Dental implants have been used for nearly 40 years, but today's implant systems are very different from those of the 1980s. Many patients can go home with a crown or bridge on the same day that their tooth is extracted.
Becker's Dental + DSO Review recently spoke with Rodrigo Neiva, DDS, chairman of the department of periodontics and clinical professor of periodontics at Penn Dental Medicine in Philadelphia, about the evolution of implant dentistry and how Dentsply Sirona's PrimeTaper system is transforming patient care and dentist workflows.
Note: Responses edited for length and clarity.
Question: How has implant dentistry changed over the years and what changes have most excited you?
Dr. Rodrigo Neiva: When implant dentistry started in the 1980s, it was used primarily for patients with complete dentures. Dentures usually don't have good retention. They work well for a couple of years, then they become loose and they have to be realigned often. The implants that we used back in the 1980s were very successful in the lower arch, but not very successful in the upper arch.
In the 1990s, implants changed in terms of their surface texture. Enhanced roughness allowed implants to have good success in the upper arch. With that success, we started to use implants for people with partial dentures, mixing implants with teeth. That's when things really started to change in implant dentistry.
We started using implants to replace several missing teeth and things evolved even further and we used them to replace single teeth. To accelerate the process, we started to push the envelope. Up to that point, the rehabilitation process for patients took 12 to 18 months. We pushed to use implants sooner.
Today we use implants for a variety of clinical situations and indications. We have much more aggressive protocols for placement and rehabilitation. Instead of waiting for the tooth socket to heal, we place implants in the socket at the same time that we extract the tooth. That saves four months of healing. In many situations, we can place a crown or bridge on the same day, so the patient can go home with teeth instead of waiting 12 to 18 months to finish the process.
What really excites me is seeing this constant evolution of implant dentistry that helps us better serve our patients.
Q: Can you talk about your experience with the PrimeTaper system? What about this system stands out?
RN: The significant evolution in implant design to allow for more aggressive placement protocols came at a price. Many implants that were designed for more aggressive use also had problems. They weren't as bone friendly as some of the more conservative protocols. One of the drawbacks of some of the early aggressive protocols was that they started to fail quite soon after implantation, rather than lasting for the rest of the patient's life or for as long as possible.
A persistent challenge has been finding the sweet spot where we have an implant protocol that can be aggressive, but also bone friendly. When we place implants in a more aggressive way, we also want good long-term outcomes. What excites me about the PrimeTaper system is that we have finally found that sweet spot.
It's an implant design that can be aggressive when needed, but it can also be very conservative. It allows for more aggressive protocols with regard to placement and rehabilitation. At the same time, PrimeTaper brings a lot of the Astra EV key features — it's bone friendly and gentle on bone healing.
The PrimeTaper implant gives you a lot of confidence to place it with ideal torque which is primarily what we use to determine whether we can restore a tooth same day. At the same time, it's also very tissue friendly. I think this is what really differentiates PrimeTaper. It's an implant system that fits all your needs for both conservative and aggressive protocols. It's not self-limiting like some other systems that we've seen before.
Q: How does the PrimeTaper system influence patient care and the dentist workflow?
RN: PrimeTaper influences care and dentist workflows by providing many different options. You can be either aggressive or conservative, depending on the patient's wishes or needs. It maximizes and optimizes dentists' time. That increases productivity and overall patient satisfaction.
The surgical kit is very simple compared to other kits and there are fewer steps to place the implants. There are also fewer parts on the restorative side. Fewer parts simplify your office inventory and fewer tools have a positive effect on overhead. I think these are very attractive things about PrimeTaper.
Conclusion
Dentsply Sirona's PrimeTaper offers excellent stability, is easy to handle and enables an efficient workflow. "I think it's very significant that PrimeTaper is following modern trends in implant dentistry. Older implants were complicated in terms of the parts and pieces that were needed," Dr. Neiva said. "PrimeTaper has really simplified things."