North American Dental Implants Competitive Landscape

1. Nobel Biocare, Straumann, Dentsply International, Zimmer, And Biomet Led The North American Dental Implant Market

In 2020, the North American dental implant market continued to be dominated by major multinational competitors, namely Nobel Biocare, Straumann, DENTSPLY International, Biomet, and Zimmer. Together, these companies generated over 70% of dental implant revenues that year. Each of these companies is recognized globally as leading dental implant competitors and has strong reputations, sales networks, and product pipelines, which have allowed them to maintain strong positions in this extremely competitive market.

Nobel Biocare led the dental implant market, followed closely by Straumann. Nobel Biocare and Straumann have continually battled for the lead in the dental implant market, having built their success through strong sales networks, excellent training programs, and building a strong reputation and relationship with specialists.

The positioning of these large players may shift over the next few years in the wake of recent and pending acquisitions among major competitors. For example, in 2011, Astra Tech was acquired by DENTSPLY International, and later Astra Tech’s implant fixture and abutment business was combined with DENTSPLY International’s implant division DENTSPLY Friadent under the name DENTSPLY Implants. Because both companies had strong reputations, DENTSPLY Implants was able to achieve the third-highest position in the North American dental implant market in 2014. In a move that mirrors the union of DENTSPLY International and Astra Tech, Zimmer announced that it will acquire Biomet and expects to close the transaction.

2. Multinational Companies Have Been Able To Gain A Competitive Edge Through Training Programs And Customer Support

Although there are a number of smaller or low-cost competitors in the dental implant market, the large players maintain their leadership positions by leveraging extensive sales and distribution networks, large marketing and R&D budgets, and comprehensive training programs. In particular, offering training programs has been highly important in North America, where there is still a substantial opportunity to develop training programs for GPs. Given that there is an increasing volume of GPs entering the field of implantology, companies that target marketing to GPs—in addition to dental specialists—will be in a strong position to maintain or gain market share over the forecast period. Generally, dentists remain loyal to the brand of dental implant they were exposed to during their training, and offering these programs can therefore foster continued sales for manufacturers.

Because training programs of an adequate scale and quality generally cannot be offered by smaller competitors, larger firms can maintain a competitive advantage in this market. Three examples of large companies with well-developed training programs are Straumann, Nobel Biocare, and Zimmer.

3. Companies That Offer Product Bundling, Convenient Purchasing Methods, And Strong Customer Service Will Gain A Competitive Edge In The Dental Implant Market

Larger competitors are also able to offer better convenience for customers due to their larger product offerings; companies that offer convenient product bundles including various fixtures, abutments, and tools will be better positioned because of their ability to provide customers with a convenient “one-stop-shop” for all dental implant-related purchases. In addition, providing easier and more convenient purchasing options, such as online purchasing, will also help competitors maintain their standing in the market.

Companies that are readily available to provide adequate support in terms of product education and distribution will be better positioned to maintain market share over the forecast period. Generally, larger manufacturers are able to do this more effectively over larger geography than smaller manufacturers due to their more extensive resources and corporate networks.

4. Competitors That Look To Improve Their Products—Whether By Improving The Surface Treatment, Core Material, Or Architecture Of The Product—Will Be Able To Gain Traction In The Marketplace

Furthermore, these large companies have higher budgets to spend on R&D and clinical trials, which is important in the dental implant market due to the fierce competition in this space. Although the market is not characterized by major product advances, minor improvements in dental implant design continue to be important for maintaining market share among such a wide variety of competitors. In particular, dentists and patients are looking for products that reduce the invasiveness of the procedure or increase the speed of osseointegration, thereby making the procedure less time-consuming for the patient.

