How does a dentist choose an implant?
Not all implants are the same. There are thousands of brands on the market now. However, because implants have been used for decades and our administrative drug body, the TGA, oversees the quality of implants sold in Australia, most brands perform very well and are of the highest quality.
However, how a dentist chooses an implant goes beyond brand name. The biggest factor a dentist considers when choosing an implant to place is the size of the implant.
Missing teeth at the front of the mouth usually leave a narrower space, which is why dentists often use a narrow platform implant, up to 3.5mm in diameter. Generally speaking, wider implants can bear more chewing forces and last longer, but because you don’t do much chewing with your front teeth, a narrow platform can be used and often looks much more aesthetic in the smile zone.
Narrower implants do exist, often called mini-implants, but they should never be used as a permanent solution, only as a temporary option or during orthodontic treatment.
The premolar teeth, the ones next to your canines, are often replaced using regular platform implants, approximately 4mm in diameter. Wide enough to stand the additional chewing forces, but narrow enough to fit in these smaller gaps and be aesthetic, it’s the perfect size.
Molars are the teeth we use most for chewing, and therefore we use the widest platform possible for the space. Research shows these wide platform implants are the best for longevity of the implant.
Length is also a factor. The ideal implant length for individual implants is 12mm, but they can often be a little shorter, more in the 8-10mm range, depending on how much bone is available and where the sinuses lay. Nothing shorter than 8mm is recommended for permanent teeth replacement, however.
When replacing all the teeth with a fixed bridge, such as All-On-4™treatment, implants can be much, much longer, even double the length of individual implants. Because the implants are supporting a whole bridge of teeth and not just a single crown, we need as much anchorage as possible to keep the teeth sturdy while eating, sleeping, etc.