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Factors that Influence the Cost of Dental Implants

Many adults lose one or several of their permanent teeth at some point during their lifetime. Missing teeth are more than just a cosmetic problem, as gaps in your smile can lead to crooked or shifting teeth, bone loss and decreased self-confidence. Dental implants are a great option in many cases and can last a lifetime if well cared for. These five factors influence the final cost of your dental implants.

  1. Number of Replacements
    Replacing several teeth will cost more than the restoration of a single tooth. Depending on the configuration of your mouth and the health of your teeth and gums, you may undergo replacements concurrently or at different times.
  2. Location of the Tooth
    Each mouth is different and needs individualized care. Different types of teeth require slight adjustments in procedure to achieve the desired results. The angle of front teeth is especially important as it needs to match the existing jawline to ensure your smile looks great. Some situations require more advanced work, which can affect cost.
  3. Bone Density
    In order for implants to be successful there must be enough bone to secure the titanium post. Low bone density does not disqualify you from choosing this treatment option, but it does require more preparatory work to ensure a successful result. Initial bone grafts or sinus augmentations are used to successfully prepare your mouth to receive a replacement tooth.
  4. The Need for Extractions
    If the tooth that needs replacing has not yet fallen out of your mouth, it will need to be extracted, which is a separate procedure with an associated cost.
  5. Overall Oral Health
    Patients suffering from gum disease or other oral health conditions will need independent initial treatments to ensure a healthy mouth and the best possible likelihood for a successful implantation.

Patients are often confused and frustrated as to why All on 4 dental implants costs vary so much. From the outside perspective, this frustration is warranted! Cost can vary as much as $15k-$35k per arch depending on these factors:

  1. Geographical location – Depending on where you live, the cost of All-on-4 dental implants can vary up to $20,000 per arch. The lower the cost of living usually leads to a lesser price.
  2. Two Office specialist approach vs One Office that does both Surgical and Restorative – When two offices are involved the fees are almost always more expensive versus an office that handles the surgical phase as well as the restorative phase.
  3. The Surgeon’s Experience (Specifically with All on 4 Dental Implants) – Unfortunately many dentists have a desire to begin doing All-on-4 implant procedures, but they also have so little experience that they will often lower the cost to win a case. This is often done without letting the patient know of the level of experience. This is a big factor in the price, and their inadequacy will usually result in tacking on costly and often times unnecessary warranty fees. Labs that have more experience and provide extra customization charge more to the doctor and therefore the price increases. Some doctors do not disclose that they send their work overseas to other countries with lower cost of labor and no regulation of materials. These devices often look similar to other dental offices but lack the integrity and can fail 3-5 years later.
  4. Number and type of Implants – Although four implants per arch is the perfect and ideal number, at times additional implants must be placed. This can be due to loss of bone, severe infection or the density of inner bone.
    1. Majority of implants are placed in the maxilla or mandible but in certain cases with severe bone loss, longer implants, which are more invasive must be placed in zygoma bone just below the eye.
  5. Sending out Lab Work – offices that can keep most and in some cases all of the lab work in the office are able to lower price as well due to economies of scale. Most offices have the final device made outside of their office.
  6. Cosmetics and Functional Demand varies by Patient – The material used for an all-on-4 dental implant bridge can vary in price significantly .
    1. Titanium Bar is the most commonly fabricated and will usually be cheaper than zirconia because stock denture teeth are used to save money in most cases.
      1. With Denture teeth
      2. With Monolithic polymer
    2. Zirconia is more expensive because it is 100 percent customized to the patients mouth and cosmetic needs, as well as being the most durable bridge
      1. Stained Monolithic
    3. Other Materials not as common – generally these are less expensive than the titanium or zirconia due to the type of mill needed to fabricate titanium or zirconia and are only the substructure attached to implants and need other materials for the teeth and gums.
      1. Trilor substructure
      2. Trinia substructure
      3. Pekkton substructure
    4. The presence of any porcelain for gums and teeth and how it’s veneered or crowned (Porcelain weakens the device but gives it an even more customized appearance)
  7. Level of Anesthesia – This procedure can be done under local anesthetic, I.V Sedation, or General Anesthesia, which increases the price with each level of anesthesia, as well as the location it is rendered in. A hospital setting will be much more expensive than a dental office that brings in an Anesthesiologist.
  8. Additional advanced techniques required to deliver the all on 4 dental implant bridge
    1. Existing implants that are used or removed can increase the price in both scenarios because it creates more work for the doctor and staff to research the implant system or remove the implant/s.
    2. Excessive infection in bone and soft tissue
    3. Excessive bone loss
    4. A maxillary sinus that is positioned more anterior
    5. A mandibular foramen that is more anterior and has branches reaching into anterior chin
    6. Lack of keratinized leather tissue over ridge
  9. Overall level of Difficulty and Risk Factors in healing and long term success with All on 4 Dental Implants
    1. Teeth Grinders – Often break temporaries and have more failures and some doctors will increase the price in anticipation of the higher likelihood of complications
    2. Smokers – Carry an implant complication risk that is 3 times higher than a healthy patient that does not smoke.
    3. Diabetics – As long as the diabetic is controlled with an A1c of 7 or lower, there is no need for higher fees.
    4. Previous drug abuse – Can make the treatment more complicated depending on the likelihood of rebound
    5. High smile pull – One of the most challenging presentations that often carries with it added surgical procedures and restorative appointments in order to satisfy the patient and produce a bridge that is comfortable and easy to clean.
    6. Skeletal deficiencies – Can increase the price because more visits are often needed to systematically create the skeletal appearance that is pleasing, as well as comfortable for the jaw.
  10. Time – If you want to have your All-on-4 Dental Implant procedure expedited, this is great for someone who is extremely busy or someone from out of state that doesn’t want to fly back in 4-6 months, you can have your permanent implants in one weeks time! This expedited procedure, if the patient qualifies, can be a little more costly, but it is definitely something we can have done at Dream Dental!

