Implant Placement: A Quick Scan of the Basics

Dental implants are becoming an increasingly popular choice for those outliving their teeth. In fact, the global dental implant market, valued at $3.77 billion in 2016, is expected to increase at a compound annual growth rate of 7.7% into 2024.¹

When a tooth can’t be saved via root canal treatment, the next best thing for many people is an endosseous implant, which can, for the most part, pass for the real thing. And, unlike removable prosthetics, they don’t come loose at inopportune times or require an overnight soak in a glass.

Prep and Impressioning

Once a tooth has been extracted, the site may be allowed to heal or immediately prepared for an implant. In any case, subsequent to soft tissue reflection, successively larger drill bits are used to create a space in bone for the implant abutment. In some instances, alveolar bone tissue must be removed, reduced, smoothed or recontoured to secure a better fit. In other cases, bone tissue must be added through grafting. Sometimes, due to spatial constraints in the upper jaw, a sinus lift may be indicated to make room for more bone.² 

To capture the landscape of the prepared implant site, traditional or digital impressions must be taken either at the implant or abutment level. Traditional impressions can be taken with conventional materials and either an open-tray or closed-tray technique, and then shipped to the lab for prosthetic fabrication.³

Digital impressions can be taken via an intraoral scanner, through which a series of point-and-click stills or videos record anatomy. These can be stitched together into a final, seamless impression. If a spot is missed, digital methods allow it to simply be rescanned, unlike analog impressions, which, if a flaw is discovered, must be entirely redone.³

Planning Ahead

Digital methods allow guided surgery, in which procedures can be planned long in advance. Digital scans can be used to virtually map out a procedure before it happens. This includes the use of scan bodies, fiducial markers and the fabrication of stents, which serve as drill guides, or templates, for drilling and incisions.³

Digital technology also facilitates the emerging use of robotic surgery for osteotomy precision,⁴ and allows practitioners to use software and milling, in-house if so desired, to design and fabricate prosthetics, including surgical guides, with the help of a cone beam computed tomography scan for three-dimensional planning. The benefits of digital impressioning include enhanced patient comfort, efficiency, and dead-on accuracy.^3,4

Regardless of which techniques are employed, when performing implant procedures, many clinicians report that a good isolation system such as Isolite 3 helps in myriad ways. Not only does it excel in keeping the area clean, but it increases efficiency, which speeds the process. It also quietly takes care of evacuation and retraction, freeing up assistants to attend to other aspects of the procedure. And thanks to the mouthpiece’s ability to act as a throat shield, there are no worries about tiny implant pins or other parts being aspirated or ingested. The end result is less stress for all involved.

The permanence of implants is a far cry from what many regard as the hassle of removable prosthetics such as dentures. And with the right preparations, clinicians can give their patients a relatively stress-free experience and dentition they can be proud of.

REFERENCES

1. Grand View Research. Dental Implants Market Size, Share and Trends Analysis Report By Product (Titanium Implants, Zirconium Implants), By Region (North America, Europe, Asia Pacific, Latin America, MEA), and Segment Forecasts, 2018-2024. 2016. Available at: https://www.grandviewresearch.com/industry-analysis/dental-implants-market. Accessed on February 20, 2019.
2. Stone R. Cutting remarks. Mentor. 2017; 8(3):20–22,24.
3. Stone R. Copy right. Mentor. 2018; 9(4):24–28.
4. Ludlow M. Digital workflow for implant dentistry. Decisions in Dentistry. 2017;3(7):13–17.