Explore Dental Implant Types & How to Choose the Best

Losing teeth is not just an aesthetic problem; it has a profound impact on a patient’s quality of life. As dentists, we understand this all too well – whether it’s a loss of ability to chew food, difficulty speaking clearly, or a loss of social confidence.

Patients often express embarrassment or discomfort due to their missing teeth, and this is where dental implants emerge as a revolutionary and most reliable restorative solution in modern dentistry. These implants don’t just fill a gap, but they make a real difference in patients’ lives by providing them with the same strength, functionality, and beauty as natural teeth.

The field of implantology is constantly evolving, and as a result, a wide and diverse range of dental implant types has become available. While this diversity provides patients with more options, as a practicing dentist, it becomes extremely important to understand how to choose the most appropriate dental implant for the patient’s best and long-term outcomes.

Does the patient need endosteal, subperiosteal, or zygomatic implants? When are mini implants suitable, and when are full-arch solutions like All-on-4 more suitable? Each of these decisions requires an in-depth assessment of the patient’s specific clinical situation, bone quality, overall health, and expectations.

We have prepared this comprehensive guide especially for committed dental professionals like you. Here, we will discuss all types of dental implants in depth, highlighting their principles, indications, benefits, and potential limitations. Our aim is to provide you with the comprehensive knowledge and clinical confidence you need to choose the best dental implant.

Also, we will provide you with insights that will help you provide the most appropriate, effective, and successful restorative solutions for your patients. Let's delve deep into this fascinating world of implantology and understand every aspect needed to make your patients' smiles shine again.

Exploring 3 Main Types of Dental Implants

In the field of implantology, you know a variety of dental implants, each designed to suit specific clinical situations and patient needs. So, let’s understand in detail the three most common and important implant types: endosteal, subperiosteal, and zygomatic implants. Understanding these types in depth will help you create the most appropriate treatment plan for your patients.

Endosteal Implants

Endosteal implants are the mainstay of modern dental implantology and are the most widely used type. The term “endosteal” means “within the bone,” which directly refers to their method of placement.

What are they, and how do they work?

Endosteal implants are typically small, screw-shaped posts made of highly biocompatible titanium metal. Through a surgical procedure, we insert these implants directly into the patient’s jawbone, in place of the tooth root. Once the implant is securely anchored in the bone, it undergoes a process called osseointegration. During this process, the implant naturally fuses with the bone, creating an incredibly strong and stable foundation.

Who needs Endosteal Implants?

These implants are ideal for patients who have sufficient healthy and satisfactory jawbone. If the patient’s jawbone density is insufficient, you may advise them to undergo bone grafting before implant placement. Bone grafting provides the required quantity and quality of bone to successfully support the implant.

Key Benefits

Exceptional Stability and Strength: Due to osseointegration, these implants provide a strong hold similar to that of a natural tooth root.

• Long-Term Success: With proper care and maintenance, endosteal implants can last a lifetime.
• Natural Experience: Patients experience the same comfort and functionality as natural teeth while chewing and speaking.

Subperiosteal Implants

Subperiosteal implants are less common than endosteal implants, but they provide a valuable alternative for patients who do not have sufficient quantity or quality of jawbone to accommodate an implant and who do not want to undergo or are not suitable for a bone grafting procedure.

What are they, and how do they work?

"Subperiosteal" means "beneath the periosteum (the top surface of the bone)." These implants are not inserted directly into the bone, but instead, we place them on the surface of the jawbone and below the gum tissue. This is a custom-made metal framework (usually made of titanium) that is designed to exactly match the shape of the patient's jaw. Small posts (pegs) protrude from this framework through the gums, onto which artificial teeth (dentures or bridges) are securely attached.

Who are the ideal patients for Subperiosteal Implants?

These types of implants are especially considered for patients who have experienced significant bone loss and do not have enough bone for traditional endosteal implant placement. They can also be a good option for patients who want to avoid the lengthy process of bone grafting.

Key Benefits

• Avoids Bone Grafting: The main benefit of this is that it eliminates the need for major bone grafting.
• Faster Treatment Time: Without bone grafting, the total treatment time can be shorter.
• Denture Stabilization: This provides excellent stability for patients wearing dentures, allowing for much less movement and greater comfort compared to regular dentures.

