What is the best dental implant

hi everyone so in this video we're going to talk about what is the best dental implant so if you've been thinking about dental implant treatment you probably found out that there's a whole bunch of different varieties and different brand names available and what's the difference which one's the best wires are the best why do some cost more than others so when we're thinking about dental implant treatment there's a couple of things that we can kind of almost take for granted the first is if you've got missing teeth then dental implant treatment is probably the gold standard treatment when it comes to replacing missing teeth so what I mean by this is it's the closest thing to giving you your natural teeth back now I understand that in some people dental implant treatment may not be the best treatment available to them but if we're just looking at the laws of averages for the vast majority of people dental implant treatment does seem to be the best treatment the second thing about dental implant treatment which is a big misconception is that people think dental implants are forever the truth is that everything has a lifespan any dental treatment has a lifespan natural teeth have a lifespan so if you take care of your natural teeth perfectly from the day that you got them to whenever you probably won't even ever be looking at a video like this but if you've lost in your natural teeth then you'll understand that even natural teeth have a lifespan as do implants if you take care of dental implants they will last much longer than if you don't clean them or if you're using them kind of too heavily if that makes sense so dental implants are susceptible to heavy bite forces the third thing about dental implants which I'm sure you would have figured out by now is that they are expensive they're probably the most expensive thing you could have done at the dentist so taking all of this into account let's assume for a second that you're not shopping purely on price if you are then the differences between the dental implants doesn't really matter you just always go with a cheaper surgeon with the cheapest implant right now being a dentist I would definitely encourage you not to do this but at the end of day so it's a personal choice now when it comes to dental implants how much variation can you get in a screw I mean essentially that's all it is right you're putting a screw in the bone it gets fixed into the bone and that's it so why does it matter that one is slightly different to the other let's take it let's take a slightly deeper dive into this because I used to think exactly the same and therefore I all think you know what it's titanium everything sticks everything works now there's three different levels of implants okay so I don't mean like price points or anything like that I mean when you put the implant into the bone it can either be a little bit underneath the bone we call this sub crystal and it can be finished at the bone level which is bone level or we can have it finishing epoch gum the advantage of the gum ones or the tissue level implants is that there's one continuous piece of metal all the way down to the bottom there's no area where bacteria can seep in it's not that this is a more friendly dental implant to the soft tissues to the gums and it also helps reduce kind of bone loss around the neck of the implant the downside is is not the most aesthetic implant so the way that the tooth eventually comes out of the gum is a little bit kind of controlled by the position of this this collar of implant coming up so in aesthetic zones ie the front of the mouth where the junction between the tooth and the gum is really important I wouldn't really recommend this kind of implant I'd recommend either the bone level implant or the sub crystal implant now both of these two implants have their own advantages bone level implants are quite easy to to work on the sub crystal implants usually have something called a platform shift so the the abutment which screws directly into the implant is a bit more narrow than the implant itself and this takes the junction of the the implant reverse of the apartment in the area where bacteria can sitting and be away from the bone and again it helps preserve the bone around the implant now this is just one tiny design feature let's have a look at the whole implant itself there's a whole different number of shapes of dental implants one shape is the parallel sided implant so this is the kind of traditional implants shape you can make a hole and the implant fits directly into that now this is great if you've got really solid hard bone but what have you got soft bone we then have tapered implants and tapered implants are really cool because they're kind of like a v-shape you make a little hole and as you're tightening the implants in what it does it pushes the bone out sideways it compresses the bone and increase there's something called initial stability of the implant this is how tied the implant is held into the bone has it's placed in and when we're placing the implant we use a either a ratchet or a gauge built into the drill to measure how much torque there is going in okay so what I mean is how tight the implant is engaging into the bone and we want this torque value to be relatively high most people will aim for somewhere between 30 to 60 Newton centimeters of torque which is pretty tight you can't get that just using hand instruments you'd have to use either a ratchet or a or a handpiece to to get the implant in now if you've got very soft bone and we've got parallel sided implant it's very difficult to get that kind of torque so that's when and kind of a v-shaped or a conical implant is much more advantageous another thing we could look at is the actual threads on the implant you could have a rectangular cross-section of thread which is which is great it works nicely it compresses the bone a little bit and also a lot of implants have it so that the pitch of the threads the distance between each thread gets smaller and smaller as you go up the implants so as you're tightening this thing in the the pitch is compressing is compressing the bone helping to increase the primary stability which we know is linked to the success of the implant and conversely if we've got very hard bone we can use an implant which has got more of a triangular shape pitch to the the thread and what this does this cuts into the hard bone rather than trying to compress it so by now I think you can idea you know that there's a lot of different variations on the the implants all helping in different situations and we just talking about the employee haven't even talked about the the surface where the virus acid-etched whether it's a titanium surface whether it's titanium oxide whether it's has a negative or a positive charge and that attracts or repels oxygen which improves healing so all of these factors different implant companies have different surfaces different types of implants it's impossible to know which is the best one and really the question on what is the best implant is kind of useless because certain implants are better in certain situations whereas others are better in other situations about 15-20 years ago when implant dentistry was still in his kind of early days what we used to try and do was when the tooth was out we just put the implant wherever there was bone and the kind of protocol for this was they had a tooth which needed to be removed you'd remove the tooth wait three to six months let the bone heal see what you're left with if you need