All Dental Implant Companies Aren’t the Same

3 Tiers of Dental Implant Companies

Dental Implant

I’ve been placing dental implants for over 35 years and, unfortunately, I’ve noticed a disturbing trend developing in the industry. It seems that the dental implant industry has become segregated into 3 basic tiers.  The 1st tier is what I call “Industry Leaders”.  These are predominantly long-standing players in the field, with big market penetration, extensive research in their products, and great field representative support with high manufacturing/ distribution standards.  Obviously, these implants are the most expensive!  You’re paying for that marketing and for their expertise.  The 2nd tier is the ‘Me Too” group. This group of implant companies say that they are just as good as the market leaders, have equally high standards and are “just as good’ as the industry leaders. It’s possible that their manufacturing is as good, although not guaranteed, but they clearly don’t have the research and education budgets of the market leaders. Their implants may be more price competitive.  Additionally, they will commonly have less field representation for the surgeon and restorative dentist. The 3rd tier implants, the “We’re Cheaper” group, are companies that primarily market directed to the doctor, and compete on price only. They have limited to nonexistent sales staff and are supported with minimal research.

The part of this trend that concerns me the most is, the “race to the bottom” based on cost.  Dental implants are a business and a significant portion of many dental practices.   If costs can be reduced, this saves on overhead and ultimately improves profit.  Nobody wants to hear about profit in healthcare. Unfortunately, it is a reality, and the balance between what is best for our patients and the cost of providing those services is always part of any decision.  If it was as simple as saying, the cheapest implants are equally as good as the best implants, then the decision would be a “no-brainer”.  However, this is not the case. The tier 1 and tier 2 implant companies have spent millions of dollars in research and development to make sure that their devices are optimally manufactured and delivered.  Hey, aren’t these just machined titanium screws?  Hardly!  The fit and finish of these devices is highly engineered and specific to brand.

Dr. David A. Burt, at wrote an interesting article recently entitled,” The importance of using authentic implant parts”. Find it here at . In this article, he talks about some of the marvelous engineering that goes into dental implants and, in particular, the abutment/ implant interface issues such as micro gaps, appropriate implant screw preload forces, abutment mechanical tolerances, elastic deformation, and cyclic fatigue.  All of these issues can affect the dental implant or restoration and can lead to premature failure if protocols are not followed.  Mixing aftermarket components with existing dental implants invalidates the manufacturers research and voids warranties. Being penny wise can certainly be pound foolish.

Another issue of using 3rd tier implants, is that if the patient moves to a new location, the new treating doctor may have no clue as to the type of implant utilized. This creates issues in trying to repair and/or replace existing implants. We have certainly seen this to be the case, as we commonly see people referred to us who had implants done either out of the country or somewhere else and they have no clue what is in their mouth!  In the rare cases where we can identify the implant, often times finding the components becomes a challenge.  If we are unable to identify the implant system, then repair is not possible and the implants must be removed.  This makes for a very unhappy patient!

I’ve reached the point in my career where I have many patients who have dental implants in place that are 35+ years old.  It makes me realize that, when I place an implant it’s going to be there for a while- in all probability, and I want to be able to have another treating doctor know exactly what is in this patient’s mouth, and be able to obtain components for this implant in the future.  For this reason, you can be assured that the doctors at Texas Oral Surgery Group will never use the “3rd tier” type implants. Your mouth and your dental health is too important to cut corners!

If you are searching for high quality dental implant care, we encourage you to contact one of our four convenient office locations at Plano, Denton, Decatur, or Gainesville and schedule a consultation.  We look forward to providing you with the care you deserve.


The views expressed, are mine and mine alone, and I might be wrong…but I doubt it! I’m open to hearing opposing points of view and have been known to change my mind… from time to time. 😊

Larry R. Stewart DDS, MS, FACD, FICD

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