Replacing missing teeth with dental implants is a special interest of Dr Milisha Chotai at Newnham Dental Practice, we have therefore compiled a frequently asked questions section specifically to help people interested in dental implants.
What are the different types of dental implants?
There are three types of dental implants:
- Endosteal implants. These are the most commonly used dental implants and attached directly to the bone in your jaw, recreating the natural tooth root.
- Zygomatic Implants. Used far less frequently but in situations where the patient needs and upper jaw dental implant but does not have enough bone in the jaw. Implants are used which connect to the zygomatic bone (cheekbone). This is a complex procedure and not commonly undertaken.
- Subperiosteal implants. This was the original type of dental implant prior to the full understanding of osteo integration (the process by which the dental implant integrates into the bone). With subperiosteal implants the dental implants sits on top of the bone but underneath the gum, popping through the gum is then the replacement tooth. From the patients perspective you would not see any difference between an endosteal or subperiosteal implant, it is simply the difference by which a dental implant is fixed in which separates these two types.
Once the initial decision about the type of dental implant to be used is made (95% of the time this will be endosteal implants) a decision about the implant specifics with regards to its design and manufacturer can then be made.
2 further types of implants
Just to complicate things a little further each of the above is a way of attaching the implant into the mouth, another way of classifying them is to look at how the implant connects to the final restoration.
Implants can either be:
- Screw retained.
This is not normally an option offered to the patient, your dentist will typically decide on the best way to fix the new restoration onto the implant. It will either be screwed on, in which case there will be a little screw hole in the biting surface of the tooth, or it will be permanently bonded on with a dental cement.
Screw retained crowns/bridges and dentures can be easily removed by the dentist for routine maintenance, cemented implants, because they are permanently bonded on cannot be removed for this type of maintenance and for this reason it’s even more important that you look after your dental implant as well is a natural tooth.
Implant width and length
The dental implants themselves also vary extremely in width and length.
This is to allow for different bone densities and depths. If there is not much bone then a dental implant dentist may choose to use a shorter but wider implant in order to gain as much surface area contact with the bone as possible, they may also opt for grafting. Of course, a wider implant cannot fit into a small space, for example in a lower single tooth replacement.
The balance is always to achieve the best stability in the bone whilst having the best aesthetic result for you, the patient.
How to choose which type of implant to have
The best way to choose the right type of dental implant is to explain your desired outcomes to your dental implant dentist. The dentist can then listen to your concerns and make design plans based on what you want to achieve. You might like to think about:
- If you have many teeth to replace, would you be happy with a denture which is removable?
- Would you be happy with small screw access holes on the biting surface of the back teeth?
- Is your oral hygiene excellent? If not then you may need to consider a removable appliance which can be cleaned outside of your mouth.
- How concerned are you with the aesthetic look of the final restoration? Or are you more concerned about functionality?
- Are you committed to the entire process, dental implants can often take 6 to 8 months to complete and you need to be prepared to commit for the whole time.
Some types of implants are quicker, others more aesthetic, others more suitable to having removable appliances… Based upon all of your considerations your implant dentist within be able to make suggestions tailored to your own requirements.