Since their advent in the 1960s, dental implants have provided a solid and permanent solution to natural teeth replacement. While they have a 97% success rate and are the preferred treatment option for many, there are occasions where complications may arise. These can, however, be mitigated by understanding the design features that determine the success or failure of a dental implant. Here are four osseointegration aspects that you should discuss with your dentist beforehand.
Implant Geometry
The shape of an implant can either be parallel or tapered. Tapered-shaped implants offer more stability compared to their counterparts. The stability of the tapered shape is attributed to the compression forces that increase the sturdiness of the interfacial bone. Although tapered implants require more torque to screw into place, this inadvertently translates to more stability and shorter installation time. As far as the shape and geometry are concerned, tapered implants offer more in terms of durability.
Macrostructure
The macrostructure of an implant is important in interfacial stress distribution and attachment to the surrounding bone. The surface of the implant can either be threaded or non- threaded. The threaded implant is the more preferred option because it generally results in a better attachment outcome.
Features such as thread thickness, pitch, face angle, lead, and depth affect the functionality of the implant, and there are predominantly five types of threaded implants used in dentistry today. The spiral, buttress, v-shaped, square, and reverse buttress thread types are created so that they distribute the interfacial stresses differently. Clinicians are therefore advised to pick a macro design that offers long term support and higher chances of success after the assessment of a patient.
Microstructure (Surface Texture)
While the microstructure undoubtedly plays an important role in force distribution and implant stability, the microstructure is just as important in biocompatibility and achieving osseointegration. The microstructure involves aspects such as the materials and surface morphology of the implants. A rough surface texture provides more surface area and has also shown to provide better grounds for osseointegration and healing of the peri-implant tissue. To achieve the rough surface, a variety of methods exist including, machining, plasma spraying, grit blasting, acid etching, and laser treatment. While a rougher surface heals faster, it's important to note that it encourages plaque accumulation in the oral environment.
Implant Length and Diameter
Implant length is measured from the top surface to the apex. The stability of an implant relies on the contact between the implant and bone, and the length is vital to achieving this. Studies have shown that shorter implants fail more often, but implant stability is not proportional to the increase in length. Implant diameter, on the other hand, is measured from one end of the crest to the opposite side at the widest point. The implant diameter is integral in implant success and the ability to withstand the occlusal load. When determining the implant diameter, dentists should pay attention to the bone quality and edentulous space.
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