What are digital implants?

Summary

  • Ancient Implants
  • The 1700s ad 1800s
  • The 1900s
  • Modern-Day Leading up to Digital Implants
  • The creation of Digital Dentistry
  • Digital implants in 2024
  • Analog implant workflow
  • Digital Implant Workflow
  • Advantages for Your Patients
  • Advantages for You

Ancient Implants

The history of dental implants spans ancient civilizations such as the Egyptians, Etruscans, and Phoenicians. They used materials like gold, ivory, and bones to stabilize and replace missing teeth, showing early innovations in dental prosthetics and implantation techniques. For example, the Phoenicians wrapped gold wire around the surrounding teeth to stabilize a central failing tooth. These developments laid the groundwork for modern-day digital implants.

The ancient Maya civilization (circa the 8th century) was known to use bow drills made of jade or copper to make perfectly round holes in living teeth. This was done to remove cavities and make room for carved stones that fit so perfectly they would remain in place for hundreds of years after death.

Ancient Maya bow drill stone implants *2

The Renaissance significantly impacted multiple fields of medicine, including dentistry. There was an expansion of “dentists” and early specialized medicine practitioners, such as Ambroise Paré and Gabriel Fallopius. Implants during this era often required other human teeth, making them more like transplants.

The 1700s and 1800s

In 1728, Pierre Fauchard, known as the father of modern dentistry, published “Le Chirurgien Dentiste.” This book covered a wide array of dental problems and their elaborate solutions. Pierre, born in Brittany in 1678, joined the French navy at 15 and became an informal tutor of a surgeon major who had studied dental diseases extensively. After returning from the navy three years later, he started his practice and became one of the first dental-only surgeons, specializing in dental prostheses.

Pierre Fauchard *9

Pierre’s fame peaked when he was considered the most outstanding dental surgeon in France. He spent around 10 years writing and revising “Le Chirurgien Dentiste,” which is why the book is considered the origin of scientific dentistry.

During this time, the first metal implants were invented, utilizing osseointegration for the first time. In the 19th century, efforts in dental implant development progressed, leading to the creation of the first attempts at endosseous metal implants, representing a significant advancement in dental prosthetics.

The 1900s

In 1913, Dr. E.J. Greenfield placed a 24-gauge hollow latticed cylinder made of iridio-platinum soldered with 24-karat gold as an artificial root in a patient’s jawbone. In the 1930s, Drs. Alvin and Moses Strock experimented with orthopedic screw fixtures made of Vitallium, observing successful implant placements in humans and dogs for dental restoration. Their work emphasized the selection of biocompatible metals for dental implants. Dr. Alvin Strock also pioneered the use of antibiotics for treating periodontal infections at sea.

In 1938, Dr. P.B. Adams patented a cylindrical endosseous implant threaded internally and externally, featuring a smooth gingival collar and healing cap. In the 1940s, Formiggini and Zepponi developed a spiral stainless steel implant allowing bone integration. Dr. Perron Andres of Spain modified Formiggini’s design by incorporating a solid shaft into the spiral construction.

Continuous improvements in the 1940s included creating burs for the best fit of an implant and developing subperiosteal implants. In the 1950s, modern implant techniques emerged, placing screw holes in the strongest parts of the bone. By the 1970s, most implants evolved through changes in implant material, leading to titanium.

Modern-Day Leading up to Digital

Two well-known dentists, Dr. Schroder and Dr. Straumann (the founder of the billion-dollar company Straumann Group), experimented with different metals for use in orthopedic surgery to help manufacture implants. The modern-day endosteal implant became mainstream in the 1980s. Hydroxyapatite coatings and titanium plasma-sprayed coatings were introduced, along with a stream of implant inventions and improvements. Other coating surfaces included composite coatings, titanium nitride coatings, carbon, glass, and ceramic coatings, as well as titanium dioxide film coatings.

Titanium plasma spray coatings and PEEK*10

This period saw streamlined advancements in osseointegration and endosteal implants, setting the stage for digital implants, the largest modern innovation in dental implants.

The Creation of Digital Dentistry

Digital dentistry utilizes computer-based technology to aid dentists in delivering treatment, such as digital scanning for impressions and diagnostics. While CAD/CAM has been used since the 1960s in plane operating systems, digital dentistry originated with Dr. Francois Duret’s CAD/CAM application in 1984, and since then, the technology has expanded massively. To learn more about digital dentistry as a whole, https://northstardentalstudio.com/blog/what-is-digital-dentistry

The ADA found that intraoral scanners are used by only half of all U.S. offices, despite having massive advantages over conventional methods (more on that later). The CAD/CAM process covers everything from intraoral scanning, creating a digital dental design, printing, and implementation into the mouth. Cerec 1, the first digital impression system, was introduced in 1985, originally intended for the fabrication of inlays and onlays, designed by Dr. Marco Brandestini. While this process is used for most digital restorative products, it also applies extremely well to implants.

Digital Implants in 2024

Incredible improvements in intraoral scanning software and CAD/CAM applications have been nonstop. Northstar Dental Studio has been a long-term user and supporter of iTero and Exocad. Digital implants describe the entire process from impressions to surgery, which we will explain in the digital workflow section. The digital workflow has been so optimized that analog impressions and workflows are now detrimental to the growth of your dentistry. If you’re not growing in a growing market, you stagnate. The global dental industry is expected to nearly double by 2032, with 40% of all current dental revenue in the U.S. The industry is overwhelmingly moving towards digital solutions, leaving those with traditional workflows missing out on incredible growth with new technology.

