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.

[@bwill3337]

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!!

[@OBrienDentalLab]

It's unfortunate how common it is!

[@sl4983]

How can that be avoided?

[@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.

[@OBrienDentalLab]

These videos are made for dental professionals. You should speak to your dentist about your implant needs and they will be able to create a treatment plan for you.

[@TheKentist]

Sorry you feel overwhelmed! You are paying the dentist for those decisions. You have the assignment to show up, get new teeth and restore your smile ✊🏾

[@user-rw311]

I had ten implants done in south America for 500$ each it's was the same exact procedure that's done in the USA. Bio horizon implants were used. Take it from me this brand is awesome. Check out there website

[@springteen3743]

If you rely only on a professional then they would do anything to make money probably implants made in China 😂

[@SHRNOOR]

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

[@alexthai2456]

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????

[@Cyberoll]

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

[@OBrienDentalLab]

If you are concerned with the recommendation of your dentist I would suggest consulting with another dentist or specialist who can evaluate your needs and give you a second opinion.

[@Mr0Ma]

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

[@OBrienDentalLab]

Yes, we have worked with them. They have the standard type of stock components that are available for other systems. We use Atlantis for custom abutments on Osstem/Hiossen implants.

[@zamzam4131]

What are your thoughts about Direct implant system ?

[@sl4983]

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

[@itsaaronlolz]

why do third world countries only use zirconia and in america we use ancient crowns like PFM

[@AK-hw3uo]

Because of cheap labor costs in these countries, the patients can better afford higher quality. I work in a Turkish dental clinic and the patients are usually offered Straumann, Noble Biocare, etc.

[@FL-gg4dq]

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?

[@painless4415]

Yes, you are correct. Atlantis is a great solution and you get Atlantis abutments for other major implant systems.

[@ahmedsaeed103]

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?

[@OBrienDentalLab]

The best solution is always dependent on the situation. You will need to consult with your doctor on which solution is best for you.

[@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.*

[@jacobclark89]

I'm concerned about implant screws from China that look like standard wood screw thread. They are listed as titanium but look like stainless . They say FDA approved but I found out many electrical items that have a CE approval stickers are not Certified but instead China claims it stands for China export

[@inkbold8511]

That's because you are biased, 90% of medications in the USA and medical products are made in China. Even the phone you are using are made of it! The only concern you should be worried about is getting the right brand, it's the brand that controls the quality works made in China, some American branded companies want to go cheap and hence source things cheaply from China while others pay high dollar for quality man from China.

[@hl-yz7gr]

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

[@painless4415]

Astra Tech Implants from Dentsply Sirona. No micromovement, no microleakage, microthreads properly stimulate cortical bone, maintains biologic width, grows bone faster and maintains it longer, clinically proven to lose a maximum of 0.3 mm of bone over 5 years while most systems will lose 1 mm to 1.5 mm of bone.

[@FL-gg4dq]

Such a good post

[@fossilized02]

Hi doc, My wife is getting ready to have a dental implant and my friend was telling us about a nuvo product that is out in the states that is part of the Straumann group. Have you heard of these and what are your thoughts?

[@OBrienDentalLab]

We have not yet worked with that system.

[@jasonbrown9864]

You can do custom zirconia copings (not just screw retained crowns) on those Pure Base abutments (therefore a custom abutment) for the Straumann Pure. As well as angled screw channel Pure Base and also overdentures with the PUREloc abutment.

[@OBrienDentalLab]

We were not aware of the angled screw variant of the Pure Base. Thank you for the comment!

[@jasonbrown9864]

@@OBrienDentalLab my pleasure. I love your videos!

[@SG-qq4ig]

Unfortunately the Straumann Pure is not metal free. There is titanium within the abutment and it uses a metal screw. The Nobel Pearl has zero metals

[@ThuLe-eh1xe]

@@SG-qq4ig how do you know nobel pearl has no metal? I will have implant with nobel pearl zirconia. But one dentist told me that that zirconia has metal also. Now i am confused.. please andwer me.

[@SG-qq4ig]

@@ThuLe-eh1xe Zirconia is ceramic, no metal. The screw is carbon fiber, no metal

[@MonMon-rs7ol]

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

[@OBrienDentalLab]

No, there are a few. Another common one is the Straumann Pure Ceramic implant system.

[@bhavanarathore8370]

Hi, Have you ever heard about basal implants.

[@hameedfateh]

Thank you for sharing.

[@OBrienDentalLab]

You're welcome!

[@ThuLe-eh1xe]

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.

