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Comment by jstanley | Hacker News Reader

I lost one of my front teeth and now have a titanium bolt threaded into the tooth socket, with a ceramic tooth screwed into the titanium bolt.

https://en.wikipedia.org/wiki/Dental_implant

There was a CT scan of my mouth, and then a bolt was selected and a ceramic tooth created that would accurately fill the gap. It works just like a real tooth, except it is slightly chunkier (but it's chunkier in the direction that points inside my mouth, so I'm the only person who can tell).

It felt pretty high-tech to me, although the article mentions that the first titanium dental implant was placed in 1965.

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Apparently implants have been made for over 100 years, even before titanium was 'discovered' in the 60s.

The best bet we have to replace that are root-analogue implants [1] - essentially a physical 3D-printed copy of the whole tooth, including roots. Unfortunately information is scarce (as you can see in that wikipedia page), it's not even mentioned in the main 'Dental implant' article. There is a single dentist in the entire world [2] actively offering these implants, and going at it for 20 years.

[1] https://en.wikipedia.org/wiki/Root_analogue_dental_implant

[2] http://www.bioimplant.at

I worked at BioImplant in Vienna.

We tried very hard to get even one sentence into the Wikipedia article, to no avail. The editors insist on secondary sources of information (articles in magazines or newspapers), which apparently must be in English. Sadly, all news pieces so far have been in German.

We were equally unsuccessful in raising interest among popular science journalists.

As per my reply to the parent comment, thank you for sharing!

Here's one paper I found while reading around about the technology (no idea what sort of credibility JOADMS has):

http://www.joadms.org/download/article/149/19102016_27/14762...

Mind if I ask how much these cost? I've been wanting to get my whole lower replaced due to significant wear and this would be a great excuse for a trip to Vienna.

The upfront cost is comparable to that of a (reputable) regular implant; a few years ago, in my case, this was in the region of €1800-2000. Then, after a 12 week healing period, you need a crown, which is a separate cost (and usually dealt with by your local dentist).

However, you also have to factor in the long-term cost: there are no surgical complications, and no follow-up treatments to deal with infection, as would typically be the case with typical screw-type implant. This is a huge win.

Also note: BioImplant is currently a single tooth replacement, so it's not possible to get a row of adjacent implants. (At least, not yet - I understand this is more an issue of research than practicability.) Make sure you go through the FAQ on the website! (http://www.bioimplant.at/faq-2/)

There's really no information about this group or their product. What little I did find seemed to indicate it's a scam or at least not very vetted. Can you contradict this with some good information?

It's been clinically proven over 14 years now. Papers published in top journals. A very comprehensive set of cases on the website, with before/after photos and X-rays (nothing like this exists for any other implant company!).

The founders are medical doctors, one a maxillofacial surgeon, the other a famous heart surgeon, both associated with the Medical University of Vienna.

Lastly - you'll have to take this on trust - I have a BioImplant. It's a front incisor (one of the worst places to get an implant). That video on the website front page - that's me! I've had it for about 5 years, and it's faultless.

Major questions for me include:

1) What sort of guarantee does BioImplant offer?

2) If an implant fails can it be removed and replaced?

3) When do they expect FDA approval? Why haven't they received it after over a decade?

4) Why is it only a single tooth procedure? Have they never tried to replace a row of teeth?

5) Who are the primary customers to date (how many and where from)? If these are foreigners traveling for the procedure, why don't they offer details on how to go about scheduling the trip/travel and the procedure/stay?

1) It's never possible to get a guarantee! Everyone's medical situation is different, so the outcome is very dependent on the individual. My situation was bad, and this was clearly explained to me at the time. (I followed instructions to the letter, and took good care of my implant; it all worked out.)

2) The first few weeks are critical: if the implant fails (ie. falls out), the procedure can be attempted again. If it's a complete failure, no damage was done, and one can opt instead for a regular screw-type implant.

3) FDA approval: other zirconia implants are already approved. A few years back, we got quite far with the BioImplant application, but other (medically unrelated) issues intervened, which I can't really discuss here. However, I agree: it's a top priority.

4) It's currently only medically proven for single tooth replacement. Research and trials are needed for multiple teeth.

5) The patients come from all over the world, wealthy and otherwise. I don't know exact numbers; I seem to recall it's in the hundreds, but you should phone to be sure. The other details: schedule, procedure, are all sorted out by telephone or email. Usually an X-ray or CT scan is the first thing to send.

I've been eyeing BioImplant for a few years now, wondering why they don't get more coverage. Any stories on that? A panacea would be something like this with an bio-engineered PDL.

This has been a source of great frustration.

There are many implant companies, all vying for attention. It's difficult to fight through all the noise. The top academic journals are another barrier: their main concern appears to be to maintain the status quo.

Popular science journalists didn't express any interest when we approached them. I was very surprised by this!

Lastly - and probably most importantly - the company really needs to get a decent PR person on board!

That's not always the case. A secondary source is any web URL. They just don't want original research IN the article. Citing material in foreign language is usually not a problem.

The editors for the implant page are extra picky. We certainly had a lot of problems even introducing simple edits - and any mention of root analogue implants (not naming BioImplant) was an insurmountable issue.

I think the reason is that there are too many implant companies, so competition is fierce. The editors are rightly suspicious of product placement or promotion. However, where there is legitimate innovation in an otherwise stultified field, it's important to draw attention to new developments. Perhaps it's time to try again for an entry!

This is very interesting - thank you for sharing. I am looking into the possibility of a dental implant and I am very uncomfortable with the idea of a titanium screw in my jaw bone. I think a trip to Vienna will be on the cards later this year.

Do you have any details of the implant manufacturer?

I'm curious because this sounds rather like an 'anatomic' implant; the world leader in this technology is this small (but awesome) company in Austria: http://bioimplant.at

I don't think it's the same as that.

Here's an X-Ray of the titanium bolt: https://img.jes.xxx/594

And here's a temporary plastic tooth that I had installed while the ceramic one was being manufactured: https://img.jes.xxx/741

The inner screw has a small torx head on it and is threaded up the inside of the larger bolt that is tapped directly into the bone of my jaw.

can you use MRI machines?

I believe so, yes.

Probably not, actually - I have a similar thing and was told that although the MRI machine won't rip the metal out of your jaw like it would for ferrous metals, the titanium will essentially act like a little antenna and obliterate the image

I have a titanium implant and have had MRIs. It might be a problem if you wanted an MRI of your teeth, but anything else is fine.

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