Zygomatic Implants

When there is severe bone loss in the upper jaw, placing traditional implants can be challenging. In such cases, zygomatic implants provide an advanced and effective solution.

What are they, and how do they work?

Zygomatic implants are significantly longer than traditional implants. Their name comes from the "zygoma", which is the cheekbone. These implants are inserted not into the upper jawbone, but into the cheekbone (zygomatic bone), which provides it with an extremely strong and stable anchor. This method often requires a surgical specialist.

Who are the ideal patients?

These implants are particularly suitable for patients who have severe bone loss (severe atrophy) in the upper jaw, and where more extensive procedures such as a sinus lift or bone grafting are not effective, or the patient does not want to undergo these procedures. They can be combined with full-arch restoration methods such as "All-on-4" or "All-on-6".

Key advantages

• Solution to severe bone loss: This method makes implant-based restorations possible even in severely damaged upper jaws.
• Avoids bone grafting: In most cases, it eliminates the need for extensive bone grafting procedures.
• Immediate functionality: In some cases, immediate loading is possible with zygomatic implants, meaning patients can receive temporary teeth shortly after implant placement.

Specialized Dental Implant Solutions

In addition to endosteal, subperiosteal, and zygomatic implants, the field of implantology and prosthetics has developed a number of specialized solutions to meet different clinical situations and patient needs. Here are some of these important and highly effective implant-based restorative methods that will enable you to help more patients and provide them with the best treatment.

Mini Dental Implants (MDIs)

Mini dental implants (MDIs) are a smaller alternative to traditional implants, which can be very beneficial in certain circumstances.

Mini implants, as the name suggests, have a smaller diameter than traditional implants, usually ranging from 1.8 mm to 2.9 mm. We insert them into the jawbone in the same way as traditional implants, but their placement procedure is often less invasive due to their smaller size. MDIs usually have a ball-shaped attachment on the top, which fits into a socket on the inside of the denture.

MDIs are especially suitable for patients whose jawbone has limited ridge width and is not large enough for traditional implants. It is most commonly used to stabilize dentures, especially lower jaw dentures. It is also a good option for patients who are looking for a less expensive and less invasive procedure, or for whom bone grafting is not possible.

Key Benefits

• Less invasive surgery: Due to the smaller size, the placement procedure is often quicker and less painful, with less recovery time.
• Improved denture stabilization: It provides a stable hold on dentures, allowing patients to eat and speak with more confidence.
• Cost-effective: MDIs are often a more affordable option compared to traditional implants.

Single-Tooth Implants

When a single tooth is missing, a single-tooth implant is the most effective and popular option for replacing a natural tooth.

In a single-tooth implant, we insert an endosteal implant (usually a titanium screw) into the jawbone at the root of the missing tooth. Once this implant has osseointegrated with the bone, a custom-made dental crown (an artificial crown that looks like a natural tooth) is attached to it via an abutment. This crown matches the color, shape, and size of the patient’s other teeth.

These implants are suitable for patients who have lost only one tooth and have healthy surrounding teeth. In this method, we do not cause any wear to the adjacent healthy teeth, which is common in traditional methods such as bridges.

Key Benefits:

• Completely independent: It does not rely on the adjacent teeth, thus maintaining their integrity.
• Natural look and feel: The crown blends in perfectly with the patient’s natural teeth and provides a natural experience when chewing and speaking.
• Bone preservation: The implant stimulates the jawbone, which prevents bone loss caused by tooth loss.

Implant-Supported Bridges or Dentures

When a patient is missing more than one tooth, implant-supported bridges or dentures provide an excellent and stable solution.

In this method, we place two or more dental implants (usually endosteal) into the jawbone, depending on the number of missing teeth. These implants then act as a support for a bridge (if several teeth are missing) or a complete denture (if an entire arch of teeth is missing). The implants hold the prosthesis firmly in place, preventing it from moving and providing maximum stability.

This type of implant is suitable for patients who have lost multiple teeth and do not want to have traditional teeth extracted for a bridge, or who have lost an entire arch of teeth and are concerned about the instability of their dentures. It offers much better functionality and comfort than traditional removable dentures.

Key Benefits

• Stability and Comfort: Implants hold the prosthesis securely, reducing discomfort when chewing, speaking, and smiling.
• Bone Conservation: Implants help prevent further bone loss, which can occur with traditional dentures.
• Improved Quality: Patients can enjoy a wider range of foods and experience a significant improvement in their quality of daily life.