[@titanrhama9068]

U will lose bone if its missing unfortunately

[@rigao7533]

Did you have the Nobel zirconia implant finally?how do you feel? Thanks!

[@ThuLe-eh1xe]

@@rigao7533 i had noble pearl zirconia implant by oral surgeon periodontist 6 months ago. He was excellent and did it in 20mn. No hurt, no pain at all. If he used screw, he would use carbon fiber screw, no titanium screw. You tube shows horrible pictures about implant, but in reality, getting implant is much painless and quick and easier than cavities filling or root canal. Mind you that dentist uses lot of antibiotic when he gives you a shot to numb. And when you go home, you have to take antibiotic also. And this will damage your health. Make sure to take probiotoc pills one hour after you take antibiotic. You can buy probiotic in the cold section of natural food store like Sprouts, whole food. Eat yogurt, kefir, kim chi, sauerkraut. They have good probiotic like GARDEN OF LIFE brand. NANCY plain yogurt is good brand. It has to be NOBLE PEARL zirconia. No metal in it. I will have zirconia abutment, crown, carbon fiber screw on this Wednesday by his wife, the holistic dentist. She had done 30 cases of zirconia, so she has experience. She will use RELY X LUTING AGENT to cement the crown to abutment. she will make a tiny hole on the crown in case she need to go in and unscrew the screw that attach the abutment to the implant in case I do not like the crown . But she is confident that I will have no problem with the crown and abutment. Of course she will fill the tiny hole of the crown with composite. Make sure to have a night guard made to wear every night after you have new crown so that you do not break your crown by clenching your teeth when you sleep. My total price including implant, abutment, crown is around 6000. Insurance paid 1000. Night guard may cost 900. Do not have bridge. It is cheaper, but eventually, it will damage adjacent teeth and you will end up losing all your teeth and pay more. Good luck. Make sure to go to dentist that has experience with zirconia. At least 20 cases.

[@linearmemories]

Titanium is highly biocompatible. You do not have to worry about it being in your jaw, unless you are allergic to titanium.

[@88lauradiana]

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.

[@OBrienDentalLab]

There are ceramic systems that are completely metal free. The NobelPearl and the Straumann Pure Monotype are both 100% metal free systems which can be used for posterior (back) teeth. Whether they would work for you specifically is something that would need to be determined by your dentist or specialist after they have done an evaluation.

[@88lauradiana]

Thank you for your prompt reply & great support, Doc! This is a great news! 🙂 🌈🙏 Much, much appreciated!

[@ThuLe-eh1xe]

@@88lauradiana i will have zirconia nobel pearl implant, abutment and crown for my molar also because i do not like titanium which has aluminium in it. But one of the dentist told me that even zirconia has metal mixed with it. Now i am confused. Have you had implant yet? With zirconia? What do you think about zirconia has metal in it? Are you pleased with zirconua implant, abutment and crown? Please let me know. Thanks.

[@SavDog262]

@@ThuLe-eh1xe did you ever find a solution for your implant. I need one at one of my back teeth. Looking to use Zirconia as well. How did yours go?

[@ThuLe-eh1xe]

@@SavDog262 i had my molar done, zirconia a year ago by holistic dentist. Make sure abutment and crown are zirconia. No titanium screw. My dentist use glue . Please read all my comments. I have to go now. When I am back, I will talk more. I am very pleased with my zirconia crown and abutment. Make sure you go to dentist that has at least experience with 25 patients getting zirconia. Do not use STRAWN, USE PEARL BOBLE ZIRCONIA.

[@VicTheflyingDentist]

Very helpful video

[@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?

[@fdcendm]

Full titanium abutment are more durable

[@MyouKyuubi]

@@fdcendm like i said in my comment, it's not all about durability.... :P

[@inkbold8511]

If you already made up your mind why bother to ask the question?

[@MyouKyuubi]

@@inkbold8511 It seems neither of you understood my question. Although it puzzles me how my question is so hard to understand... But that's alright! I wasn't asking either of you anyway, i was asking the actual dentist who's opinion would actually matter. Have a nice day.

[@fdcendm]

@@MyouKyuubi you can make a full zirconia crown

[@Bahramiish]

Hello, just wanna say I am an Alex from O‘Brien ULTRA Fan. Keep it up

[@OBrienDentalLab]

Thank you so much!

[@manaaladam]

Hi there, I wanted to ask whether SGS implants would be great, it's a German brand. Or eurotecnika (ETK) a french brand.

[@nyatio]

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

[@OBrienDentalLab]

Both of those are popular and highly respected implant systems.

