features Straumann’s SLActive surface technology, which is designed to deliver safer and faster treatment in 3 to 4 weeks for all indications.
The Bicon SHORT Implant features a plateau design that offers at least 30% more surface area than a similarly sized screw implant—allowing for the callus formation of mature, cortical-like bone between the fi n of the implant.
Available in a variety of dimensions, the implant can be placed in edentulous sites where there is minimal bone height to avoid the cost and morbidity of bone-grafting procedures.
Zimmer Biomet’s T3 Short Implants provide a tight implant-to-osteotomy fit to assist with primary stability, as well as platform switching to medialize the implant/abutment junction and maintain bone levels. They are ideal for use in cases where bone height is insufficient for standard length implants that would require complex surgical procedures like a sinus lift or vertical ridge augmentation.
Featuring a slightly tapered body and tapered apex, Nobel Biocare’s NobelSpeedy Shorty is designed to maximize primary stability, while its extra-short design makes it ideal for use in sites with limited bone. The time-efficient implant requires a short drilling protocol that reduces chair time, while a unique TiUnite surface with grooves encourages fast bone formation.
Available in 2.5-mm diameter and various lengths, the Shatkin One Piece Mini Implant by Shatkin F.I.R.S.T. features a blossom thread design at the apical portion and microthreads at the abutment end. It incorporates a one-piece tapered abutment with platform switching to promote bone healing and long-term bone stability, as well as an Ossean surface for faster osseointegration.
Hiossen Implants’ ETIII 3.2 Implant offers a strong, mini-solution when a fixture with a smaller diameter is needed. In addition to its smaller size, the implant system features earlier loading times—as early as 6 weeks after implant placement—and a self-sealing, 11° Morse taper connection offers built-in platform switching.