Tim,
You have some good questions, and have touched on two of the subjects that are critical to avoiding dental implant failure. I will answer those, and add a third criterion you didn’t address.

On the first subject, I would do the CT scan. I will tell you that a lot of dentists will place an implant without a CT scan, and it isn’t hard to find them. But there are a lot of implants placed to replace front teeth where the root form pokes through to the nasal sinus. Or the dentist will try to avoid that by using a short implant, which isn’t sturdy enough to hold up long term. So I would do the CT scan. There are some x-rays you could cut out, but I wouldn’t cut out this one. Placing an implant is a 3-dimensional activity and the dentist needs that 3-dimensional CT scan in order to assess if there is enough bone, in both depth and thickness, to accommodate the implant without poking through somewhere it’s not supposed to.

On the second matter, as far as the brand of implant fixture, the problem you want to be concerned about isn’t so much finding a replacement part or making an adjustment later–you should be most concerned about the quality control of the manufacture. I’m not sure about the quality of Southern Venturi implants. I interview many top dentists about their dental implants treatment and I’ve never interviewed a dentist who has used that brand, so I’m leery. These fixtures need to be made to very exacting standards, which is required to avoid dental implant failure. This is a big issue with implant dentists. A dentist can save a lot of money by going to cheaper manufacturers, of which there are many, but they sacrifice that precise fit that is required for long-term success.

Excellent implant dentists are very fussy about the brand of implant fixtures they use. The top two manufacturers are Straumann and Nobel Biocare. Also excellent would be 3i, BioHorizons, Zimmer, and Astrotech. Some dentists add Bicon to this list, but that company is controversial with some top implant dentists who question their long-term success rate. I would not go to an implant dentist who uses a cheaper implant fixture.

You have to be very careful with implants. This is the number one field for dental malpractice lawyers in the United States, and I have no reason to believe that the situation is any better in Europe. Since dental implantology is not an officially recognized specialty, a dentist can get into it here in the states without any specialized training. If you want to be really certain of your dentist, look for some credential (fellowship, diplomate status, or accreditation) from either the International Congress of Oral Implantologists or the American Board of Oral Implantology. (While these organizations don’t have many members in Ireland, both of them have some.) This is a third key to avoiding dental implant failure. Otherwise, you can walk out of the office very happy with your dental implant but then five years later be looking for a dentist who can put you back together because the implant came loose and the surgical site needs to be rebuilt with bone grafting. Or you could have any of a host of other problems with them. I should add that many quality implant dentists do not have one of these credentials, but if they do have one, it is a reassurance that you are in good hands.

I hope this is helpful.
Dr. Hall

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