Which Implant System Should You Use?

00:00 Introduction
I often get questions about which implant systems I recommend, which ones are my favorite or easiest to work with and in this video I'm going to discuss several aspects that should be considered when choosing an implant system. And I want to emphasize that I'll be speaking from my perspective on restorability only. Other factors such as the implant alloy, body style, surface technology, and many other aspects should be considered, but I won't be covering them in this video.

00:34 Restorability
And so probably the biggest restorative factor is the abutments. Most implant systems have a variety of stock and custom abutment options and so a big consideration when choosing a system is to determine the types you prefer, and make sure you choose a system that meets those preferences

The most common type of abutment we use at our lab is custom titanium and honestly those are available for almost every system out there with just a few exceptions.

Other abutment options include custom zirconia, stock titanium, UCLA , and angled screw channel abutments.

The thing is, most of those options are available for the major implant systems used in the United States. And so usually it's not a matter of one implant being better than the other but a matter of specific systems not being well suited for a certain type of case or restorative plan.

01:23 Splinted restorations
For example, if you're planning for screw retained splinted restorations, Dentsply Astra implants might not be a good option because implant level non-engaging UCLA abutments aren't available for Astra. You can still do screw retained bridges on Astra implants, but it would require using Uni-abutments or third party parts.

01:41 Angulation
Another example is if it's determined during the implant planning phase that angle screw channel abutments will need to be used, you'll want to make sure the system you're working with has the type of abutment you want to use. For instance. Nobel Biocare's angled solution consists of a zirconia top portion with a metal base. If you want to do a full zirconia crown or bridge, this is a great solution. However, if you want to do a PFM, this really isn't the best choice.

02:06 Implant Size
You should also keep in mind that most 3mm diameter implants have less abutment options than the larger sizes. Those 3mm implants are often placed in lateral incisor positions with the expectation of doing zirconia abutments, but that's not an option for most 3mm implants.

02:23 Zirconia Implants
And zirconia implants have even fewer options. The NobelPearl from Nobel biocare only has two abutment options available, straight zirconia and angled zirconia. And those are stock abutments, there's no custom option available for the NobelPearl implants. Likewise, the Straumann Pure implant only has one style of abutment available, a titanium base with two height options.

02:44 Impression Components
Aside from the abutment options, other components should be considered as well. For example, when it comes to impression copings, some companies offer them in multiple emergence profiles while others only have one option for each platform. Whether or not this is important depends on how you take your impressions. If you use stock impression copings as is, it's beneficial to use one that matches the diameter of the healing abutment. If, however, you make custom impression copings to match a temporary restoration then one impression coping option is adequate.

03:16 Implant Company
Another factor that I think is really important is the long term stability of the company. I always recommend choosing one of the well established companies which includes Straumann, Nobel Biocare, Zimmer Biomet, Dentsply, BioHorizons, and several others. There is a much higher likelihood that those companies will be around for the life of the implant which makes it easier to get replacement screws or new abutments when it's time for the crown to be replaced.

03:41 Depends on Plan
So, I want to make it clear that I don't really have a favorite system, but I do think that depending on the restorative plan, some systems will be better suited than others to achieve your desired result.

And we're always happy to consult with you on those restorative plans prior to implant placement.

[bwill]

Good breakdown. That last point is crucial, especially for the patient! Nothing worse thrash having to replace an implant restoration only to find you can't get parts because the system is no longer available!!

[whateveritwasitis]

this is all overwhelming. i thought i was paying a professional to make these decisions. i feel like i need a degree to know all this. my 2 front teeth need implants and i am overwhelmed.

[jennycamitchell]

I didn’t even know there were options. Glad I’m doing my research

[MrMa]

Hi,

I really like your clear and precise videos. I'm wondering if you have dealt with Osstem/Hiossen implants? If so do you have any comments on the restorative parts? Thanks

[TrodVods-joiy]

Hi Doctor, opinions on the brand Hiossen please? Many offices use it but I cannot find much info online

[Cyberoll]

Hi O'Brien one of the dentist recommend me mini implant. I'm a bit hesitant wondering if mini implant is ideal.

[rw]

Bio Horizons in the only implants any dentist should ever use. 💯💯💯💯

[alexthai]

patients have no option for this…. the dentists do for us we didn’t know….. are they going to ask us to pick which once during the procedure????

[sl]

What's good for an upper canine/cuspid? Also, would titanium work in that spot?

[SHRNOOR]

Doc plz tell me for molar teeth which implant was best product 😪

[zamzam]

What are your thoughts about Direct implant system ?

[nyatio]

I got 4 implants consisting of straumann BLX and Straumann BLT. Both type is good?

[ahmedsaeed]

Hi Dr. Do you think screw retained crown is the best solution with Straumann Roxolid SLActive implants? Please recommend the best solution for this implant type?

[lauradiana]

Hello Doc! I came across your videos & like a lot the way you explain things! Also, I'd like to know if technology went that far to allow a truly Pure Ceramic replacement for any of a patient's back teeth. I'm asking as I've done my research but couldn't find one option that includes a pure Zirconia solution both for the implant + abutment (as the last turned out to have some metal in it in all my searches). Now I see you mentioned in your presentation the Custom Zirconia abutment & my question comes now: is this a purely ceramic abutment & if so, does it work in combination with a Ceramic implant for the back teeth? Moreover, do you recommend ceramic implants for mastication purposes as I understood they're more likely to crack. I'd look forward to receiving your reply.

[PlanetIscandar]

I would like to add that *any metal* (especially the implanted), that interacts with the "ground substance" causes potential differences in it, causing gigantic amounts of current to constantly flow through the spinal cord, gradually melting it. This is then amplified by the presence of strong electromagnetic fields (you may guess a few already).
*O'Brien Dental Lab* created a wonderful, informative and honest brief-video, *jasonbrown* wrote the correct complementary comment and *SG-qq4ig* answered the most of my remaining questions thanks to *ThuLe-eh1xe.*

[hl-yzgr]

Straumann or biohorizon or dentaurum and why? I need an answer plz and why biohorizon is not considered best? Thank you

[ThuLe-ehxe]

Hi doctor
I had my tooth molar number 4 extracted. Now i plan to have nobel pearl implant, abutment and crown done. But one of the dentist told me that zirconua has metal too. Now i m confused. I do not like titanium, aluminium in my mouth, not good for health.
So. Does nobel pearl zirconia have metal? Can i just keep my missing tooth and not to have implant? Will i lose my jaw bone and mess up my bite? What should i do? Thank you.

[FL-ggdq]

For astra fixed bridgework . Why so you need ucla... you can just get a non engaging custom milled from a blank. Ie atlantis willthis no?

[MonMon-rsol]

Is Nobel biocare the only company that made implant with full Zirconium structure ?!

[MyouKyuubi]

I don't need implants (yet), but i would want the most long-term viable option with the least chance of serious infections or gum disease.

Would a titanium screw, with custom Zirconia abutment (as seen at 1:05) be the best solution for that?