All-on-4 / All-on-6 Implants

In modern implantology, All-on-4 or All-on-6 is a revolutionary solution for patients who have lost all their teeth, providing them with a complete set of new teeth in a single visit or a short period.

In this technique, we place only four (All-on-4) or six (All-on-6) dental implants in specific, strategic positions in the jawbone. These implants are placed at an angle to maximize bone availability and avoid the need for bone grafting. These implants then provide a strong and stable support for the full arch of teeth, which can be loaded immediately (if possible) or in a short period.

All-on-4/6 is best for patients who have lost most or all of their teeth in one or both jaws. It is especially beneficial for patients who are suffering from instability of their dentures and are looking for a permanent, non-removable dental option.

Key Benefits

• Fast Complete Restoration: In most cases, patients can have a full set of functioning teeth in a single day or in much less time.
• Avoids Bone Grafting: The strategic placement of implants often avoids the need for major bone grafting.
• Enhanced Quality: These permanent dentures provide significant improvements in chewing, speaking, and appearance over traditional dentures.
• Greater Confidence: Patients can smile and eat with confidence, which dramatically improves their quality of life.

How to Choose the Best Dental Implant Type?

As a dentist, you know that choosing the best dental implant is not a “one-size-fits-all” decision. It is a carefully considered decision tailored to the patient’s individual needs, clinical condition, and long-term health goals. Read this in-depth guide that will help you determine how to choose the most appropriate dental implant type for your patients.

Bone Health & Density

The quality and quantity of the jawbone are fundamental to implant success. You can accurately assess the height, width, and density of the bone using a CBCT scan. If the bone is insufficient, then there is a need for bone grafting (e.g., sinus lift, ridge augmentation). Depending on the need for bone grafting, patient preference, and healing time, you can consider options such as endosteal, subperiosteal, or even zygomatic implants.

Overall Oral Health & Medical History

A patient's comprehensive medical history and oral condition directly affect the success and choice of implants. You can review the presence of periodontal disease, uncontrolled diabetes, osteoporosis (and related medications), or conditions that affect the immune system. These factors can influence implant healing and sometimes require less invasive options, such as mini dental implants, or may limit the choice of a specific implant type.

Number of Missing Teeth & Location

The number of teeth the patient is missing and their location in the mouth will determine the type of implant-based restoration.

One tooth: A single-tooth implant (a crown on one implant) is the usual choice.

Several teeth: An implant-supported bridge (supported on two or more implants) is appropriate.

A complete set of teeth: Implant-supported dentures or All-on-4 / All-on-6 implants are used. You can choose the best option based on the patient's expectations and stability needs.

Budget & Cost Considerations

The patient’s ability to spend, as well as their aesthetic expectations, play a role in the choice of implant.

Cost: Openly discuss with the patient the total cost of the implant treatment, which depends on the type, number of implants, and additional procedures.

Material: Explain the advantages and limitations of titanium and zirconia implants, taking into account the patient’s allergies or aesthetic preferences.

Aesthetics: For the anterior teeth in particular, select the type of implant and the final restoration (crown) that provides a natural appearance and functionality.

Dentist's Expertise & Experience

The final decision depends on your clinical expertise, your experience in implantology, and your relationship with the patient. You can inform the patient about the best options available, answer their questions, and provide examples of successful cases from your clinic. This will allow the patient to fully trust your decision and agree to the treatment.

By comprehensively evaluating these factors, you, as a dentist, will be able to choose the best dental implant type for your patients, which will provide them with a long-lasting and confident smile.

Conclusion

As a dentist, you have gained a deep understanding of all the types of dental implants and how to choose the best dental implant through this comprehensive guide. We have seen how vast the field of implantology is and how many different solutions are available to meet the unique needs of each patient. Your clinical knowledge, ability to assess bone health, and understanding of the patient’s overall health will help you choose the best dental implant for them.

Remember, every implant case is an individual journey. You guide the patient through this journey with confidence, communicating transparently with them about their budget, lifestyle, and aesthetic expectations. Your expertise and experience are what earn the patient’s trust and ensure successful outcomes. With your knowledge and care, you can provide the best implant solution for each patient, giving them a long-lasting, healthy, and beautiful smile.