Building a good foundation – Mark Croft myplantFeatured Products Promotional Features
Posted by: The Probe 18th December 2019
There are myriad factors that can impact the success of dental implant placement. Even the smallest design detail of an implant can make a difference, whether this is the choice of material, the shape or even the level it is placed within the bone.
One thing that is generally agreed however, is that achieving primary stability is one of the most important aspects of placement.[i] As such, clinicians should be aware of why this aspect of implant placement is so important and be able to identify implant features that help this process take place.
Why primary stability matters
Primary stability is the interaction between the dental implant and its mechanical engagement with the cortical bone. Primary stability is often cited as vital as it is said to encourage the process of osseointegration, and therefore allows the dental implant to form a proper foundation in the bone.
Without primary stability being achieved, it is likely that the formation of fibrous encapsulation could compromise the dental implant. Rather than integrating with the bone, this means that thick layers of healing matter will grow around the implant, possibly impeding its function.[ii]
The most important part of achieving primary stability is that it increases the predictability of implant function, and some sources even argue that without this foundation being achieved that implant survival is impossible in the long-term.[iii] Therefore, without primary stability it is likely that implants may fail, and in a world where successful outcomes are imperative and where litigation is at an all-time high, it’s necessary for practitioners to explore ways to achieve primary stability predictably.
The shape of you
Both implant surface and implant shape have been theorised as having a substantial impact on whether an implant can achieve primary stability and osseointegration.
In regards to shape, research has suggested that the most important factor is thread geometry and how this applies force once inserted into the bone. Both straight and tapered implants are effective, but the thread design is what dictates stress distribution, which in turn can impact primary stability.[iv] Therefore, progressive thread designs are the most effective for achieving a solid anchor, as the way they disperse forces ensures that they form a tight fit in the surrounding bone.
Dental implants are now available in a wide array of materials. Historically implants were crafted from a diverse selection of materials, including substances such as precious metals and ivory. However, with leaps forward in dental implant research, it is now clear that certain materials are capable of achieving better and more predictable results due to their biological interaction with natural human tissue.[v]
For example, in order to encourage osseointegration it’s widely accepted that titanium is one of the best choices. As the metal has a high level of biocompatibility, it promotes the formation of bone and doesn’t cause any adverse reactions such as allergies.[vi]
Implant surface topography is also essential to consider when attempting to achieve optimal primary stability. Implant surfaces that have a rough finish are typically better at achieving osseointegration than smooth materials. This is because the bone can penetrate porous surfaces readily, quickly forming a biological anchor that encourages faster bone regeneration and good stability.[vii]
Innovation and opportunity
As well as taking these physical details into account, it’s important to consider the lifetime of the implant after placement and what sort of prosthesis it will be supporting. It’s also vital to factor in the area of the dental implant and the available space when making your decision, especially as some implants are unable to perform well in more challenging space restrictions.
In this case it’s a good idea to find dental implants that have a conical connection and platform switching capabilities. Platform switching can help prevent crestal bone loss, again supporting better osseointegration and reliably assisting long-term success.[viii]
A result of decades of research and mastering a clinically proven approach, the new myplant two implants from myplant, the UK subsidiary of Meisinger, are an excellent choice for professionals who value predictable primary stability. Made from titanium with a conical abutment connection and a special expansion thread in order to promote osseointegration, these revolutionary implants are also ideally suited to a wide array of cases due to their platform switching capabilities and subcrestal placement.
Let the case decide
In the end, it’s important to explore the complexities of every case with an individual approach, especially when performing complex surgery such as dental implant placement. Regardless, primary stability is a gold standard, so aiming to achieve this should always be a chief concern.
By choosing dental implants that promote primary stability, you are not only giving the dental implant the best chance at success, but also making it clear to patients that you are helping them achieve a long-term solution to tooth loss.
[i] Javed, F., Ahmed, H., Crespi, R., Romanos, G. Role of Primary Stability For Successful Osseointegration of Dental Implants: Factors of Influence and Evaluation. Interv Med Appl Sci. 2013 Dec; 5(4): 162–167.
[ii] ResearchGate. During Implant Placement, If the Primary Stability is Not Achieved, Is the Implant a Success or a Failure? Link: https://www.researchgate.net/post/During_implant_placement_if_the_primary_stability_is_not_achieved_is_the_implant_a_success_or_a_failure[Last accessed August 19].
[iii] Patil, R., Bharadwaj, D. Is Primary Stability a Predictable Parameter for Loading Implant? Journal of ICDRO. 2016; 8(1): 84-88.
[iv] Ryu, H., Namgung, C., Lee, J., Lim, Y. The Influence of Thread Geometry on Implant Osseointegration Under Immediate Loading: A Literature Review. J Adv Prosthodont. 2014 Dec; 6(6): 547–554.
[v] Saini, M., Singh, Y., Arora, P., Arora, V., Jain, K. Implant Biomaterials: A Comprehensive Review. World J Clin Cases. 2015 Jan 16; 3(1): 52–57.
[vi] Oh, J. Biocompatibility of Advanced Manufactured Titanium Implants—A Review. Materials (Basel). 2014 Dec; 7(12): 8168–8188.
[vii] Smeets, R., Stadlinger, B., Schwarz, F., Beck-Broichsitter, B., Jung, O., Precht, C., Kloss, F., Grobe, A., Heiland, M., Ebker, T. Impact of Dental Implant Surface Modifications on Osseointegration. Biomed Res Int. 2016; 2016: 6285620.
[viii] Prasad, KD., Shetty, M., Bansal, N., Hegde, C. Platform Switching: An Answer to Crestal Bone Loss. J Dent Implants. 2011;1:13-7. DOI: 10.4103/0974-6781.76426.
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