Tooth gone, gap there. Sometimes it flashes faster than you fear anyway: after a slide over wet leaves or a crash in a sport. The tooth often crumbles slowly due to inflammation or tooth decay. In order to close the gap in the teeth, more and more Germans are opting for a dental implant. This year, the one million mark was exceeded for the first time: That’s how many women and men had an artificial tooth root used instead of a bridge or prosthesis – despite the high costs of around 1,600 to 3,000 euros per implant. Understandable, because fixed replacement teeth offer many advantages. The implantologist and oral surgeon Prof. Günter Dhom, head of the dental department of the private clinic Tolfioowitas in Neustadt, lists: “Studies show thatmore than 90 percent of the implants are still intact after more than ten years . They also look like natural teeth, feel like natural teeth and are firmly anchored in the jawbone like natural teeth, so that they give you a feeling of security when eating, speaking and laughing.” Other gentle innovations are also on the rise, as is the case with the Dental care.
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Cheekbone Implants
Cheekbone implants also hold where others wobble ,namely when the jaw has dramatically receded. This usually happens after years of wearing a bridge or a (partial) denture. At around five centimetres, the “zygomatic implants” are much longer than conventional root replacements so that they can be anchored at a 45-degree angle in the cheekbones. “Due to its dense structure, the cheekbone is an ideal foundation,” confirms Dr. Richard J. Meissen, Medical Director of the Duisburg Kaiserberg Clinic. In order to fix a permanent bridge in an edentulous upper jaw, only two “zygomatic implants” (all-on-four concept) have to be inserted on each side. After inserting the four implants, a temporary bridge is screwed firmly onto the implants. The patient leaves the practice with fixed teeth! Three months later he gets the final bridge. It is important to use a volume tomograph to create a three-dimensional image of the jaw and teeth before the operation so that the facial nerves are not injured during the operation.
ceramic implants
Bone replacement material with the growth factor rhGDF-5 accelerates bone formation on the implant. This allows artificial roots even with very fine jawbones (still in clinical testing).
ceramic implants
Ceramic implants are making a comeback because they are more resilient than they used to be and are optimally tolerated . The end of the 1980s was the end of ceramic implants. Too many shattered. Now it’s booming again. Because the new ceramic implants are made of zirconium oxide, a much more robust material. And the fact that they contain no metals makes them ideal for allergy sufferers. The color of ceramic implants corresponds to the natural white of the teeth – a particular advantage, e.g. B. to titanium implants when the gums recede and the implant becomes visible. However, they also have serious disadvantages. For example, it takes much longer for them to grow into the tooth bed: around 20 to 24 weeks compared to 6 to 12 weeks for the usual titanium implants. Individual implants have to be protected by a splint during this time – not exactly pleasant either. And the extent of their longevity still has to be clarified in studies.
Computergesteuerte Implantation
Computer-controlled implantation enables interventions that were previously considered impossible. Traditionally, two-dimensional X-rays are used to insert replacement roots into the jawbone. Computer-navigated implantology, which enables three-dimensional planning, is more modern and precise. The oral surgeon or dentist calculates on the screen at what angle and where in the jaw the artificial tooth root is optimally located, and thus determines the anatomically correct drilling direction and drilling depth. Then the special computer process produces a kind of surgical template that enables ultra-precise precision during the subsequent implantation. This leaves significantly less room for dentist errors.
Functionality of modern implants
We’re living longer, that’s the good news. The less good is: not all original parts of our body accompany us into old age. At some point, a hip joint often no longer wants to, or a knee. Most often, however, the teeth go limp: 13 million pieces have to be pulled by German dentists every year. Sometimes well before their time, for example after an accident. As with many joints, an implant is increasingly used as a replacement – in this case an artificial root, which is usually made of titanium and screwed into the jawbone. She usually closes a single gap and gets a crown on her head. Unfortunately, the cost of dental implants is always very high. There are no cheap alternatives.
Gentle on neighboring teeth
The result of the treatment fits so well and looks so good that no difference to a real tooth is noticeable or recognizable. “Unlike with a bridge connection, healthy adjacent teeth do not have to be ground down to the stump,” says Dr. Gerhard Michael Iglhaut, dentist in Memmingen and President of the German Society for Implantology. In addition, an implant ensures that the chewing forces when eating continue to be transferred to the jawbone. This prevents the body from breaking down bone mass here. And because the titanium forms a stable connection with the bone tissue, the root conveys a secure feeling when chewing, speaking and smiling. However, for these advantages, patients also have to invest a lot of time, patience and at least 1500 euros per implant without health insurance subsidy.
The operation itself takes about 30 to 60 minutes. Under local anaesthetic, the dentist makes a small incision in the gums, drills a channel in the jaw and inserts the screw-shaped implant. He determined the exact location beforehand using a three-dimensional imaging process on the computer. A custom-made template helps him to actually hit the exact spot. He then sews the gums up again and allows the implant to grow under the mucous membrane to protect it. However, not every jaw is immediately ready for the procedure – it has to be built up first for every second patient so that the implant can be securely attached. Bones are taken from another part of the mouth or artificial replacement materials are used. Researchers are constantly testing new methods. One idea is to use the root of the removed tooth. Immediately after pulling, it should be screwed onto the bone to widen it. Alternatively, shorter and thinner implants can also avoid major procedures to build up the jaw in certain situations.
Healing process after tooth implantation
After the operation everything depends on the bone: the artificial root has to heal and grow firmly with it. Depending on the situation, this takes three to six months; it usually goes faster in the lower jaw than in the upper one. In this phase, the dentures must not be loaded too early. Certain factors also increase this
Risk of complications: Wounds often heal more slowly in diabetics with poorly controlled blood sugar levels and in people who take bisphosphonates for osteoporosis . Smokers are also more prone to bacterial infections. Anyone who has opted for a white zirconium oxide ceramic implant instead of a metal titanium one because of an intolerance must also be careful. “With ceramic implants, we do not yet have any long-term experience for some systems. The surface texture has a major impact on whether these ceramic screws heal safely in people with soft bones,” explains Dr. Gerhard Michael Iglhaut. Only when everything has healed and is stable is the final crown screwed or cemented onto the substructure. From there areBacteria are the biggest enemies of artificial roots , so they always have to be meticulously removed. But support is also in sight here: special surface coatings are intended to reduce the formation of plaque in a new generation of implants and at the same time ensure that the gums attach better to the implant – this makes it more difficult for bacteria to penetrate the tissue. And how long does an implant last these days? Scientific studies show that 90 percent are still intact after ten years. “With good follow-up care and hygiene, they can stay in the mouth for longer than 30 or 40 years,” promises Dr. hedgehog skin.
The right dentist for implants
The experience counts
In principle, every dentist in Germany can call themselves an “implantologist”. There is no protected professional title. Therefore, first find out about the experiences of the doctor. Some specialist societies have introduced their own quality standards, e.g. e.g.:
• For example, a doctor may only use the designation “Activity focus on implantology” of the German Society for Implantology . If he has worked in this field for at least three years, has placed or treated 200 implants and over a longer period of time has trained.
• An “implantology specialist” from the German Society for Dental Implantology must prove, among other things, that he has carried out 400 implantations within the past five years.
Proceed with caution
A good implantologist does not just recommend an implant. He first examines the teeth and jaw carefully and takes the time for a detailed discussion. In it he explains the advantages and risks and possible alternatives to artificial roots.
Get a second opinion
Since implants are expensive, before you decide, get a second or even a third quote. You can search for implantologists in your area on the websites of the specialist societies. Get written suggestions from all practices in the form of treatment and cost plans as to what should be done and how much it will cost.
