Penam Periodontics - Evidence based Personalized Periodontics

The Ideal Dental Implant.

There is considerable debate about which implant or implant system is the best. However the scientific evidence allows us to draw some conclusions regarding several of the factors. The ideal implant should have the following characteristics:

  1. It should have a conical connection and not an external hex connection. The conical connection reduces the possibility of bacterial contamination of the implant/abutment interface thereby reducing the number of biological complications. It also reduces the risk rates for screw loosening and screw fracture as the forces are applied to the implant from the abutment and not principally to the screw as is seen in external hex connections. The data on the external hex implant survival and complications rates indicate an increased risk of biological complications. Platform switched implants use this conical connect mechanism.
  2. It should be retrievable. If there are issues with the prosthetic components than they can be removed and replaced or adjusted. Retrievable implants also facilitate the maintenance of the implant. Cementation of the prosthetic components to the implant abutment was originally developed as a result of the screw fracture issues with the early external hex implants. Cementation of the prosthetic units should be kept to a minimum as excess cement is associated with an increased risk of peri-implantitis.
  3. The surfaces should be slightly roughened and not polished smooth or excessively rough. The excessively rough surfaced implants seem to have higher bacterial contamination rates and more rapid implant bone loss. A polish surface for a tissue level implant would seem essential as it will reduce bacterial adherence.
  4. The prosthetic units should be highly cleanable by the patient. Failure to design prosthetic units to be cleanable will increase the risk of the development of peri-implant biological complications, especially in patient who have periodontitis, smokes or has a systemic disease such as diabetes. Use of good abutment designs will reduce the possibilities of these events. Using ridge lap designs should be only used where the superstructure can be removed as many of these designs cannot be cleaned by the patient.
  5. Implant placement should be in the ideal position for prosthetic outcomes. If this is not done than complex abutment prosthetic arrangements are required which not only increase the cost but also the complication rates. This may lead to the use of cross pinned prosthetic unit placement and cementation and it related issues. Cross pinned units are not able to be sealed well and therefore increase the risk of biological complications.

We welcome suggestions for other as to what may be the ideal implant.

© Penam Investments Pty Ltd 2020

Translate This Page