Implants and dental surgery are performed by Karl-Jürgen Hollmann, DMD, MD, PhD, and his team of doctors. Dr. Karl J. Hollmann is a maxillofacial surgeon with over 30 years of expertise in the field of implantology and maxillofacial surgery.
Implants
What are dental implants?
Implants are artificial tooth roots made of particularly well-tolerated material (titanium or ceramic = zirconium oxide), which can replace missing teeth. They are bonded into the jaw bone and thus give the crown attached a secure hold. In the past two decades, artificial tooth roots have brought about a great revolution.
By contrast to a restoration with dental bridges, missing teeth can be replaced without damaging the neighboring teeth. If a single tooth is replaced by an implant, the shape and color of the attached crown blends seamlessly among neighboring teeth. If several teeth (or all of them) have to be replaced, implants offer the possibility of avoiding a complete denture. The skilfull placement of implants enables restorative procedures such as bridges and partial dentures.
We will offer you detailed advice on your individual case and available alternatives when replacing one or more teeth.
Single tooth replacement
What happens during a single tooth replacement?
In order to replace one or more teeth during an implant surgery, one or more artificial tooth roots made of titanium or zirconium oxide ceramic are inserted into the bone, in the place of the teeth to be replaced. The second step consists in attaching a ceramic crown to the implant.
Why an implant?
Almost every lost tooth can essentially be replaced by an implant.
What is the procedure for a dental implant?
Generally, the procedure is divided into two or three phases:
1.
Removal of the diseased tooth and wound healing.
If the periodontium is well-maintained and there is no acute inflammation, it is advisable to place the implant in immediately after the tooth has been extracted (immediate implant). This can prevent jawbone loss (which occurs after tooth extraction). If you decide to wait for the wound to heal, 3 to 6 months are needed. Missing teeth can be replaced with an implant even years after an extraction.
2.
The placement of one or more implants in the bones.
Sometimes it is necessary to rebuild lost bone during the implant placement procedure (bone rebuilding). Bone rebuilding may also be necessary below the maxillary sinus (sinus lift). There are situations in which bone rebuilding must be carried out in a separate session, before the implant procedure. The healing time usually ranges from 3 to 6 months. This procedure generally requires local anesthesia. Upon request, and/or in the case of longer procedures, we employ IV sedation. We will provide you with a provisional denture (upon request), designed to be either mobile or fixed – depending on the situation – until the healing process comes to its end.
3.
Completion of restoration – necessary denture preparation.
Special transfer caps are used for an implant impression, thus achieving an optimal transfer to a jaw model. The dental technician will then manufacture your dentures in the dental laboratory. Generally, dentures can either be fixed or partially removable (the removal is performed by the dentist). In more difficult cases, two or more sessions are required before the denture is finally inserted.
What are the risks of a dental implant?
Some people may experience implant failure. However, the percent probability of an implant failure in standard situations is set at below 5%. After the implant restoration has been completed, the greatest risk lies in an inadequate maintenance. Inflammation of the gums can spread relatively quickly to the implant site and lead to implant failure. Regular dental check-ups and immediate treatments used for prophylaxis are strongly recommended.
What results can you expect?
The ideal result is a functional and aesthetically perfect replacement of the missing teeth. In difficult cases, cosmetic compromises are sometimes unavoidable.
What are the alternatives to an implant restoration?
A dental bridge can generally be used instead of an implant-supported denture. In this case, however, several teeth must be crowned. The pressure exerted on the abutment teeth (that support the dental bridge) is greatly increased when chewing, because of the often large toothless gaps. If more teeth are missing, removable dentures are needed.
Extensive implant care. Edentulous patients
What happens during a dental implant procedure?
In order to replace several teeth during an implant surgery, several artificial tooth roots made of titanium or zirconium oxide ceramic are inserted into the bone, in the place of the teeth to be replaced. As a second step, an artificial tooth crown or denture will be attached to the implant. Depending on how many teeth there are and how many implants are placed, one can opt for a fixed denture or removable denture.
Why an implant?
Many edentulous patients feel unsafe or uncomfortable with their existing dentures. Denture retention by adhesion is sometimes less than ideal, depending on the anatomical conditions.
What is the procedure for a dental implant?
Generally, the procedure is divided into two or three phases:
1.
Removal of the diseased tooth and wound healing.
If the periodontium is well-maintained and there is no acute inflammation, it is advisable to place the implant in immediately after the tooth has been extracted (immediate implant). This can prevent jawbone loss (which occurs after tooth extraction). If you decide to wait for the wound to heal, 3 to 6 months are needed. Missing teeth can be replaced with an implant even years after an extraction.
2.
The placement of one or several implants in the bones.
