The initial treatment plan for dental implants should include the ideal implant size, based primarily on biomechanical and esthetic considerations. In traditional prosthetics, when a tooth is replaced, abutment teeth are already provided by nature with wide posterior abutments for posterior teeth. When teeth are replaced with dental implants, the implant team should preselect the ideal abutment size, based on the ideal size for an esthetic restoration within biomechanical guidelines.
The size of a dental implant used to be determined primarily by the existing bone volume in height, width, and length. The surgeon would select longer implants in the anterior regions of the mouth and shorter ones in the posterior areas because of the limits of the mandibular canal and maxillary sinus. The width of the implant, also determined at surgery, would relate to the existing width of available bone, and one diameter (4 mm) implant would be used in most all situations.
Over the years, dental implant treatment plans incorporating biomechanics have been advocated to decrease the most common complications—those related to stress. The prosthesis first is planned, including whether the restoration is fixed or removable, how many teeth are replaced, and the esthetic demands. The patient force factors are then considered to evaluate the magnitude and type of force applied to the restoration. The bone density is evaluated in the regions of the potential implant placement.
The key implant positions and the implant number are then selected in relation to the patient force factors and the bone density in the implant sites. The next consideration in this ideal treatment plan sequence is the implant size. Dental implants function to transfer loads to surrounding biological tissues. Biomechanical load management is dependent on two factors: the character of the applied force and the functional surface area over which the load is dissipated.
The implant size affects the functional surface area that distributes a load transferred through the prosthesis. A comprehensive approach to the overall dental implant size begins with the identification of clinical problems to be addressed. Fundamental scientific principles related to force and surface area are then combined with engineering principles to pursue the desired clinical goals. Esthetic guidelines are also a part of the evaluation.
What are the main reasons for dental implant failure?
The presence of fibrous tissue has long been known to decrease the long-term survival of a root form implant. Excessive loads on an osseointegrated implant may result in mobility of the supporting device, even after a favorable bone-implant interface has been obtained. Although several conditions may cause crestal bone loss, one of these may be prosthetic overload. Excessive loads on the bone result in increased strain conditions in the bone. These strains on the bone may affect the bone remodeling rate and cause overload, which results in the loss of bone. The amount of bone strain is directly related to the amount of stress applied to the implant-bone interface. The greater the stresses throughout the implant-bone interface, the greater the risk factor for crestal bone loss and subsequent implant failure. Therefore, the stress and strain relationship has been shown to be an important parameter for crestal bone maintenance and implant survival.
The ideal size of the implant body should be incorporated into a treatment plan, rather than the surgeon determining this dimension at the time of surgery. The initial size of an implant is determined in both length and diameter. In a two-stage healing protocol, the ideal implant length should be 12 mm to 16 mm. The softer the bone, the longer the implant requirements. The greater the bite force, the longer the implant dimension. The diameter of the implant is also an important part of an ideal treatment plan. The diameter of an implant has a surgical, loading, and prosthetic consideration. In the initial treatment plan, the loading and prosthetic components are most important. The width of the implant is directly related to the overall functional surface area.
As a general rule, the narrowest implant is found in the anterior mandible, followed by the anterior maxilla and the posterior mandible; the widest diameter requirements are found in the molar region of the posterior maxilla. The prosthetic aspects of the implant width are primarily related to the esthetics of the emergence profile, the force on an abutment screw and the strength of the implant components.
As a result, wider diameter implants are selected in the molar regions; standard diameters in the canines, premolars, and maxillary central incisors; and the smallest size implants in the maxillary lateral and mandibular incisors. The natural dentition follows the guidelines established in the implant size treatment plan consideration. The correlation is most likely found because of the biomechanical relationship of the amount and type of the forces in the location of the jaws and the type of the bone in the region. These guidelines are consistent when engineering principles determine tooth size.
When you consider whom to choose for having an implant procedure, choice of dentist is critical. Do not fear to ask about training and specialized experience of the dentist. Your Omega Dental Specialists will keep you informed of how implant size determination will be made in your individual case to achieve the most optimal outcome.
What are my financing options for My dental implants?
Insurance often covers some costs related to implants. Our team can help organize payment arrangements or in finding financing options. We have occasional special deals on our web page, so please check often to view options.
About Omega Dental
With our variety of dental specialists under one roof, Omega Dental Specialists Houston provides patients with treatment options for any need. Our dedicated staff is experienced in several specialty divisions, including Endodontics, Pediatric Dentistry (Pedodontics), Dental Implants and Orthodontics. Our technologically advanced office is equipped with some of the most modern instruments and machinery available in dentistry. Omega Dental is open seven days a week to help you to take care of your oral health no matter what your busy schedule.