The old joke about dental implants is, you need bone and money. Bone can be created. Money is usually earned. When teeth disappear, the bone housing around the roots disappears. Frequently, this requires additional surgery/grafting for the placement of dental implant(s). In the old days, and still commonly practiced today, the grafting was a separate surgery. Twenty-five years ago the surgical sequence over many months was: 1-We took the tooth out, 2-Later grafted the area, 3-Later placed and buried the implant, then we finally 4-Exposed/activated the implant. Not many people are willing to go through 4 surgeries over two years to have a fixed tooth replacement. More than one surgery is sometimes still necessary (severely abscessed tooth), but these procedures can be frequently combined.
Time, trial and error have lead to better implant design with better success and bonding strength to bone. Old rules about teeth (root twice as long as crown) don’t apply to implants. Implants are frozen to the bone (ankylosed), so they are stronger. They don’t need to be as long. Therefore, an implant can be shorter or narrower than the tooth it is replacing. This has been tested in research centers with great success. Implants can be placed in tighter spaces more directly. This translates into decreased costs, surgeries, and time to completion.
This is a retired dentist, who lost lower front teeth ultimately. Root canals failed, Maryland bridge failed; minimal bone for dental implants. Two small Bicon 3 x 8 mm implants were placed, angled into the greatest thickness of bone-no grafting. They were restored at 4 months with integrated abutment crowns (IACs). IACs are one piece abutments and crowns. These were simple to restore. The abutment/crown complex just drops into the implant well after a small incision is made to expose the implants. The first photo is immediate insertion. The second, after soft tissue healing. The patient is extremely happy with the excellent result. There are many implant systems on the market. I use three different and very good ones. The Bicon system has been used since 1985, almost unchanged. It has a great long-term track record. There is no other system besides Bicon that works as well under adverse conditions like this.