Implant options for all

As a general dentist practicing in Harrisonburg, Virginia, I had noticed that local specialists were placing conventional dental implants, but the price was out of reach for many. I started reading about mini dental implants and looked for training options. In 2009, I started placing mini dental implants in the anterior mandible for denture stabilization and since then have used mini dental implants and conventional dental implants on a routine basis. Here are four things I have learned:

Take advantage of technology. Once I began placing implants, I was uncomfortable treating patients with a two-dimensional X-ray. At the time, a CBCT machine was a 6-figure investment. I was able to finance the CBCT and have never regretted this investment. I purchased a new CBCT machine in 2019 for about ½ the price of my first CBCT. Having an in-office CBCT made it easier to provide surgical guides. At a recent meeting of the Academy of Osseointegration, the best dental implant specialists in the world advocated using the best technology. 

Look out for trends supported by research. Dr. Craig Misch, one of the most experienced dental surgeons, an amazing lecturer, and expert on intraoral bone grafting, recently published an article advocating the use of smaller dental implants to reduce the need for bone grafting.¹ Numerous articles discuss the efficacy of very short and small diameter implants. Listen to academic speakers, read peer-reviewed journals, and stay informed. 

Consider the middle market.  Even in my rural community, some dentists are dedicated to providing “All-on-4” restorations. An All-on-4 case for the upper and lower arch can cost about $50,000 in our community. This is out of reach for many patients. My practice offers mini dental implants supporting upper and lower overdentures for a more affordable $16,000. We offer a denture buyback program for a patient who wishes to upgrade to a higher level of care. In this way, we are working with the middle of the denture market.

Be curious: Too many implant providers are using dental implant product lines they were introduced to during their training. However there are other products on the market with features not available in all implants. The largest implant manufacturers have been sluggish to adopt mini-implants, ultra-short implants, and platform-shifting designs. Check the research, and form your own opinion. At a recent discussion about materials for restoring implant-retained restorations, I asked the speaker why zirconia was so popular. His answer: “I do not know.” He predicted other materials, such as carbon fiber materials, will soon surpass zirconia for dental restorations.

Learning about dental implants has allowed me to give some wonderful patients confidence and comfort. After 40 years, my practice still makes me smile.