As the multibillion-dollar market for dental implants grows, many new companies are entering the market. Each company offers implants with different surface textures, connections, components, and sizes. The diversity of situations for clinicians placing implants mandates that different sized implants be made available.
This month’s Implants Today topic is narrow-body dental implants. As the multibillion-dollar market for dental implants grows, many new companies are entering the market worldwide. Each company offers implants with different surface textures, connections, components, and sizes. The diversity of situations for clinicians placing implants mandates that different sized implants be made available. Patients vary in the height, width, and density of available bone required to place implants. Each size of an implant, in relation to the height and width, has a direct relationship to the components, connections, and surface textures, so there is a great deal of biomechanical engineering involved in the design and manufacturing process for an implant to be successful. All the fundamental design principles that the late Dr. Carl Misch used to speak and write about sum up what is needed to create a successful dental implant. When a doctor chooses to use an implant, the reasoning behind the design should be considered, and one must make sure the prosthetic components that are attached to the implant are available from the manufacturer. This is also true for high-tech reasons such as scanning jigs and Implant Stability Quotient (ISQ) scale readings with an Osstell meter, for example.
Choosing the correct size implant to treat edentulous areas requires a knowledge of hard- and soft-tissue biology, emergence profiles, and how this all relates to implant design. The advantage of narrow-body implants is that the needed spacing of 3.0 to 4.0 mm between implants, and 2.0 to 3.0 mm between teeth, can be obtained more easily with these available implant size options. The spacing of implants is one of the key principles for clinical success due to bone needing adequate vascularity to survive. Once bone is lost, so is the surrounding tissue with all the negative aesthetic and functional problems associated with that tissue loss.
The emergence profile around the implant must be considered, as well as its biomechanical strength. When replacing a molar, if the space is wide, an implant that is narrow might create a poor emergence profile, like a lollipop on a stick. In a full-arch case, I have used 3.4-mm implants in between 3.8-mm and 4.0-mm implants, but not to support the entire arch by themselves.
In our Implants Today section this month, we have 2 great articles related to narrow-body implants. Dr. Todd Shatkin et al’s “A Mini Dental Implant Alternative to All-on-Four” shows an alternative option to larger body implants using mini implants with a clinical protocol that has worked well for many clinicians. The article by Dr. Ahmad Soolari et al focuses on the correct use of a narrow-body implant to fill a lower mandibular edentulous space in a unique manner that fit the clinical situation at hand.
If you have any questions or comments about this topic, or any other subject presented in Implants Today, feel free to contact Dr. Tischler at mt@tischlerdental.com.
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Tribute to Carl E. Misch, DDS, MDS, PhD (hc)
