HOW TO PROFIT FROM...implants

Dental implants have demonstrated superior results over conventional restorative procedures to replace missing teeth. They are growing in popularity, not only for the replacement of teeth, but also as supports for dentures, crowns, and bridges. The market is distinctly dominated by endosseous, root-form implants, which are placed directly into the jawbone. Endosseous implants constitute approximately 98 percent of the entire market, while root-form implants command 95 percent of the endosseous

Market simplifies procedures for GPs

Millennium Research Group

Dental implants have demonstrated superior results over conventional restorative procedures to replace missing teeth. They are growing in popularity, not only for the replacement of teeth, but also as supports for dentures, crowns, and bridges. The market is distinctly dominated by endosseous, root-form implants, which are placed directly into the jawbone. Endosseous implants constitute approximately 98 percent of the entire market, while root-form implants command 95 percent of the endosseous market.

The major manufacturers are still developing implants based on the traditional threaded screw and cylindrical/ press-fit models. However, manufacturers are also developing new shapes of implants, such as tapered, porous, and alternative-shaped implants, hoping these innovative designs will improve osseointegration and simplify implanting procedures.

Machined surface, hydroxyapatite, and titanium plasma spray coatings were the traditional methods of treating implant surfaces to enhance biocompatibility. Today, many manufacturers have developed unique and patented implant surfaces, such as Straumann`s SLA surface, Implant Innovations` Osseotite surface, and Sulzer Calcitek`s MTX surface.

Simpler procedures drive innovations

Another progressive trend in the market is towards new implant connections and abutments. Companies such as Paragon - with its Friction Fit abutments - and Bicon - with its implant connection that acts as a bacterial seal - are a few of the market players who have moved in this direction.

One of the most significant transitions in the industry is the increased focus on simplifying implant procedures. Single-stage and immediate-load implants attract general practitioners, an largely untapped market for the technology. Virtually every major manufacturer has recently released a single-stage implant system. Single-stage implants, designed to eliminate the need for a second surgery, now seriously compete with traditional implant systems.

Immediate-load implants are expected to follow this trend. The procdure allows restorative dentists to not only perform a single surgical procedure, but also to immediately attach the prosthetic structure.

To date, these simplified implant systems do not offer the same degree of stability as the conventional two-stage implants. However, manufacturers are continuing to refine and improve implant systems, which will further enhance their progression.

The trend toward simplifying procedures with fewer components and facilitated techniques will encourage implants to further penetrate the market. Currently in the United States, approximately 10 percent of general dentists are using implants. The rate of growth of general practitioners providing implant treatment is expected to increase by at 10 to 15 percent each year.

Currently, the majority of specialists using implants are oral/maxillofacial surgeons, periodontists, implantologists, and prosthodontists. Manufacturers, however, are catering their designs to facilitate the transition from conventional restorative procedures to implants. The transition towards more simple and user-friendly implant designs has allowed more dentists to explore the advantages of incorporating implants into their general practice.

For the year 2000, the total value of the U.S. dental implant market is estimated at $243.3 million. The growth of this market for this year is 16.4 percent. Contrary to previous estimates, the market has started to expand at a significantly higher rate. During the mid-1990s, market analysts reported a growth of only 7 to 10 percent.

The increase in growth is attributed to the rising public awareness and professional acceptance of implants. In addition, the baby boomer generation has just begun to enter the age group where dental restorations and edentulism are becoming more frequent.

Another major influence on this market is the trend toward better oral hygiene and overall health. Overall health and quality of life are directly influenced by dental functions, including the ability to chew raw fruits, vegetables, and other solid foods. Conventional dentures and bridges are no longer adequate in terms of function, comfort, and esthetics. The discomfort and esthetic deterioration associated with conventional dentures has encouraged people to explore new options. Furthermore, disposable incomes are increasing and people are willing to spend more to achieve premium oral health.