Sometimes it is necessary to rebuild lost bone during the implant placement procedure (bone rebuilding). Bone rebuilding may also be necessary below the maxillary sinus (sinus lift). There are situations in which bone rebuilding must be carried out in a separate session, before the implant procedure. The healing time usually ranges from 3 to 6 months. This procedure generally requires local anesthesia. Upon request, and/or in the case of longer procedures, we employ IV sedation. We will provide you with a provisional denture (upon request), designed to be either mobile or fixed – depending on the situation – until the healing process comes to its end
3.
Completion of restoration – necessary denture preparation.
Special transfer caps are used for an implant impression, thus achieving an optimal transfer to a jaw model. The dental technician will then manufacture your dentures in the dental laboratory. Generally, dentures can either be fixed or partially removable (the removal is performed by the dentist). Even in the case of complete edentulism (toothlessness), implants are effective in safely stabilizing a removable denture. In more difficult cases, two or more sessions are required before the denture is finally inserted.
Care sunt costurile?
Cat ma costa sa imi fac un implant dentar?
Some people may experience implant failure. However, the percent probability of an implant failure in standard situations is set at below 5%. After the implant restoration has been completed, the greatest risk lies in an inadequate maintenance. Inflammation of the gums can spread relatively quickly to the implant site and lead to implant failure. Regular dental check-ups and immediate treatments used for prophylaxis are strongly recommended.
What results to expect?
The ideal result is a functional and aesthetically perfect replacement of the missing teeth.
What are the costs?
The costs depend on the complexity of the case and the materials used. Implant-supported dentures go significantly higher in price, depending on the number of implants used. A distinction must be made between the costs of the implant surgery (the insertion of the artificial tooth root) and the tooth reconstruction procedure that will follow. In most cases, the costs of the implant surgery are compensated by the costs of the implants needed.
In the case of bone loss, bone rebuilding may also be necessary. Artificial bone materials are often used. In order to allow a bone structure to heal safely, further personalized steps may be recommended or mandatory (autologous PRF membrane etc.). Tooth reconstruction costs (a process performed after the implant has healed) are generated by the abutments and implant crowns used.
As the costs are strictly dependent on each individual situation, a personal discussion and plan are essential. We will take enough time to cover and consider all aspects.
What are the post-procedure instructions?
After treatment, there will be swelling (to a different degree in the case of every individual), which is maximal 24 hours after the intervention and then regresses. The use of cold compresses is only allowed on the outside of the cheek area, never on the inside. It is not advisable to use ice, but rather a cold washcloth. Eating – preferably soft food for a week – is only allowed after the local anesthetic has completely subsided. There are no restrictions for drinking liquids. The food that promotes healing consists of plenty of fruits and vegetables. It is beneficial to limit dairy products, eggs, fat and animal products.
Good oral hygiene and a regular dental care of the oral cavity is important to avoid infection. The operated area can either be left out or carefully cleaned with a soft brush.
Analgesics can be taken as soon as the anesthetic wears off, provided that one doesn’t have an allergy to them: Paracetamol (500mg), Algocalmin (500mg), Ibuprofen (400mg). If antibiotics have been prescribed, alcohol consumption must be avoided.
An evaluation of wound healing by the dentist is recommended after 7-10 days.
The difference between titanium implants and ceramic implants
The majority of the implants used today are made of titanium. Titanium is a soft metal (gray or silvery in appearance), which medicine classifies as a health-friendly material. Artificial joints, for example, are also made from titanium. For most people, titanium implants do not pose any risks. In fact, there are no immediate Type I allergies to titanium (as there are nickel allergies). Nevertheless, titanium intolerance may develop over time, in the case of some individuals. Such intolerances are believed to be able to trigger gradual inflammation of the bone around the implants. Ceramic implants (white in colour, made of zirconium oxide), on the other hand, are absolutely biologically compatible. Even the growth of the gums is promoted around ceramic implants – a material that has so far been unique in medicine.
A disadvantage of ceramic implants is the somewhat more difficult healing process of the jawbones, even though the healing rate of titanium implants is almost the same. In the case of ceramic implants, the jawbone must be very healthy; the immune system must be optimized before the surgery and various measures must be taken to ensure that.
Ceramic implants are also considerably more expensive.
Can you determine what implants are individually more suitable?
There are no clear tests.
Blood testing is used (lymphocyte transformation test), but the results do not ascertain clear suitability.
From our point of view, the muscle test provided by biological medicine is probably the method most likely to result in a good assessment. We can use this test on you.
Risk factors for dental implants
Implant care and maintenance must follow a specific protocol. Implants are almost as sensitive to inflammation (gingivitis) as natural teeth. Smoking (nicotine in particular) is not beneficial for implants (and teeth). It has been scientifically proven that, in the case of implants, problems increase significantly if more than 10 cigarettes/day are smoked. Untreated gum infections (periodontitis) are a risk factor.
In addition, other health factors can be unfavorable for implants. We will address these in a personal conversation. We will request some blood tests before an implant surgery.