Who would pay the least for All on 4 Dental Implants?

  • Someone living in, or willing to, travel to an area with a lower cost of living and a competitive market (such as Salt Lake City, Utah!)
  • A denture-wearer who hasn’t experienced excessive bone deterioration and still has healthy, leathery tissue
  • Someone who chooses a titanium bar with denture teeth
  • Being awake for the surgery
  • Choosing a single office that does the surgical and restorative work with an in-house lab

The price could be as low as $15,000 per arch!

Who would pay the most for All on 4 Dental Implants?

  • Someone who lives in a city with a high cost of living such as LA, NYC or Miami
  • Someone who needs additional implants or zygoma implants
  • Someone whose teeth are extremely infected
  • Someone who has severe bone loss in the areas where the implants need to be placed
  • Someone with high cosmetic and functional needs
  • Anyone wanting a zirconia bridge with individual porcelain crowns and porcelain gums
  • Choosing to have it done by two offices, an oral surgery and restorative without an in-house lab
  • Choosing to use Full General Anesthesia (generally patients with high anxiety choose this option)
  • Someone requiring removal of existing implants
  • Someone with a high smile pull
  • Anyone who is a smoker, has diabetes, grinds their teeth, or has a history of drug abuse with a deep bite

The price could be as high as $35,000 per arch!

Dental implants are fully placed in the bone in order to replace the natural root of the tooth and allow the installation of a dental prosthesis. The implant has gained importance with the work of Professor Per Ingvar Brånemark, who studied the microcirculation in bone tissue. Brånemark used stainless steel optical chambers to investigate the anatomy and physiology of tissue injury. The chamber was inserted in rabbit and dog legs. In some experiments the chamber structure of stainless steel was replaced by titanium. At the end of the experiments, Prof Brånemark observed that the titanium chamber was firmly attached to the bone. In fact, the titanium chamber could not remove from the surrounding bone once it had healed. Histological studies showed complete integration of titanium with the bone. After this chance observation, Brånemark developed a new concept of osseointegration which led to dental implants. The use of titanium-based dental implants in humans begun in 1965.

Dental implant technology was improved in recent years, providing patients with unparalleled levels of effectiveness, convenience, and affordability. This is one of the main reasons why so many dentists recommend dental implants as their preferred method to replace missing teeth. Titanium dental implants can offer many benefits. Because they present osseointegration with the jawbone, they are more stable than dentures. Patients with dental implants may be able to talk and eat more easily because they do not face the risk of their dentures dislodging. Dentures require replacement when the gum tissue shrinks and changes the fit; implants are not affected by this problem. The maintenance and hygiene of dental implants are easier than with dentures. Another reason for continued growth of the global market for dental implants is that dental implants offer an effective treatment for edentulism and because of the rising demand for cosmetic dentistry worldwide across all age groups.

The conventional clinical protocol proposed by Brånemark for placement of dental implants involves two phases. The first is the placement of the implant in a surgical cavity prepared in the bone. The protocol recommends a healing period for tissue reorganization. The waiting time for healing to occur depends on bone quality and the region in which the implant was performed and was estimated by Brånemark as between 3 months to 6 months. The second phase of treatment is the prosthesis placement. With this technique, all natural teeth can be replaced, restoring function and aesthetics to the patient. The conventional protocol can be changed so that insertion of the implant and prosthesis placement can be made in a single step. In this case, the protocol is called immediately loading.

The dentistry has an interest in reducing the healing time after surgery and loading the implants with oral forces safely. To meet this expectation one must consider that the body has a minimum time to perform the reactions that lead to osseointegration. In order to shorten the healing time, the strategy is to alter the biocompatibility of titanium implant surfaces, modifying the surgical technique and changing the implant design.

Despite the influence of the implant shape on the primary stability and the distribution of oral loads, there is no standardization of implant design. There are dental implants on the market with different shapes. The cylindrical screw threaded implants are the most commonly used. Based on bio mechanics and clinical observations, it was found that tapered implants have a higher compression capacity than cylindrical ones. During insertion the tapered implant induces compression stresses on the bone and increases the implant primary stability. However, the tapered implant is not suitable for all applications.

In an attempt to increase the success rate of implants, some researchers used the control of surface properties to select the type of cell that interact with the implant. It is known that osteoblastic cells adhere more quickly to rough surfaces of titanium than to smooth surfaces . Despite the advances in prosthodontic, the explanation of the influence of the implant surface on osseointegration remains incomplete. The new surfaces improve the success of implants in patients with low bone quality and quantity. However, there is still an unexplained loss of implants.

Several papers in the literature describe the importance of titanium surface properties in implant osseointegration. These works studied the morphology, topography, roughness, chemical composition, surface energy, surface energy, surface composition, chemical potential, residual stress, the existence of impurities, thickness of titanium oxide film and the presence of metallic and nonmetallic compounds on the surface. The mentioned factors influence the concentration of cells involved in osseointegration. The importance of this work is the fact that by controlling the surface one can reduce the healing time of the implant and the bone-implant interface has enough mechanical strength to withstand the forces in the oral environment.

Welcome to Manhattan Beach Dentist Ocean View Dental Group! We are a full-service dentistry located in Manhattan Beach, CA. Some of our specialties include but are not limited to orthodontics, root canals, and implant dentistry.