In general, there are three physical properties of dental implants that companies are currently focusing on altering in order to improve implant performance: the surface structure/coating, the core material, and the architecture. In particular, the surface composition of dental implants has been an area of great interest and debate in this space. Nanotechnology-based surface treatments—and other biologically active surfaces—have recently emerged as a potential method of improving osseointegration and have generated much discussion in the industry. More clinical evidence is required to substantiate osseointegration claims, but companies continue to market their proprietary surfaces to distinguish their implants from the competition.

Core material—traditionally titanium—is another area that dental implant manufacturers are altering. For example, Zimmer launched a trabecular implant in early 2012 that is made of tantalum metal, a biologically inert metal that can be made more porous than titanium. This implant lacks threading in the center section of the implant, where it is highly porous, “osteoconductive” tantalum, which the company claims has a similar structure to trabecular bone.

Some manufacturers are simply expanding their product portfolios by offering a wider variety of dental implant architectures. For example, Nobel Biocare and Straumann both launched new smaller diameter 2-piece implants. Companies that offer small-diameter implants will be able to capitalize on recent dentist interest and demand for these products, which offer more flexibility and adaptability than small-diameter 1-piece implants; dentists who want to have a complete implant system in their office will likely look to acquire this type of implant for specific cases where narrow implants are required.

Short implants, which are 6 mm or less in length, are also becoming popular product offerings. Companies such as Bicon Dental Implants and Straumann currently offer these products. Although short-length implants are expected to remain a small proportion of the total number of implant fixtures sold over the forecast period, this segment will still undergo strong growth; therefore, companies that offer this type of implant will gain a competitive advantage because they will not only be able to capitalize on the rising adoption of short implants but will also be able to offer a wider portfolio of products for their customers.

In addition to short implants, expandable implants are another specialty implant architecture. Once placed in the jaw, the sides of the implant can be expanded so that they make tighter physical contact with the bone than traditional implants. The contact between implant and bone should speed ossification, which is why this implant is marketed as being ideal for IFL surgeries. Industry sources indicate that there will be a product relaunch and push for wider marketing and distribution of these implants over the forecast period. This is noteworthy because expandable implants are a novel implant design and have the potential to capture increased market share if marketing efforts and supporting clinical data can convince clinicians of the implants’ efficacy. Overall, although no new products are anticipated to drastically alter the dental implant competitive landscape over the forecast period, it nonetheless remains important for manufacturers to continue to update their products and expand their product lines.

5. Companies That Partner With Providers Of Custom-Milled Abutments Or Cad/Cam Systems Will Gain A Competitive Edge

Another trend that has developed recently in the North American dental implant market is collaborations between leading manufacturers and providers of custom-milled abutments or CAD/CAM systems in order to provide simplified aesthetic restoration solutions. Several market leaders have recently launched CAD/CAM or treatment planning systems. Competitors have also partnered with providers of digital systems.

6. Companies That Initially Increased Prices To Offset The Impact Of The Excise Tax Have Subsequently Lowered Their Prices Again To Avoid Potentially Losing Sales To Value Competitors

Generally, the large multinational competitors in the dental implant space sell high-quality, premium-priced products, which help them generate a larger portion of revenues. However, justifying a premium price on dental implants has become increasingly difficult in this price-conscious and competitive market.

7. Although Larger Competitors Will Continue To Dominate The Market, Value-Players Are Able To Capture A Sizable Portion Through Effective Pricing And Marketing Strategies, As Well As Through Mergers With Other Smaller Companies

As a result, despite strong competition from the larger players in this space, small dental implant companies such as Implant Direct Sybron International and IMTEC, which offer very low-cost products, have been able to capture a sizable portion of overall market revenues. Economic uncertainty has caused many dentists to switch to these companies to save money. Similar to the leading manufacturers, these companies are better able to gain share if they can offer product bundles, although they may not have as varied product offerings. Other strategies employed by small manufacturers are to engage in effective marketing campaigns to niche groups and to design products that are compatible with leading manufacturers’ components so that the dentist does not feel obligated to purchase an entire system from a small company. Mergers with other companies will also help companies gain more of a competitive edge in the market.

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