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Which is the best dental implant in Singapore?
on October 21, 2015
Dental implants are fast becoming the tooth replacement of choice today. Before the advent of dental implants, missing teeth or extracted teeth are replaced with either removal prostheses (denture) or non removable prosthesis (dental bridge). The rise in popularity of dental implants is due to the fact that it is the closest thing to a real tooth that technology can provide today. Implant dentistry is also one of the most well-reasearched and published areas in Dentistry. Along with that, many implant manufacturers have emerged to take advantage of this trend. Today, there are many brands of implants made in different parts of the world by different companies. In Singapore, most of the major brands have either set up branch offices or appointed a local distributor to get a share of the market here. With so many implant brands to chose from, dentists and patients are indeed spoilt for choice. But is there a real difference between the brands?
The answer to that question is yes and no. First, we need to classify dental implants into two major groups, those that have undergone regulatory scrutiny and found to have fulfilled the specified criteria of an implant and those that have not. In Singapore, no dental implants can be sold if it has not received the approval of the Health Science Authority. International recognized accreditation bodies for medical products like the Food and Drug Administration of the USA and the CE mark of Europe are often used as a yardstick of whether the product has undergone the necessary laboratory and clinical trials to ascertain iits safety and efficacy. This often involves a lot of basic science and engineering processes which I accept with blind faith as I do not have that kind of background in my training to appraise the validity or otherwise of the testing protocol. In short, if the product is FDA approved or have a CE mark, it is safe for use. "Safe" as in it will integrate with the bone and there will be no detrimental effect on the patient. Conversely, products that do not have such certification should not be used on patients.
Geography
Thiis third party certificaiton criterion still leaves us with many implant brands to choose from. As my practice is in Singapore, I only chose implant brands that have a physical presence in Singapore. Wihle a dental implant is just a titanium screw, there are many other instruments and parts needed to place it into the jaw bone and subsequently, to place a crown on. Having a physical presence in Singapore gives timely access to parts, including parts that are not so commonly used. While it is possible to order online from almost any dental implant manufacturer in the world, the process is not always so straight forward as the treatment plan may change as we go along and shipping in the products will lead to delay in completion of the treatment. For example, Korean dental implants are very popular in Singapore. Being a relative latecommer to the implant manufacturer scene, they have the benefit of incorporating many of the scientifically proven principles in implant design into their products and even innovate further to adapt the implant to the Asian jaw anatomy. However, they do not have as strong a presence in some European countries. As such, for a medical tourist from Europe, I will normally chose a commonly European brand so that the patient can receiving continuing care when he returns home.
Jaw anatomy
Every patient has different jaw anatomy. Dental implants need to be placed in bone of sufficient thickness and density to achieve good integration. However, in some cases, the bone may be deficient and needs to be augmented to achieve a good result. Some implant manufacturers make shorter implants than others and may be used succesfully in some of these situations to circumvent the need for bone grafting. Conversely, some manufacturers make very long implants that engage the zygomatic bone instead of the jaw bone to obviate the need for bone grafting.
Implant design
Most of the major implant brands have their own "philosophy" towards implant dentistry. Some do more research into the implant surface in an attempt to to develop a surface that will attract bone cells to bond with it better. Others research the macro design of the implant, varying the dimensions and as well the depth and pitch of the screw threads, so as to achieve better mechanical engagement of the implant in bone. Implant manufacturers also differentiate themselves by developing a better implant to crown interface ie the way the false tooth is connected onto the implant. The list goes on. There is no universally perfect implant or implant system in the world as different patients have different needs.
Restorative design
The restorative options are also important considerations. Some dental implants have a wider range for restorative components that allow for a greater variety in the design of the prosthesis to suit the needs of the patient. This is particularly implant when the treatment plan is complex or when the implant position is compromised due to deficiencies in the jaw anatomy.
CAD-CAM
CAD-CAM dentistry is another fast developing field in dentistry and some implant manufacturers have embraced the technology and developed software as well as hardware to place implants accurately and less invasively at the same time allowing for an accurately prefabricated prosthesis that can be fitted onto the implants at the same sitting. For some patients, such a protocol may be adopted and the brand of implant that can support this will be chosen.
Exchange policy
Most implant manufacturers have a exchange policy. In cases where the implant fails, the dentist can remove the failed implant and exchange it for a new one free of charge. I do not use implants that do not come with an exchange policy for obvious reasons.
The various approved brands are similar in there they all work, meaning they can achieve successful integration with jaw bone and are able to support a set of false teeth. However, they are different as different manufacturers differentiate themselves slightly but directing their research and hence product towards different needs of different types of patients.
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