Which dental interventions require a specialist?

The most common questions about implantology

With the help of frequently asked questions from patients, we would like to give you an overview of the subject of dental implants. However, this information cannot replace individual advice from a dentist. If your question is still missing, please feel free to contact us directly.

Who can properly insert implants?

A dentist who has trained as an implantologist or an oral surgeon. Nowadays, implant planning is always backward planning - that is, the prosthetic target precisely specifies the surgical position of the implant. That is why many years of experience in the prosthetic treatment of patients are essential for high-quality implantology.

What are implants?

A dental implant is an artificial tooth root, usually made of titanium. A screw-like shape has established itself as a design today. After the jawbone has been prepared, the implantation is carried out with special instruments by a dentist who has trained as an implantologist. A dental implant usually consists of three parts:

  • Implant body: part integrated in the bone
  • Implant post: connects the implant body and the superstructure
  • Superstructure: prosthetic abutment (crown, bridge, telescope)

What material are dental implants made of?

The most commonly used systems are made of pure titanium. Titanium bonds well to bone. There are almost no allergic reactions here and titanium shows good stability. The ceramic implants often used in the past show very good healing, but they are used less and less because of the higher risk of ceramic breakage. However, work is constantly being carried out to improve the mechanical properties of the ceramic. Nowadays, so-called zirconium implants represent an alternative to titanium implants, but are not yet as potent as titanium materials in contact with the bone, known as osseointegration.

How long do implants last?

The success rates over longer periods of time are over 90 percent, which means that in most cases, dental implants not only heal into the jawbone without problems, but after ten years more than 90 percent of the dental implants are still in function.

Implants protrude like natural teeth through the mucous membrane into the oral cavity. Therefore, like teeth, they are exposed to unfavorable factors in the oral cavity. These are: food residues, dental plaque and the associated pathogens. Inadequate care can lead to inflammation processes similar to those of natural teeth. These processes can lead to bone loss via gum pockets and thus endanger the dental implant. The absolute prerequisite for long-term success is therefore good oral hygiene, which should be supported by continuous care even after the work has been completed by your dental practice.

Further risk factors for long-term success are heavy smoking and certain general illnesses such as type I diabetes (insulin injections), prolonged cortisone treatment, e.g. for certain rheumatic diseases - but also a poor bone bed. This risk should be assessed as precisely as possible on a case-by-case basis.

How much do implants cost?

For professional reasons, German doctors are not allowed to give price information on the Internet. The prices differ between standard cases and those in which preparatory measures, such as B. a bone structure are necessary. In order to determine the effort and costs, an examination with the following personal consultation with an implantologist is inevitable.

Do the health insurance companies cover at least part of the implant costs?

Private health insurances usually pay for a large part of the dental implants. To estimate the reimbursement, it is helpful to submit a cost estimate.

As a member of the statutory health insurance, you will receive the normal fixed allowance for implant solutions as part of the diagnosis-based fixed allowance. In any case, a treatment and cost plan must be submitted to your health insurance company for approval before treatment begins.

Are dental implants also rejected by the body?

Rejection reactions - as they are known from allergies - occur extremely rarely with dental implants, especially those made from pure titanium. In the past, inflammation, which we are familiar with in natural teeth and which can of course also occur in dental implants, was often mistaken for rejection reactions. Should an implant not grow together with the bone during the healing phase, re-implantation in the same place is usually possible without any problems.

Even if titanium has fulfilled the long-awaited wishes of dental surgery for a suitable material for a dental prosthesis in the bone in many respects, further improvement is constantly being researched. Research focuses on the one hand on surface optimization of the titanium but also on completely different materials.

Is there the best implant system?

There is no general answer to this question. The large implant systems have all reached a high level. Each system has advantages in certain cases and disadvantages compared to comparable products in other cases. Here, implant systems are comparable to car brands. The big brands all make good cars. But there is no car that is superior to all others in all aspects.

However, there are systems that show less bone loss than other well-known systems. We prefer to use these systems to achieve the long-term possible bone anchoring of our implants.

In addition to the hardware of the implant manufacturer, the skills of the implantologist and the cooperation of the patient (oral hygiene) are decisive.

Does every lost tooth have to be replaced with a dental implant?

No: not every tooth has to be replaced with an implant. The resilience of an implant depends on the initial position of the bone such as its thickness, height and strength, but also on its position in the dental arch. It is also crucial whether the implant should have a fixed or a removable replacement - also worn on the mucous membrane. In determining the number of implants, we follow the current recommendations of the consensus conference on implantology.

How many implants do I need for a prosthesis if I have completely lost my own teeth?

In the toothless lower jaw, the aim is usually to have 4 implants to anchor a removable prosthesis. A restoration with 2 implants improves the hold of a prosthesis, but offers less stability than 4 implants. In the toothless upper jaw, 4-6 implants are required for a removable prosthesis. For a fixed restoration, 6 implants are required in the lower jaw and 8 implants in the upper jaw. In determining the number of implants, we follow the current recommendations of the implantology consensus conference, but the number of implants must be determined on a patient-by-patient basis. A long implant can therefore be subjected to higher chewing pressure than a short one.

