Editorial note: Thank you to our frequent guest blogger, Dr. Mark Wilhelm!
For years, stories have circulated about how much more efficient it is to restore missing teeth with dental implants vs conventional crown and bridge. My own experience has proven to me that well-done implants are better for patients than questionable teeth. It has also shown that failures in crown and bridge prothodontics are the leading cause of situations requiring implant restoration.
I have sat through many eight-hour presentations on the advantages and disadvantages of various implant body designs. Over the course of 20 years, I have used a variety of implant systems in a wide range of clinical conditions and have reached my own, tested conclusions about what works where and when it works best.
For now, let’s ignore the surgical advantages and discuss only the restorative/prosthetic differences between the various implants body designs. The most significant difference between most of the implants today is the prosthetic table or connection to the abutment. Many things are mentioned about platform switching and whether or not it is “better”. The platform switch simply moves the connection of the abutment to implant away from the bone/implant interface. A huge clinical advantage to this is that when you remove the healing cap to place an impression coping, you will not pinch tissue, then or ever. Implants that have an external or internal hex, but leave the abutment connection at the edge of the implant, usually will pinch tissue when you fit the pieces together.
Having some form of conical or Morse taper connection allows you to seat components in seconds instead of minutes. I prefer to have the possibility of an index inside the connection to ensure preciseness in positioning prepared abutments. This is critical when working with multiple abutments and dealing with a line of draw.
These two huge advantages were brought home to me in two recent patient examples. In both cases, the patient presented for entire arch implant reconstructions. In both cases, the impression appointment took 19-20 minutes and the jaw record appointment took another 17-18 minutes. You can do the math yourself; consider how efficient and productive is an appointment that will restore 12 teeth in less than 40 minutes – and what that could do for your practice. Compare that to working with teeth.
About the author:
Dr. Wilhelm has been in private practice in the twin cities area since 1990, where he is focused on cosmetic dentistry, sedation dentistry, advanced restorative and dental implants. Dr. Wilhelm received his Doctorate of Dental Medicine in 1985 from Southern Illinois University School of Dental Medicine and completed specialty certificates in Prosthodontics and Maxillofacial Prosthetics at Indiana University. He has held faculty positions at Indiana University and is a staff member of the Health East Hospital system. He is also recognized as a Diplomate of the International Congress of Oral Implantologists and is an active member of the American College of Prosthodontists, the American Dental Association, and the Minnesota Dental Association.
Dr. Wilhelm is an author, consultant, mentor and frequent speaker to dentists and the public on techniques that enhance oral health.
