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Filling In the Gaps: Real Concerns About Dental Implants

Dental researchers say dental-implant systems have a success rate that’s as high as 98.7 percent, but experts disagree on what constitutes success. Furthermore, no independent studies track the long-term durability of dental-implant systems.

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Three million Americans receive a total of 5.5 million dental-implant systems every year, according to American Academy of Implant Dentistry (AAID), which is a trade association. AAID expects the number of patients in the United States who receive a dental-implant system to increase by 500,000 in 2015 and says the global market will grow to $6.4 billion in 2018.

We found three reasons for the growth of dental-implant systems, which are permanent artificial teeth for when you lose a tooth because of periodontal disease or injury. First, more general dentists than ever before place, or install, dental-implant systems instead of referring patients to a more expensive specialist. Second, advancements in technology now allow consumers to get a functional dental-implant system in a matter of days, instead of waiting 3 months as is typical with traditional dental-implant systems. Finally, the least expensive “one-day” dental-implant systems now cost $1,000–$2,500 per tooth, compared with $2,500–$5,000 per tooth for a conventional dental-implant system.

A dental-implant system has three components: a crown, which is the artificial tooth; an implant, which is the artificial root; and an abutment, which is the connector that joins the crown to the implant. At least 400 dental-implant systems of varying material and styles exist in the United States. A single implant crown now costs anywhere from hundreds to thousands of dollars, depending on whether it’s premade or custom-made and whether it’s made from plastic, metal or porcelain.

Unfortunately, no independent evidence proves that dental-implant systems are more durable than ever before. Dental-implant experts often say the procedures have a success rate of up to 98.7 percent. However, we found that the term “success rate” often is used to describe the process of simply placing a dental-implant system, not as a measure of how the dental-implant system holds up to years of biting and chewing.

“If a patient has half of their jawbone gone, and the implant is still integrated into the base of their jawbone, some experts call that success,” says Dr. Joan Otomo-Corgel, who is the president of American Academy of Periodontology (AAP) and has placed dental-implant systems since 1985. “Success to me is an implant that is healthy and easy to maintain.”

Unfortunately, almost all studies of dental-implant systems were conducted by manufacturers or by dentists who place dental-implant systems—two groups that benefit from reporting the highest possible success rate.

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Experts tell us that dental-implant systems can last up to 40 years depending on the procedure and follow-up maintenance, the type of dental-implant system, the quality of the bone in which the implants are anchored and the patient’s overall oral health. However, an April 2013 report by AAP found that up to 48 percent of all dental-implant systems likely will result in some complication. Most common are peri-implant mucositis, which is inflammation in the soft tissue around an implant without loss of bone; or peri-implantitis, which is inflammation with bone loss. In other words, no matter what type of dental-implant system that you get, no matter how much that you pay for the procedure and no matter how experienced that your dentist is in placing a dental-implant system, it’s critical that consumers maintain their oral health and consult with their dentist regularly after surgery to prevent complications.

COURSE OF TRAINING. General dentists typically are the first to tell you whether you have to have a dental-implant system. Ten years ago, most general dentists referred such patients to a specialist who has 3–5 years of training beyond dental school in oral surgery or periodontics (the study of structures, such as gums, that support teeth).

However, no mandatory standards exist in the United States for how much training is required before a dentist can place a dental-implant system. Any licensed dentist can perform any dental procedure legally.

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