Dentists: Implantology Equipment

Implantology is developing rapidly in dental surgery practices. This technology constitutes a major innovation for the patients, but requires, for the practitioner, to finance specialized radiological equipment.

The benefits for the patient and the dentist

A dental implant is a titanium oxide or zirconia screw that is inserted into the jawbone and which serves as a support for a future artificial tooth. The implant treatment avoids the use of a removable prosthesis or makes it possible to eliminate an already existing removable prosthesis that is poorly tolerated, and avoids crowning the teeth adjacent to the edentulous area, as must be done when a traditional bridge is made.

The implant is the only way, for the patient, to find fixed and permanent natural teeth, with an irreproachable quality. For the dental surgeon, implantology thus makes it possible to meet growing customer demand for comfort and aesthetics.

However, the success of this method depends on the quantity and quality of bone existing at the time of implantation. Before any implant placement, it is therefore necessary to carry out a very precise radiological examination.

Note: the placement of implants requires, for the practitioner, the follow-up of specialized postgraduate training.

The materials to be provided

In addition to specific instrumentation, cements, ceramics, etc., the dental scanner or the cone beam 3D volume tomograph is the main investment to be made in order to equip oneself in implantology. Indeed, the traditional dental panoramic device is not always sufficient, and a volumetric study is very often essential for a fine and detailed study of all the dental arches in the different planes of space.

With the dental scanner , the dental surgeon can obtain the same type of images as with a traditional scanner and visualize the whole of the two jaws in three dimensions. He can therefore check the height and width of the available bone. The 3D images are analyzed by dedicated software, so as to very precisely define the location of future implants. After the procedure, the practitioner can also immediately check the position of the implants. These indications make it possible to better predict the post-operative consequences, and therefore to reduce the risks.

A cone beam type digital tomograph gives the same results, but uses a different technology. It is a sectional technique that gives an image of the entire maxillofacial complex or a complete or limited exploration of the maxillomandibular and dentoalveolar structures. Unlike the traditional scanner, this device works not with a thin x-ray beam, but with an open, conical beam, which allows it to scan the entire volume to be radiographed in one go. Advantage for the patient: exposure to X-rays is less (three to six times less than with a traditional scanner).

In both cases, having a 3D X-ray machine in a dental office prevents the patient from traveling several times: the X-rays are taken within the office, during the same appointment, and it becomes unnecessary to go to a center. radiology.

Note: there are traditional 2D dental panoramic materials that allow, as an option, to instantly switch to a 3D image.

Financing implantology equipment

From around 75,000 to 140,000 euros (software included): a 3D dental radiology machine is a heavy investment. You should also plan for the cost of maintenance, which can be high.

A 3D dental radiology machine is most often financed by leasing , this financing for all new equipment and materials. During the rental period and until the possible exercise of the purchase option, it is the leasing company which remains the owner of the equipment. The dentist will also be able to choose a contract with or without a first increased rent. He can buy back the equipment at the agreed price and without penalties. Rent can be monthly or annual.

Of course, the leasing rents are fully deductible from the firm’s results.

For less expensive equipment, the dental surgeon will be able to finance his equipment by a “classic” loan with a dedicated tariff.


Dental implants are metal “roots” often called “fixtures” that are surgically placed in the jawbone below the gum line. Once in place, the dentist can attach crowns to replace missing teeth.

The implants are integrated into the jawbone where they will provide stable support to the prosthetic teeth. The devices will no longer move when chewing or speaking, which is a huge advantage. Bridges and crowns on implants or removable devices attached to the implants give a natural appearance combined with a certain comfort due to their fixity.

For some people, bridges and removable appliances are not comfortable or even possible, due to painful areas, unsuitable tooth ridges or a gag reflex. On the other hand, bridges must rest on the teeth located on either side of the tooth to be replaced; these teeth will have to be prepared, ground, to serve as abutment for the bridge. Implants make it possible to avoid touching neighboring teeth, thus damaging them.

To place implants, the gums must be healthy and there must be enough bone to give them the necessary space. You should also know that it will be necessary to maintain the whole in good health. Meticulous oral hygiene and regular visits to the dentist are imperative for long-term success of implants.

Implants are usually more expensive than other methods of tooth replacement, and implants have been in constant development in recent years.

Osseointegrated Implants  – are surgically inserted directly into the bone of the jawbone or mandible, below the gum line. After the metal of the implant is integrated into the surrounding bone (after a few months), the implant must be connected, crossing the gum, to the prosthetic tooth which will attach itself to it. 

How long do dental implants last?  – Implants have a lifespan of approximately 10 to 20 years and even more, depending on the location of the implant and the patient’s respect for his oral hygiene and check-ups.

