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Implant selection guide

Implant types and sizes

The first thing that a dental surgeon thinks about is how a patient's occlusion will be corrected. The dental surgeon needs to have a mental picture of the final occlusion and chooses an appropriate implant. The surgeon needs to decide to use either a bridge or an overdenture and place either a freestanding or connected prosthesis. The next thing is to ascertain whether or not an implant can be placed under the given circumstances. Therefore, preoperative tests are very important in ascertaining bone width and thickness. How an implant is selected is described in detail below:

one-stage 2-piece implants
(B-type and BW-type)
two-stage 2-piece implants
one-stage 2-piece Esthetic implants
(E-type and EW-type)
1-piece implant

Choice between one-stage implants(B-type/BW-type/E-type/EW-type) and two-stage implants(C-type)

There is no set rule for using two-stage or one-stage. In most cases, the choice between the two is dependent on surgeon preference. However, surgeons who use both methods select the two-stage in certain cases:

<Bone substance>

If bone substance is extremely poor and a small amount of force can cause implant instability, the two-stage(C-type) is selected. In other words, the two-stage is often selected when placing an implant in the maxilla. Also, the same applies when combining GTR or GBR or simultaneously performing sinus lift and implant placement. In such a case, by ignoring the normal relationship between an implant and drills, an implant hole is made using a drill that is one size smaller to achieve strong mechanical fixation due to the self-tapping design.

<Near complete-denture patients>

The two-stage(C-type) is suitable in patients with full dentures or when vertical stop cannot be ensured. Whether an existing denture or a temporary denture is used, the two-stage is advantageous in terms of implant stability when compared to the one-stage where the head is exposed.

<Freestanding implants>

Arrow Implants have a 8Morse tapered part where the abutment is to be fixed. When screwed in strongly, tapered lock will not loosen. However, if tight screwing is not possible, it tends to loosen since it has no mechanism to prevent rotation. Comparing B-type and C-type in this regard, for B-Type, prosthetic appliance margin is taken from the shoulder section of the fixture as though wrapping the abutment while for C-type, the margin is taken from the straight section of the abutment. That is, Type-B implants will seldom loosen since they can be stabilized directly at the fixture. For this reason, choose B-Type for a freestanding implant, if the diameter is the same.

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