Turkish-made or imported implants?

Let us start with where it makes no difference. Almost all modern implants are made from titanium or a titanium alloy; although surface treatments go by different names, they give similar results. The country where a product is made does not change this basic fact of material and design. Neither 'it's solid because it's German-made' nor 'it's weak because it's Turkish-made' rests on any actual measure.

A second fact muddies the waters further: a brand's headquarters and its place of manufacture are not always the same. Company acquisitions, moving production to other countries and contract manufacturing are all common. So while a brand's name may call one country to mind, the place of manufacture on the box may be another. This is not a flaw but the normal way the industry works; it does mean, though, that the answer to 'which country is it from?' should be read from the product's own label rather than from hearsay.

The first thing that makes a difference is certification. Medical devices placed on the market in Turkey must be registered in the Product Tracking System (ÜTS), and this registration can be looked up using the unique number on the product's label. That is a more concrete check than anything you might hear said about a brand, and it applies in the same way to Turkish-made and imported products. You may want to see the registration for the product that will be used.

The second thing that makes a difference is continuity. An implant system is not just the screw in the bone; it is a whole that includes the parts that sit on top, the screws and the impression components. If you need to replace a screw ten years later, that part has to still be in production. This risk applies equally to Turkish-made and imported systems; what decides it is not origin but how long the system stays on the market.

The third thing that makes a difference is geography, and this is the one place where origin really matters. If you live in Turkey and will have your follow-up here, getting parts for a system whose manufacturer is here takes days. If you live in Germany and would go to a clinic there in an emergency, a system recognised there makes things easier for you. This is not a question of quality but of logistics.

As for the difference in price: with imported products, shipping, customs duties, the importer's margin and the exchange rate push the price up. Not all of that difference is a difference in quality. But the reverse is not true either: not every cheap Turkish-made product has been made to the same standards. The right approach is to start not from the price but from the certificates; once the certificates are on an equal footing, the price becomes an item that can be discussed.

The distinction below is drawn not on quality but on where your life is based.

Once these four have been answered, the question of 'Turkish-made or imported' fades into the background by itself.

1. 1

   Can I see the ÜTS registration for the product that will be used?

   The registration can be looked up using the unique number on the label. This applies in the same way to Turkish-made and imported products, and it is far more concrete than any debate about brands.

2. 2

   How long has this system been in production?

   Systems that have been on the market for a long time have stronger follow-up data and continuity of parts. A new system does not have to be bad, but more about it is unknown.

3. 3

   Where do I live, and where will my follow-up take place?

   Tell your dentist the answer to this yourself. If you live outside Turkey, choosing a system that is available there settles from the outset a difference that is hard to make up for later.

4. 4

   Will I be given my implant card?

   Brand, manufacturer, diameter, length, serial number and position. Whatever the country of origin, this document is the only thing you will still have in hand ten years from now.

Putting your budget and attention here gives a far better return than the debate about countries.

Each side produces its own cliché, and both push the patient to look in the wrong place.

Whichever side you choose, the following stay the same.

1. Ask for your implant card

   Brand, manufacturer, diameter, length, serial number and the area where it was placed. This document is part of your health record, and asking for it is a normal request.

2. Note down the manufacturer and country of origin

   The place of manufacture on the box is more reliable information than your impression of the brand. If a part ever needs to be tracked down, this is where to start.

3. Keep the X-ray taken after treatment

   The only document that shows where your bone level was on the day of the procedure. Years later, if bone loss is being discussed, this is the point of comparison.

4. Keep digital copies of your documents too

   Have a copy on your phone and in your email. When you move to another country, this will be the only thing you can take with you.

Not all of the difference in price between Turkish-made and imported implants is a difference in quality. Separating the items makes the decision easier:

Shipping, customs duties and exchange rate

Items that push up the price of an imported product and have nothing to do with the product itself. With products made in Turkey, these items drop out.

The cost of research and follow-up

Clinical studies with long follow-up are expensive, and that is reflected in the price. What you get in return is knowing how the system performs ten years on.

Bridgework and labour

In most plans, the prosthetic material and laboratory work take up a larger share than the price of the implant itself. The debate about origin does not cover this item at all.

Repairs in the future

With a system whose parts are easy to find, a repair stays small. A part that cannot be found turns the same job into remaking the bridgework; this is the most expensive item that never appears on the bill.