Dentists: The Characteristics Of Dental Centers

There are several types of dental health centers: the oldest are those managed by the mutualist network, and the most recent are those, usually at low cost, created by private individuals in the form of associations.

Dental health centers offer all types of treatment, including implantology and periodontology, and all types of dentures. They practice third-party payment and receive beneficiaries of universal health coverage (CMU). The economic model of dental centers is based on controlling salary and purchasing costs in order to reduce the bill for the patient. But, for it to be viable, this model must operate with a high volume of activity.

The typology of dental centers

These centers are created on the initiative of various organizations. First of all, some primary health insurance funds (CPAM) directly manage one or more dental health centers.

There are also nearly 500 dental centers created by mutual benefit organizations, some of which are specialized, in orthodontics and implantology for example. These mutual centers are approved: they therefore do not exceed the amount of treatment listed in the nomenclature and, in principle, commit to a controlled out-of-pocket charge for other procedures. They benefit from a legal framework recognized by the laws of December 29, 1999 and July 21, 2009 and one by national agreement signed with the Health Insurance in April 2003.

Finally, there are also dental health centers managed by private individuals, through non-profit associations created for this purpose. These low-cost centers have multiplied in recent years. Main reason for their success: they offer very advantageous prices, up to 50% lower than those practiced by liberal dental surgeons. These very low prices are made possible by the fact that these centers are most often backed by commercial companies which supply the equipment. Through a set of cross-services, it is these commercial companies which perceive, in practice, the profits generated by the centers.

But several of these structures, of the “low cost” type, have known or are still experiencing financial problems such as patients and the Order of Dentists have been led to file criminal complaints against them for excessive care or unlike unfinished care.

Very flexible regulations

This is why, in a report submitted in 2016 to the Minister of Health Marisol Touraine, the General Inspectorate of Social Affairs (IGAS) proposes a stricter framework for the activities of this type of center, in order to avoid any commercial drift. .

The opening of a dental health center is in fact subject, since the Hospital, Patients, Health and Territories (HPST) law of 2009, to a simple declaration to the Regional Health Agency (ARS), accompanied however by ” a health plan and internal regulations specifying in particular the health and safety conditions (article L.6323-1 of the Public Health Code). In addition, each year, an activity report must be provided by the center to verify compliance with the commitments made.

But as long as a dental health center complies with the prescriptions of the public health code, with qualified dental surgeons and certified equipment and respecting the treatment protocols, it can quite easily obtain authorization from the ARS. It is this regulation that the public authorities would like to see evolve.

How Is The Placement Of A Dental Implant?

The duration of the operation  varies according to the complexity of the operation (number and location of implants, volume of bone available, etc.). 

The installation is carried out in the OR or in a room dedicated to this function in the dental office. After performing local anesthesia , the practitioner incises the gum. He digs the implant seat into the jawbone with a bur, places the implant and makes two stitches. For two to four months, depending on the location, the wound heals and the bone reforms around the implant: this is osseointegration . It is only after this step that the artificial tooth is fixed on the implant.

For aesthetic or functional reasons, he can place a temporary prosthesis . Can he fix a definitive prosthesis during the same session? Opinions are opposed. Dr Thomas Fortin, dental surgeon, prefers to avoid it:

“This presents a risk of infection, and in my opinion is the number one cause of implant failure. Most dentists prefer to do it in two stages: placing a temporary prosthesis while waiting for the bone to adhere to the implant. implant, then place the false tooth at another appointment. ” 

After two to six months , the practitioner therefore checks whether the implant has integrated well into the jawbone. If it is firmly anchored, the prosthetic step with impression taking and try-in of the final prosthesis (crown, bridge or removable appliance) is initiated.

Bone grafting may be necessary

It is offered when the jawbone does not appear deep enough to receive the implant . “When a tooth is pulled out, the bone tends to get thinner over time,” explains Dr. Thomas Fortin. A part may also have been destroyed by mining. “If a little bone is missing, we can fill the space with synthetic biomaterials or human bone bank , says Dr. Ardouin. If a lot is needed, bone is taken, for example. , at the level of the lower wisdom teeth “. Alternatively, remove bone from the patient’s skull or hip, which requires hospitalization and general anesthesia. The bone is then  fixed with screwswhich is removed when the implant is placed. This operation weighs down the surgery, and lengthens the delays. The risk of implant failure also increases.

Dental implant: better to be patient 

Placing an implant and a prosthesis is a process that can last from a few weeks to over a year . It starts with the diagnosis and workup, then, if there is to be a tooth extraction, the dentist allows the gum to heal for two to three months. Six months must be added in the event of a bone graft, then two to six months after the placement of the implant to install the false tooth. Some practitioners reduce these delays by placing the implant just after extraction, or by placing the false tooth on the same day as the implant. “But the mouth must be healthy, and this is not true in the majority of cases”, recalls Dr. Ardouin.