to do a bone graft you do a bone graft then you put the implant in after the bone graft has healed and then you put the tooth on top of that this could be a six to 12-month project by the time you're through with it so we've done a lot to help improve the the treatment times to really cut this treatment time down and still allow adequate healing what we do is we try and get as much done in in one kind of go so let's say you have a tooth which needs to be removed as long as there's no really bad infection around this tooth it's possible to remove the tooth and preserve as much bone as possible we then pack the bone grafting material into the socket and we engage in the bone around the socket with the implant now what we're doing here is we're putting an in in the hole where the teeth came out of so already we've got less bone so this is when the individual implant features become really important because if you've got an implant which has got a very aggressive thread design it's going to engage in the little bit of bone that you've got and we're going to get that initial stability of the implant which remember is linked to the success this is this is what we want especially imagine on an all on four case where you've got four implants going in four or six implants however many you want them to all be as tight as possible so that everything is linked and everything is successful so that's when individual think individual designs of implants do become important and the quality of the bone I would use a different implant in kind of what are called standard quality bone and then if we've got a really soft bone there's my other preference for the implant for soft bone which is got a lot of design features designed to get maximum stability in really soft bone so this whole emphasis on driving down the treatment time is really very patient driven it's it's because these days nobody wants to have an Instagram selfie with a missing tooth everybody wants to have Tim pretty fair or something to fill the gap as quickly as possible and the the kind of more up-to-date dentists kind of think about this and they understand this which is why we try and give template a fixed template teeth in as many situations as as we possibly can if you speak to a lot of dentists they will categorize dental implants into kind of three categories based on the cost of these these implants so you've got your your premium brands like Stralman nobel biocare astra and cos all these kind of brands which are the most expensive dentists to buy in and ultimately cost the most for our patients so that's one kind of way of categorizing it then you've got your mid-range implants which cost a bit less and then you've got your entry-level implants which I wouldn't touch with a bargepole they they are just a nightmare you don't want to have the wrong implant from the beginning because it's going to cause you problems all the way down the line the mid-range implant are a lot of them are pretty decent to be honest and I mean this way of categorizing implants is okay but doesn't really help anyone I try and look at each individual patient and the situation and what I'm trying to replace the kind of timescales were working with and then I advise the best kind of implants for that situation now doing this about 80% of the implants that place are either Stroman dental implants or a company which is owned by Strom and the reason I've kind of got a little bit of an allegiance with this company is because it is a good quality company the implants are excellent quality all the abutments all the bits that go into the implants excellent quality and you can you can feel the difference I can feel the difference as a dentist as a patient you probably won't know the difference but if I was a patient I would want to know that I've got a premium brand dental implant in in my head if if that's what I needed now straumann do have all of these variations in their implant design or they've got the vast majority there which is why about 20% of the implants I use a non straumann but it's it's nice to have the ability to choose the exact design of implant for every single situation it just means that my patients are getting why I genuinely think is the best solution for the individual treatment needs another reason I like a big company like straumann is that they I do some implant work for my patient and five years down the line they move abroad and then they have a tooth which I is on an implant and the tooth breaks and they need to replace that tooth if it's a well known company it's going to be really easy for that dentist to find the the component you know I've got all the information about the dental implant which was used Stram ins a global company they can easily get all the components they need to put a new tooth on that implant a couple of years ago I had a patient come to see me and he had had dental implant work done in India it was super cheap and now he was in my chair about ten years after the work was carried out and it was all falling to pieces one of the implants have actually come out completely and I think about almost about 3/4 of the top teeth needed to be replaced and he had one implant which was still quite firm but that implant was a really cheap quality implant and it turns out that being in the UK I wasn't able to order the components for that implant in India because they just didn't ship to the UK although they didn't even sell to the UK they wouldn't even let me open an account not only that but because it was such a limited implant system it didn't have the choice of abutments which go into the implant system so it was not suitable for making a full bridge which is what this patient needed it was really more suited to just doing single teeth so now this implant which was placed and the implant itself is still fine is completely useless because of the limitations of the implant system now for this patient we ended up placing three implants elsewhere and we're in the process of making a brand new bridge but I just want to tell you that story just to give it a little bit of emphasis to show you that a good quality system has almost future-proofing you can do more stuff with it it's not limited and if you think you know you're saving a couple of pounds by having the treatment done cheaply having a lower level implant place it can actually add a lot of complexity later down the line you just don't know in my opinion it's worth spending a little bit more to get a good quality dental implant placed so in short there is no such thing as the best dental implant there are a whole bunch of really good dental implants available a lot of it will depend on the kind of knowledge of the surgeon who you're choosing to have to do this treatment for you have the conversation find out what the best implant is in your case yeah quite often for my patients if I don't know what the best implant is I'll have two or three ordered and ready to go on the side and once we start surgery I'll get a feel of the boat and I'll know exactly what's what's going to be the best implant for for my patient there so I hope you found this useful if you did give it a thumbs up give it a like it helps other people find the video if you got any questions or comments you can just pop them below take care

Channel: Dr Gurs Sehmi

Views: 28,831

Rating: 4.9395604 out of 5

Keywords: Dental Implants, Cosmetic Dentist, Implant Dentist, Best Implant Dentist, Best Dental Implant, Dental Implant Surgery

Id: bupQmr4HXK0

Length: 15min 34sec (934 seconds)

Published: Fri Jul 19 2019