[@nyatio]

@@OBrienDentalLab but sad my case cannot be done on immediate loading. Have to wait at least 3months before get my permanent cronws

[@nyatio]

I just got another implant placed, Nobel Biocare Active. Is it also good implant?

[@zaynumar0]

Hello Doc. I'm a young man and I've had a titanium implant for my Central upper incisor. What sort of abutment will I be expecting

[@OBrienDentalLab]

There are a lot of factors that your dentist will consider when choosing an abutment. Every patient's situation is unique so the answer to that question can only be answered by a dentist who has evaluated you.

[@yanchan640]

Hi Dr I have No.19 need to do implant, which brand is good for my teeth thanks

[@dr.avinashksajnani7930]

Can’t go wrong with Straumann

[@ThuLe-eh1xe]

Nobel pearl has no metal in it. Go with nobel pearl. My dentist will use nobel pearl zirconia company with me. Please read all the comments and the dr reply. He said nobel pearl zirconia has no metal in it, but strauman has. Good luck.

[@215Ride]

@@ThuLe-eh1xe look up zirconia on the periodic table of elements. it is a metal a couple spots away from titanium, furthermore it is usually combined with yttrium which is also a metal.

[@SG-qq4ig]

@@215Ride zirconium is metal, zirconia is ceramic

[@MaxStudioCG2023]

hello ..i got a question more as a doubth ....i want zirconia implants but my doctor pnly work on titanium telling me that titanium is the best trying to convince me to put titanium ...etc but i still want zirconia sience i hear alot of people that is almost as good as titanium and better estetics in time wont see the metal color ... so should i stick to my decision and search a doctor that work with zirconia ... (my doctor ...alreadu evaluate my mouth but telling me where posible to put implants and how many to put ....but no what material is better ...sience he only work with titanium always saying titanium is better)

[@ThuLe-eh1xe]

Titanium has aluminium in it that will cause memory and health problems in future. Most dentists do not know how to use zirconia. I have to go to holistic dentist. It is more expensive. But our health is worth it. I went to 7 dentists for consultation. and research a lot. I choose nobel pearl zirconia. The dr of this channel said nobel pearl company do not mix metal with zirconia. So, i choose nobel pearl company for zirconia. And my holistic dentist use nobel pearl slso. Good luck.

[@MaxStudioCG2023]

@@ThuLe-eh1xe but you talking about the implant itself or the tooth (the exterior) i want to know about the implant the interior

[@ThuLe-eh1xe]

@@MaxStudioCG2023 what do you mean interior? The implant is like a scew made of zirconia. Dr will put in through the gum and the bone. The abutment is like a screw made of carcon fiber that will screw the new tooth ( crown made of zirconia also) to the zirconia implant . So the whole thing is mafe of zirconia, no intetior, no exterior according to my knowledge. Make sure your dr do not put titanium posts inside the crown to strengghen the tooth. My dentist put titanium posts in my other crowns without asking our permission when he did crowns to me. Now, to undo and get new crown, it cost 2000 dollars for each crown. So. Always let your dr know you do not want titanium posts inside the crowns either. No metal in the mouth, no mercury either.

[@MaxStudioCG2023]

@@ThuLe-eh1xe ok ...same thing i asked ...thank you ..verry helpfull ...now i cleared my unansered queations ...ok ...that was all i want to know if the implant made of zirconia also .thank you

[@ThuLe-eh1xe]

@@MaxStudioCG2023 my implant will cost 2120 if the insurance does not pay little bit. My abutment and crown will be 3600 if the ins does not pay little bit. So total will be5720 if insurance does not cover. If they cover, it will be 1000 less. I live in USA. Where do you live?

[@innasokolov5328]

What do you think about Bicon implant system?

[@dr.avinashksajnani7930]

One the of the best

[@MaxStudioCG2023]

hafe of bitcoin you get gold implants :)))))

[@painless4415]

Bicon is a good implant but in limited situations. Astra is a better solution that works in all circunstances.

[@toheedhamid7784]

Great video 👍🏽

[@OBrienDentalLab]

Thanks!

[@vimalah190]

I found it jabbing through and with letters for words and very cacelly - not custumer friendly

[@subhash7408]

Mono implants

[@user-jo7jj5sr9e]

i love you

[@user-jo7jj5sr9e]

you taught me more than any of my lecturers

[@OBrienDentalLab]

Thank you so much!

[@abou374]

لن أستعمل أي واحدة لأنني لن أبيع منزلي لأعطي ثمنه لكم أيها التجار الكذابون . وإلا ففي أي منطق يكلف الزرع عندكم 40 ألف دولار ؟ أنتم تجار لا رأفة عندكم