Dental implants: what contraindications? what precautions?

“There are local contraindications : insufficient quantity or quality of bone, and general contraindications in cases of pregnancy , heart valve disease, bone disease, poorly controlled diabetes , chemotherapy or immunosuppressive treatment. after an organ transplant “, explains Dr. Fortin.

Precautions should be taken in the event of antiplatelet therapy or osteoporosis treated with bisphosphonates , as the latter weaken the jaws. “You have to put yourself in the place of the doctor who follows the patient, insists Dr. Lasry. It is he who gives his authorization for oral care.”

If you smoke a lot , the dentist is likely to refuse to have implants for you. You will have to temporarily concede to stop. In fact, smoking impairs healing and considerably increases the risk of failure of the bone integration of implants.

On the other hand, age, even advanced, does not prevent implantation .

Dentists: How To Finance A Dental Chair?

The dental chair is the most important investment for a dentist who wishes to settle in a private practice. It is therefore necessary, before choosing this material, to carefully examine the possibilities and methods of its financing.

The components of the dental chair

A dental chair conventionally comprises a reclining chair, one or more articulated arms, a compressor, a set of treatment instruments with micromotors, an air / water blower, a spittoon, a suction system, an operating light, a wheelchair for the practitioner.

Most dental chairs on the market also have an ultrasonic scaler, curing light, amalgam separator, and sometimes a dental x-ray machine attached to the chair itself. On the most sophisticated models, we can even find a mobile intraoral camera and its screen or a dental laser, for example.

The cost of a wheelchair varies on average between 10,000 and 25,000 euros. For x-rays, depending on the technology used, it is necessary to count from 10,000 € to nearly 30,000 €.

Note : in a dental office, you must also finance a sterilization autoclave (approximately € 6,000), storage cabinets, syringe kits, curettes, forceps, spatulas, etc., as well as a microcomputer with its peripherals and professional software.

The financing of the chair

The dental chair and all the equipment and materials necessary for the activity of the dentist can be financed by credit or leasing.

The credit allows the liberal health professional to choose his equipment, then the duration and the terms of repayment of the loan. It is also possible to determine the amount of repayment deadlines according to the duration of the loan.

From a fiscal point of view, the depreciation and interest on the loan are fully deductible from the results of the activity as soon as this loan finances equipment for professional use.

Leasing , on the other hand, can finance all of the dentist’s new equipment and materials, including computer hardware.

Advantage: the health professional chooses himself the equipment he needs and which will be purchased by the leasing company. Of course, he also chooses the duration of the rental and the amount of rents, their frequency and the redemption value at the end of the contract.

From a tax standpoint, rents are deductible from the firm’s results as soon as the leasing finances a property for professional use.

Dental implants:

“In rare cases, there may be a risk of damage to a nerve or an artery which can cause bleeding,” warns Dr Ardouin.

You must therefore be informed of the risks involved, as well as of other treatment options (removable prosthesis, for example). The specialists advise the greatest caution vis-à-vis these heavy surgical interventions, sometimes too quickly decided. 

An improperly positioned implant can cause throbbing pain or loss of sensitivity in the face . These rare cases concern 1% of patient sarteries and veins pass, says Dr Ardouin. This should not happen with a specialist who is well equipped in imaging, in order to visualize perfectly the images. obstacles and simulate implant placement. “

Dental implant rejection remains rare

The failure rate is low : from 3% to 4%, estimates Jean-Luc Ardouin. Most of the time, the site becomes infected, or the implant does not hold. We realize it without difficulty: it hurts and we feel it moving . The most common reasons are a poorly treated tooth with residual bacteria at the time of the operation, or a bone overheated by the dentist’s burr when he dug the space. It can then no longer adhere to the implant and must be reconstituted for a month and a half. Poorly maintained teeth are also a cause of failure. The implant is sometimes removed after a few days, or several years. “When it does not hold or breaks for no apparent reason, or following an error on our part, an implant is placed at our expense”, concludes Dr Ardouin.

Why are dental implants so expensive?

The implant material is expensive. And the castillage (small screws…) is also invoiced. In addition, some ceramic crowns are on a gold alloy: the use of precious metals therefore increases the price.

The placement of the implant also requires a small surgical intervention , aiming to dig a cavity in the bone of the jaw. This requires the presence of a larger technical platform than for other dental procedures, with a lot of disposable material or to be renewed regularly (such as drills for digging the bone). 

The dentist performing the installation must have received special training , which influences the part of the price remunerating the labor.

Finally, the risks of infection and haemorrhage are greater than for other dental procedures: they are taken into account in the price.

The prices therefore vary according to the materials used and the operating techniques , but also according to the regions and the practitioners .