Implant Design: What Every Dentist Should Know

The video script introduces a webinar featuring Dr. Rob Stanley, focusing on dental implant design. Adam, a marketing specialist at Henry Schein, moderates the session. This is the second part of a four-part series, with the first part aired in July 2020. The audience is encouraged to email for a link to the first part. The webinar does not offer CE credit and Dr. Stanley's credentials are highlighted, including his role as an adjunct professor and senior instructor. Dr. Stanley emphasizes the importance of understanding implant design, suggesting it's often overlooked but critical for success in dentistry.

Dr. Stanley discusses the critical factors contributing to the success of dental implants, highlighting location as the most important, followed by implant design. He uses an analogy of a house's temperature being a function of the thermostat and open doors to explain how multiple variables can impact implant success. A list of success criteria is presented, emphasizing that while many factors are important, location and design are paramount. The presentation aims to debunk the myth that 'all implants work' by showing how design improvements have increased success rates and reduced failures.

This section delves into the material aspects of dental implants, noting that most are made from titanium but vary in grade, which affects strength. Dr. Stanley advises inquiring about the specific titanium grade when selecting an implant. The discussion also covers how bone reacts differently to compressive and tensile loads, favoring compression. Implant design, particularly threading, is crucial as it can either put bone in compression (with reverse buttress threads) or tension (with buttress threads), significantly affecting implant stability and longevity.

The script explores thread design, specifically the angles and pitch, which influence how forces are distributed to the bone. A smaller theta angle and a tighter thread pitch (alpha angle) are preferable as they reduce shear forces, which are detrimental to bone. The presenter warns against implants with multiple thread leads, as they increase the risk of shear load and can compromise implant stability. The explanation includes practical advice on choosing implants with single thread designs to ensure better compressive force distribution and bone health.

The focus shifts to crestal bone loss, a common issue in dental implantology, especially in aesthetic regions. The presenter introduces a hypothesis that all crestal bone loss is associated with connective tissue to implant contact. Emphasizing the importance of the epithelial attachment to the implant, the discussion highlights 'Laser Lock', a technology by BioHorizons that allows connective tissue attachment to the implant surface, potentially reducing crestal bone loss by preventing epithelial downgrowth and providing a seal against bacterial invasion.

The script introduces 'Spiral Lock', a technology originally designed for NASA to prevent screws from loosening. It is now applied in dental implants to distribute forces more evenly across threads and radially, reducing the risk of screw loosening. This is particularly beneficial in cases where the implant is not ideally located, creating a cantilever effect and bending moments that can compromise implant stability. The explanation includes the advantages of using OEM screws and the benefits of Spiral Lock in maintaining implant stability.

The discussion continues with the importance of platform design and internal fit in implant systems. It contrasts implants with a common platform size to those with varying sizes, suggesting that while the former may be more convenient for clinicians, they could pose a higher risk of breakage due to thinner walls. The presenter advocates for implants with changing platform sizes to reduce patient risk. The benefits of internal conical fits in self-centering and stress distribution are also highlighted, emphasizing the importance of considering the entire implant system, including surgical guides and prosthetics solutions.

In conclusion, the script outlines the four keys to implant success, reiterating that location is paramount, followed by implant design, and the importance of the overall system. The presenter stresses that even a poorly designed implant has a chance of success if placed correctly. The webinar concludes with an invitation for questions and a reminder that attendees will receive a recording of the session. It also encourages feedback and hints at future webinars to cover the remaining keys to implant success.