Analog Implant Workflow

For example, let’s say a patient is missing a couple of anterior teeth and wants to get them replaced. You take an impression, mount it, and send it to a lab like ours. We do a wax-up, you review it and take a CBCT to see its relation to the bone. We then make a model so you can take X-rays. Finally, we make a surgical guide and the implants. This process takes weeks of back and forth and incurs higher labor costs compared to our digital workflow.

Conventional impressions rarely offer accuracy advantages over the latest intraoral scanners and can be uncomfortable for the patient, as you know.

Digital Implant Workflow

Let’s use the same example. You take a 30-second scan of the patient’s edentulous site, take a CBCT scan, and send those scans to us. In about a day, our experts will have planned the implant, restoration, and abutment, providing you with all that data. When you and your patient are ready, we can immediately start working on the restoration pieces, preparing you for surgery within a week. We achieve all of this more efficiently and cost-effectively, significantly benefiting the growth of your practice.

Guided surgery implant planning, Northstardentalstudio

Analog workflows simply aren’t worth it anymore. Digital workflows are here to stay, and there’s no reason to wait. This leads us to the numerous advantages of digital implants for you, your patients, and your practice.

Advantages for Your Patients

As far back as 2015, intraoral scanners halved the procedure time compared to analog impressions, reducing it to about 6 minutes. While there have been virtually no innovations in analog methods over the past decade, digital dentistry tools have continually improved.

iTero’s (Northstar’s preferred intraoral scanner) latest model, Lumina, demonstrates the advantages of digital methods. For example, Dr. Al-Hassiny from the Institute of Digital Dentistry found on February 24, 2024, that he could scan a full arch model in under 30 seconds with Lumina.

iTero Lumina release*11

Beyond reduced chair time, intraoral scanners offer many other advantages: no gag reflexes, nothing in the mouth, no setting time, less awkwardness, and no aftertaste.

The entire intraoral scanning and digital implant process is much easier to explain to patients. Almost everyone is familiar with pictures and 3D printing, making it straightforward to convey the process.

Additional Advantages for You

Many of the benefits for patients also benefit you. Happier patients improve your business. Additionally, some digital implant processes can be performed by less experienced dentists, enabling easier scaling of your practice.

Less back-and-forth shipping reduces the need for extensive organization. More information is automatically recorded digitally, allowing you to accomplish the same tasks in less time with less stress.

Finally, the industry isn’t reverting to old methods. Digital implants are here to stay, and patients are primarily concerned with receiving the best possible care.

We are happy to answer any questions you have regarding the digital implant workflow and would love to service your digital dentistry needs. Many dentists hesitate to switch to digital because they don’t trust the competency of the lab. We are eager to build trust and demonstrate our expertise. Visit our website to schedule a meeting or contact us.

Sources

  1. Morris, T. (2024, May 13). Pierre Fauchard Academy. Pierre Fauchard Academy. https://fauchard.org/#_more-about-pfa/
  2. Pasqualini, U., & Pasqualini, M. E. (2009, October 1). THE HISTORY OF IMPLANTOLOGY. Treatise of Implant Dentistry – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK409631/#ch1.s4
  3. A Brief Historical Perspective on Dental Implants, Their Surface Coatings and Treatments. (2014). Ncbi. Retrieved June 19, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4040928/
  4. ACE Panel report finds about half of dentists use intraoral scanners. (n.d.). American Dental Association. https://adanews.ada.org/ada-news/2021/september/ace-panel-report-finds-about-half-of-dentists-use-intraoral-scanners/#:~:text=The%20report%2C%20which%20includes%20the,practices%20and%2047%25%20do%20not.
  5. What is digital dentistry and how does it work? (n.d.). 3Shape. https://www.3shape.com/en-us/digital-dentistry
  6. The Transition to Digital Dentistry. (n.d.). Copyright ©2024 AEGIS Communications, All Rights Reserved. https://www.aegisdentalnetwork.com/ida/2014/10/the-transition-to-digital-dentistry#:~:text=Marco%20Brandestini%20developed%20the%20concept,which%20was%20introduced%20in%201985.
  7. Research, S. (n.d.). Dental Industry Market Size, Share and Forecast to 2032. https://straitsresearch.com/report/dental-industry-market#:~:text=The%20global%20dental%20industry%20market,period%20(2024%2D2032).

      8. Schepke, U., Meijer, H. J., Kerdijk, W., & Cune, M. S. (2015). Digital versus analog complete-arch impressions for single-unit premolar implant crowns: Operating time and patient preference. ˜the œJournal of Prosthetic Dentistry/˜the              œJournal of Prosthetic Dentistry, 114(3), 403-406.e1. https://doi.org/10.1016/j.prosdent.2015.04.003

9. Pierre Fauchard the father of modern Dentistry (1678 – 1761). (n.d.). https://scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162020000100012

10. Walsh, W., Bertollo, N., Christou, C., Schaffner, D., & Mobbs, R. (2015). Plasma-sprayed titanium coating to polyetheretherketone improves the bone-implant interface. https://www.semanticscholar.org/paper/Plasma-sprayed-titanium-             coating-to-improves-the-Walsh-Bertollo/ef57114454a1aaee9525e82740e4a17d6ee541d3

11. Rodríguez, S. (2024, February 16). Align Technology presenta el nuevo escáner intraoral iTero LuminaTM – Gaceta Dental. Gaceta Dental. https://gacetadental.com/2024/02/align-technology-presenta-escaner-intraoral-itero-lumina-                 57290/