Do I need general anesthesia for implants?

No, implants are usually placed under local anesthesia. General anesthesia is only advisable if the procedure is very extensive or if the patient is very anxious about the procedure.

How long can I not work after an implant placement?

More precise information can only be given after an examination and assessment of the operational effort. As a matter of routine, three days off should be planned in which you rest and cool the wound with cold compresses. Ability to exercise is usually given again after a week.

What kind of complaints do you have to expect?

Here, too, more precise information can only be given after an examination and assessment of the operative effort. An implant operation can be carried out safely and painlessly using potent local anesthetics. If wound discomfort occurs after the operation, these can be suppressed well with painkillers. Swelling can also occur. The swelling increases in the first two days after the procedure and then subsides again. The extent of the swelling depends on both the size of the procedure and the cooling provided by the patient. A visible bruise may also occur.

Can I place an implant immediately after removing a tooth?

The time of implantation varies between immediate implantation, immediately after removal of the tooth, delayed immediate implantation after approx. 8 weeks and late implantation after more than 3 months. Immediate implantation has the advantage of shorter waiting times and, above all, faster use of the remaining bone, since the thin bone in the tooth socket often breaks down rapidly after the tooth has been removed. However, this can only be done under certain conditions.

For safety reasons, there is usually a waiting period of 8 to 12 weeks after tooth extraction. During this period, new functional bone has formed from the bone cavity of the removed tooth, which can then be safely implanted.

How long does one have to wait after implantation before the prosthesis or crown can be placed?

There are differences depending on the location and number of implants. A direct supply of the implants with the prosthesis or crowns is only possible in certain cases. Usually a healing time of approx. 3 months is expected before prosthetic restoration.

Do I have to have multiple operations?

Usually one procedure is enough to place the implants. In the case of implants that have been placed under the mucous membrane, it must be freed from its covering mucous membrane before it is loaded. This is done under local anesthesia and is a very small procedure compared to placing the implants. Only larger bone bearing deficits that require a separate structure of the bone require an intervention at a separate time from the actual implantation.

Is there a maximum age for implant patients?

No: The decisive factor is not the nominal age, but the biological age. The bone metabolism, even in patients who have reached the age of 80, is usually sufficient to enable the implants to grow on.

I have osteoporosis, can I still put implants?

Osteoporosis is not a general exclusion criterion for implants. The final decision can only be made after a detailed investigation in the individual case.

My jaw has already shrunk a lot. Do implants still work?

To ensure long-term success, the jaw should generally have a width of at least 5 mm and a height of 10 mm. The height and width of the jaw can be determined using a panoramic x-ray and, if necessary, a three-dimensional volume image. If there is not enough bone available, bone grafting is possible. To build up bones, depending on the amount required, the following are used: bone chips from the drill hole of the implant, bones from other regions of the jaw such as the wisdom tooth region or, if required, from the hip bone. Alternatively, purely synthetic or animal substitute materials are used. Volume deficits below the maxillary sinus can also be built up (the so-called sinus lift) to enable implants in the maxillary posterior region.

Can implants also be placed in children and adolescents?

The placement of implants in adolescents is carried out to support tooth regulation. The implants in the palate or behind the row of teeth can replace a more complex apparatus.

However, replacing lost teeth in adolescents with implants is problematic because the jaws are not yet fully growing. The jaw around an implant does not continue to grow normally. Therefore, implants should only be placed after the growth spurts.

Do I have to be completely healthy for implants?

No, but there are diseases that pose a higher risk for long-term success. These include, for example, diabetes for which tablets are insufficient, blood cancer, condition after jaw irradiation and severe cardiovascular diseases. In individual cases, a precise assessment of the risk is carried out after consultation with the family doctor. Every time you have to weigh up the risks and benefits. For example, a patient who received chemotherapy for gastrointestinal cancer will still not be excluded from the implantation because the gastrointestinal tract needs fiber-rich food. In such cases, the advantages and disadvantages are always weighed up in the triangle between patient, general practitioner and implantologist.

How often do I have to have a check-up after an implantation?

Regular examinations of the implants are urgently required, as early stages of possible inflammation are much easier to treat. In addition, severe inflammation can lead to bone loss and thus to loss of the implant. After the prosthetic restoration, the implantologist will determine a reasonable control interval with you.

Does an implant crown look exactly like the natural tooth?

In addition to the white aesthetics (crown or denture tooth), the red aesthetics (gums or artificial denture gums) are decisive for an appealing appearance. Depending on the individual situation, an experienced implantologist will show you the possibilities, but also the limits of what is feasible. Interventions are often used to thicken the tissue around the implant and thus make it more stable against mechanical and bacterial influences. Experts nowadays agree that a stable situation in the soft tissues around the implant is essential for long-term success.

I've heard that implants heal better if you have blood drawn beforehand and then put it back into the drill hole?

There are no studies that clearly prove that the addition of autologous blood plasma significantly improves the success of an implantation.