How are dental implant types classified?

In this video Dr. Dt. Kıvanç Türkoğlu classifies the implant types that patients often confuse, in two ways: by material and by the bone they anchor in. The article below follows that classification and outlines when each type is considered.

What the video covers

• Implants placed inside the bone fall into two groups by material: titanium and zirconia.
• Titanium has been used the longest and most widely; zirconia may be considered especially at the front of the mouth to avoid a dark shadow.
• When the upper jaw has lost a great deal of bone, zygomatic implants anchored in the cheekbone and pterygoid implants supported by the pterygoid bone at the back are among the options.
• Subperiosteal implants sit on top of the bone, are designed individually from a 3D model made from a CT scan and can be used in advanced bone loss.

Material: titanium and zirconia

Most implants used today are made of titanium or a titanium alloy. The material has been used for decades and its bonding with bone has been studied extensively.

Zirconia is a white ceramic. It may be discussed for front teeth, where a grey shadow could show through thin gum. Clinical data on zirconia implants are shorter-term and more limited than for titanium, so the material is chosen with your clinician according to the site, gum thickness and prosthetic plan.

Standard implants and their sizes

Most implants placed in everyday practice are screw-shaped standard implants that sit inside the jawbone. They come in different lengths and widths. Shorter implants may be considered where bone height is low and narrower ones where the bone is thin.

Whether a standard implant fits is found by measuring the bone on a CT scan. If bone is lacking, grafting or a sinus lift is discussed first. These options are covered in the dental implant surgery section.

Zygomatic implants

A zygomatic implant is a long implant considered for some patients with severe bone loss in the upper jaw. It starts inside the mouth and its tip anchors in the cheekbone, which can provide support for a fixed bridge without grafting.

The procedure is more extensive than standard implant surgery and has its own risks. Who it is considered for and which risks are discussed are explained in the zygomatic implants section.

Pterygoid implants

At the very back of the upper jaw, behind the sinus, there is an area of dense bone extending towards the skull base. A pterygoid implant is placed into this area at an angle. When bone at the back is short, it can be an option for gaining support without a sinus procedure.

Because the area is deep and access is limited, planning is done on a CT scan. Suitability depends on the bone anatomy and the prosthetic plan.

Subperiosteal implants

A subperiosteal implant does not go into the bone. It is a thin framework that sits on the bone under the gum and is fixed with screws. In current practice a 3D model is made from the patient's CT scan and the framework is manufactured to fit it.

This option is discussed in selected cases where the jawbone is far too thin for implants inside the bone and other routes are not considered suitable. Long-term data on these custom-made frameworks are still accumulating. Problems such as the gum receding over the framework have been reported.

What does the choice depend on?

The main factors are the amount and quality of remaining bone, the position and number of missing teeth, the type of prosthesis planned and general health. For most patients the first option considered is a standard implant inside the bone. Zygomatic, pterygoid and subperiosteal implants are reserved for advanced bone loss where the standard route is not suitable.

The benefits and risks of each option are discussed after the examination and CT scan, and the right route for you is decided together.

Frequently asked

Is a zirconia implant healthier than titanium?

Both materials are considered biocompatible. There is more long-term data on titanium. Zirconia is mainly discussed as an option in the aesthetic zone, and the choice depends on the site and plan.

I have very little bone. Are fixed teeth still possible?

For some patients it may be possible through grafting, zygomatic or pterygoid implants. The bone first needs to be measured on a CT scan.

Can anyone have a subperiosteal implant?

No. It is considered in selected cases where implants inside the bone are not suitable, and it requires individual planning.

Related section and videos

• Section on the expertise page: Dental implant surgery
• What is a dental implant and what are the stages of treatment?
• Who are dental implants suitable for?
• Care after implant treatment
• How is an implant chosen?

This information is for general guidance and does not replace an examination. Rapidly spreading facial swelling or difficulty swallowing or breathing is an emergency. Go to a hospital emergency department.