Why are dental implant estimates so different?

I have gotten that question multiple times in my office regarding why dental implants are being advertised for $600 as opposed to our estimates which can average $3500 per tooth!

Assuming the philosophy, "you pay for what you get", has already been exhausted, there are many factors to consider when getting a dental implant.  I will list a few of the things I have observed that affect the quality of implant.  By quality I do mean you do not have problems with them as early as 3-5 years.  An implant comes in 3 parts, implant body, implant abutment and implant crown. Below are a few things to consider when deciding to move forward with a dental implant tooth replacement.

1. The surgeon placing the implant body is very important in my opinion.
 
Have they placed implants successfully for many years and are they honest about this from the beginning? (3-5 years)

Do they take precautions to place it in the right location? (Cone beam xray)

Are they selecting the right thickness and length of implant? (Cone beam x-ray or utilizing gauges to measure bone or extracted root thickness).

Are they selecting a reputable implant company with good support from the company?

Are they keeping to placing implants based on their training? If they are getting started placing implants are they case selective and able to select simple cases with you while also offering the use of a specialist?

Did they make sure adequate bone was available before placement and discussed the extra costs for bone grafting or sinus lifts?

Was a Cone Beam CT scanner used to obtain the bone in the 3-D in order to study ideal placement, vital structures, bone denstiy and implant size?

Do they take precautions to avoid vital facial anatomy, like the maxillary sinus, inferior alveolar nerve, mental nerve, and perforation past bone as to limit risk of complication?(Cone Beam CT Scanning)

Are they utilizing current techniques is bone grafting, membrane placement and tissue management where needed(emergence profile)?
 
Here are a few things to consider regarding implant body. With hundreds of dental implants on the market, it is recommended to be using the type of implant that has a strong customer support team, solid research proving it's success, flexibility to adapt to unique situations (bone level vs. tissue level, mini-implant, etc, etched surface for better osseo-integration), threading to allow ideal primary stability of the implant at placement.  Generic or less know companies producing implants may be available but in 5-10 years they may be out of business or hard to get in contact with since they may have discontinued production or discontinued earlier models(I've run into this restoring an implant system I will not choose to mention here).

3. Here are a few things to consider regarding the implant abutment. Ever heard of failure due to dental cement excess, or failure due to a loose abutment from a weakened screw.  Well if the abutment was a screw retained abutment vs. solid abutment life has gotten a lot easier for you.  Removal becomes very predictable and most of the time inexpensive. Did they use implant abutments that are manufactured from the same implant body company as to avoid errors in fitting and not void the warranty or increase chances of loose abutments? 

4. The implant crown.  Is it screw retained or cement retained? Did the dentist take the extra precautions to limit the excess cement around the implant? Did they offer a screw retained option vs. cement retained to allow access easy access to the screw if the abutment get's loose and decrease risks of complications due to cement? Are they keeping good records so in 8 years there is a problem the solution can sometimes be a simple implant maintenance visit versus having to redo the whole abutment and crown.

Not to overwhelm the patient but I do encourage knowledge. Not all implant cases are done with the same level of quality and concern as they should.  I do believe some specialists are not always perfect either and few can be caught charging high costs for implants.  That being said I also feel cutting corners to go with the cheapest dentist can sometimes result in getting what you pay for.  

Another note, after calling a few of the offices that advertise 'cheaper' implants I found they were only pricing out the first step of the implant process and that was only given after a consult concluded it was an 'basic' case.  If not so 'basic' you would be given the 'real' cost of the implant.  So $600 was only the implant body but the abutment and crown resulted in a total of $2800-$3000.  A little misleading if you ask me!

Best of luck on your journey to good oral health.  We are always happy to give a second opinion on any cases out there so feel free to call the office number and set up an appointment.  I am always happy to tell people they do have an excellent dentist and encourage them to stay with them if they found one!

Dr. Maq Serang, DMD 
CEO, Serang Dental Associates