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Preferences for fixed restorations and resulting impact on the US and European overdenture markets

According to analysts at iData Research, patient demand for fixed dental restorations has increased across the US and Europe. (Image: labden/Shutterstock)

BURNABY, British Columbia, Canada: In recent years, patient preferences for fixed restorations have driven significant growth in both the US and European fixed-hybrid overdenture markets. This trend is particularly pronounced in the US, where patient awareness has also been a significant factor in recent years. Though it was slowed momentarily by the COVID-19 pandemic, this market has made a full recovery and is set to experience single-digit growth moving forward. 

Fixed-hybrid overdentures are full-arch restorations that use an implant bar into which the dentist screws the denture prosthesis and, therefore, they cannot be removed by the patient. This makes them similar to natural teeth and eliminates much of the hassle of regular maintenance. As a result, the proportion of patients seeking a fixed-hybrid restoration has soared across the US and Europe despite their premium price tag. During the pandemic, there has been a rise in demand for more affordable options such as implant-supported overdentures, but the fixed-hybrid overdenture market has now recovered and is set to grow steadily in the coming years.

Fixed attachments gaining ground

The growth of the fixed-hybrid overdenture market as well as that of the total overdenture market has had a positive impact on both implant bar and attachment markets. In 2016, Zest Dental Solutions launched its Locator F-Tx fixed attachment system. This system operates as an alternative to screws and cement, and has created significant value in the attachment market. Zest’s fixed attachment system has experienced significant growth, as the system has been used to secure an increasing number of fixed-hybrid overdentures. Whereas Zest Dental Solutions’ Locator F-Tx currently dominates the fixed attachment market, other minor competitors exist, such as the Smileloc system. Naturally, the fixed attachment market not only benefits from a steadily increasing rate of adoption but also from being tied to the fastest growing segment within the overdenture market.

A shifting landscape for the implant bar market

Like the attachment market, the implant bar market is also undergoing substantial changes that will affect it in both the short and long term. The first such change relates to the market’s competitive landscape. The implant bar market can be broken down into implant bars manufactured by dental laboratories and those manufactured in independent milling facilities. Traditionally, there was a near-even split between dental laboratories and milling facilities in the US; however, dental laboratories command a significantly higher share of the market in Europe, particularly in Italy, Spain and Portugal. Recently, the growing use of CAD/CAM technology has increased efficiency in the milling process and decreased the cost. Hence, smaller dental laboratories are now able to produce their own implant bars inexpensively, substantially increasing their share of the implant bar market.

The competition between milling facilities and dental laboratories, in addition to the increased efficiency and cost savings of CAD/CAM technology, have combined to place downward pressure on implant bar prices across the US and Europe. As CAD/CAM technology becomes more accessible, an increasing number of dental laboratories have begun in-house manufacturing of implant bars. The increased efficiency of this process has caused the cost per implant bar to decrease. Whereas dental laboratories and CAD/CAM milling facilities are interested in maintaining their profit margins, reduced costs present an opportunity to capture greater market share. As a result, the price of implant bars has been decreasing while the use of CAD/CAM technology increases. This is expected to reach a plateau as the implant bar market becomes saturated with CAD/CAM milling. These price reductions also have an impact on the pricing of splinted overdentures such as fixed-hybrid overdentures and removable implant bar overdentures, since the implant bar is a key component of these overdentures.

“Smaller dental laboratories are now able to produce their own implant bars inexpensively, substantially increasing their share of the implant bar market”

Another current trend within the implant bar market regards the materials being used in their fabrication. Implant bars in both the US and Europe are primarily fabricated with titanium, cobalt chromium or, occasionally, gold. In the US, the use of titanium has been most popular whereas in Europe, cobalt is used more often. Both titanium and cobalt chromium have benefits. Cobalt has been used in dentistry for decades and is a very strong, biocompatible material with high corrosion resistance. Titanium is also a very strong and corrosion-resistant material. Where titanium distinguishes itself, however, is through its lightweight nature, elasticity and superior biocompatibility. In the implant bar market, titanium has been gaining considerable popularity, mostly owing to its biocompatibility. Germany, Scandinavia, Austria, Switzerland and the Benelux region have paved the way in the use of titanium in Europe. Cobalt chromium still commands a significant unit share of the implant bar market in France, the UK, Italy, Spain and Portugal, but titanium is expected to become the dominant implant bar material in these countries over the next decade.


Closing thoughts

In summary, shifting patient preferences towards fixed-restorations and the widespread adoption of CAD/CAM technology has led to significant changes in the overdenture market. Whereas the future may be uncertain, iData Research forecasts indicate that this market is expected to experience substantial growth over the next five to ten years across Europe and the US. This will be spearheaded by remarkable growth within the fixed-hybrid overdenture, implant bar and fixed attachment markets.

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