Implant Depth Demystified: Why Position Matters

After three decades of placing implants, I've learned something fascinating: only about 20% of the total implant length supports almost all of the stress from loading forces. This insight fundamentally changes how we should think about implant positioning. When we talk about implant depth, we're really discussing three distinct approaches: Supracrestal, Equicrestal, and Subcrestal positioning. Each has its place, but not all implant systems are designed for all positions. The key insight? Implants entirely embedded in trabecular bone produce the lowest stress and strain compared to epicrestal placement. But the type of connection matters enormously - Morse cone connections with platform switching remain the most favorable design for subcrestal placement. As I like to say: An implant system is like a boyfriend - if you don't know him very well, he may cause you lots of problems. Know your implant system, understand the biological principles, and let the evidence guide your clinical decisions.