The industry`s transition toward simplistic and user-friendly implant designs has allowed more dentists to explore the advantages of incorporating implants into their general practice. It is estimated that 910,000 implant procedures will be performed in the United States during 2000. This number is expected to increase with a compound annual growth rate of 18.6 percent from 1998 to 2005.

Although the number of implant procedures performed each year is relatively low, strong growth is expected to drive the overall market value upward.

Analysis of manufacturers

The major leaders in the dental implant market are Bicon Dental Implants, Implant Innovations International, Lifecore Biomedical, Nobel Biocare/Steri-Oss, Paragon Dental Implants, Straumann, and Sulzer Calcitek.

One of the most significant occurrences in the market was the acquisition of Steri-Oss by Nobel Biocare in September 1998. Nobel Biocare has historically been the most established dental implant company with its Brånemark system. Dr. P. I. Brånemark developed the first modern dental implant on the market, the traditional titanium threaded screw implant.

Nobel Biocare has experienced great success with its implant system and held approximately 20 percent of the U.S. market prior to the acquisition. Steri-Oss, on the other hand, was a far more innovative company, specializing in HA-coated implants. Together, marketing products under both brand names, Nobel Biocare occupies 39 percent of the U.S. market.

Nobel Biocare`s sales by brand, though, are heavily dominated by HA- and TPS-coated implants. Their traditional machined-surface implants currently represent approximately 10 percent of the company`s dental implant revenues. Nobel Biocare is trying to further develop its Brånemark system and has recently introduced new products, such as the Mk III with Stargrip, designed for simpler insertion. But 60 percent of Nobel Biocare`s sales are based on HA-coated implants, while 30 percent is credited to TPS-coated implants. By 2002, it is estimated that 80 percent of Nobel Biocare`s U.S. implant sales will be generated from its HA-coated implants.

Implant Innovations Inter-national (3i) is currently the second largest market player with a 17.3 percent market share for 2000. 3i offers a comprehensive product line, which includes its exclusive Osseotite implant surface. The Osseotite surface is a patented surface texture, designed to increase the surface area of the implant by approximately 40 percent when compared to other conventional coatings.

Straumann is currently the fastest-growing dental implant company in the United States. The company`s growth is attributed to the success of its ITI implant system and its SLA surface technology. Straumann currently holds 11.2 percent of the market, which is projected to increase to 14.2 percent by 2002.

Paragon Dental Implants offers a very broad range of implant systems, including friction-fit abutments and its patented internal hex design. Paragon is estimated to have a 7.6 percent market share for 2000. However, the company is not expected to surpass any of the major market leaders, based on its projected growth rate.

Lifecore Biomedical is another active player in the U.S. implant market. The company offers competitive pricing on standard implant systems and is heavily focused on the marketing and sales of its implant products, which constitute a large portion of its oral restorative division.

Sulzer Cacitek has also been an important player in the implant market. The company is well-known for its Spline implant system, designed for added strength and prevention of rotation and loosening.

Although Bicon Dental Implants is the smallest of the major competitors, the company is experiencing high growth rates. Bicon is known for its innovative plateau of fin-designed implants for increased surface area, and for its locking taper abutments that prevent rotation.

Other companies, such as PerioSeal and Camloc, are also attempting to penetrate the market with implant systems that prevent bone loss around the implant. PerioSeal in particular is projected to become an active player in the near future because of its superior cosmetics. Overall, many implant companies are striving to compete with the larger players. Other significant companies include Bio-lok, Friadent, Imtec, Innova, and Park Dental Implants.

For the immediate future, the major market leaders are expected to hold their ground, but will be forced to offer more simplistic systems, enhanced cosmetics, implants that support bone maintenance, and overall superior products to remain at the apex of the market.

Millennium Research Group (MRG) is a research and consulting service on the economy in the health-care arena.MRG prepares information and advice on diverse subjects such as health-care e-commerce and new medical technologies. For more information about MRG research reports or consulting services, visit the company`s Web site at www.mrg.net.

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