Probably more than a million dental implants are used in Germany every year. There are no exact figures because implants are billed as a private service. Based on the sales data of the implant manufacturers, an increasing demand can be assumed, since around 380,000 dental implants sold in Germany were assumed in 1999 and a good 800,000 in 2009.1 After a slump as a result of the financial crisis in 2008, the German dental implant market stabilized.
Dental implants are titanium or partly also ceramic screws, which are anchored in the jaw as an artificial tooth root and can wear crowns, prostheses or bridges. They are only one way of getting dentures, but they play an important role in public perception. They are considered a symbol of modern dentistry and are often advertised aggressively through advertisements.
Usually, implants with a long lifespan are advertised. So are after ten Years - depending on the implant system, number, position and oral hygiene - up to 95 or 98 percent of the implants in the jaw. However, these studies are often manufacturer studies and they only provide a "survival rate". That means: how many implants are still in the jaw after five or ten years is counted. The survival rate does not say whether the tissue is healthy and the situation is medically stable.
However, there may be complications with implants. During the operation, a nerve can be injured in the lower jaw, the maxillary sinus floor in the upper jaw. A neighboring tooth can also be damaged if it is placed incorrectly. Implants can as well not heal like a bone structure. These so-called early losses are not systematically recorded. A so-called late complication is peri-implantitis, which usually only occurs after several years. This inflammation of the tissue around the implant is rapid, often goes unnoticed, is difficult to treat, and leads to bone loss. According to studies, every fifth implant (20-22%) is affected. According to current research, only two thirds (66%) of patients with implants are free of complications after five years.
Implantation: indications for surgery
Such operation should be made in the following cases:
- Local tooth defects that can be eliminated with prosthetics. Doctors recommend this procedure when implantation helps to save adjacent teeth and avoid damage of the weakened root.
- Included defects that can be eliminated without installation of movable implants.
- Problems with edge teeth that can be solved with the help of non-movable construction.
- Absence of teeth when prosthetics helps to restore a dental row quickly and accurately. Such indications for dental implantation are typical of the elderly people and those who suffered from serious injuries.
Positive factors for prosthetics
It’s not always possible to reach optimal results. There are many aspects that matter.
- Research of every individual case. A doctor checks smile line, gum edges, defines biotype of the soft tissues (it can be thin or thick), looks for defects on bone tissues and atrophic processes. The result also depends on absence/presence of the tooth, whether it should be deleted before prosthetics and aesthetic aspects.
- Orthodontic and surgical standpoints. It’s crucial to evaluate all pros and cons of prosthetics and define the type of construction, materials, sizes of devices, quantity of implants and the method of their installation.
Contraindications for prosthetics
Indications for implantation matter, but there are many contraindications, as well. These include:
- Chronic diseases of inner organs at the stage of depletion.
- Problems with hemostasis process.
- Conditions with psychic system.
- Rejection of movable prostheses.
- Allergic reactions to most materials.
Relative contraindications also pose risks at some certain conditions. These can be:
- Inflammatory processed of inner organs, acute viral infections.
- Chronic diseases caused by infections (tuberculosis and other conditions), onset of malaise.
- Bacteraemia, or a high risk of development.
- Heart strokes and brain strokes that have appeared within the last 6 months.
- Pregnancy and lactation.
- Hormonal therapy and immunodepressants.
Dental implantation is not performed in patients with osteopathy, central nervous system affliction, alcohol or drug addiction, blood diseases, problems affecting connective tissue function and those who use antibiotics. Before the surgery, complete physical examination is performed to define whether a person is a good candidate for it. If some contraindications haven’t been revealed before the procedure, it can lead to complications in a post-surgery period, high risk of rejection and other negative outcomes.
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Types of implants and methods of dental implantation
Although dental implants have the same construction (that is installed in bone tissue), there are some classification differences.
Endoosseous blade-vent implants
This is a special group of implants that are used when patient’s bone tissue is too thin, and a classic dental post cannot be fixed. Instead of it, a thin irregular-shaped plate is used. Its bent shape allows fixing the implant at any directions. Endoosseous implants from the most well-established producers may have porous structure which allows the implant to get inside the bone tissue and take better. Such plates were first used in 1983 and got negative feedbacks from dentists and patients. Some claimed they had a lot of disadvantages including unreliability during chewing load, low take change, low hygiene level and insufficient robustness of crown fixation. However, the technology has been greatly developed since then. Modern implants imply using neutral and strong titanium material – oval constructions and oval perforation makes up for better growing into bone tissue. Zimmer implant is a good example of reliable construction.
Installation of endoosseous implants is a complicated dental operation that requires not only using quality materials, but also accuracy and high skills of the surgeon. It should be performed by qualified specialists only.
*Brand matters – Zimmer Biomet Dental
Zimmer European company is a leading supplier of endoosseous implants. Many German clinics use Zimmer Biomet Dental due to a high quality of service and excellent technical characteristics.
To reduce the risks of implant rejection, Zimmer offers:
- high level of product examination;
- individual approach to cases in dental practice;
- step-by-step procedure guidance;
- quality guarantee on procedures.
Technological portfolio of the brand includes more than 480 combines and united patents.
Zimmer made a considerable contribution to development of implantology. It has more than 650 scientific works, MDEA sphere awards, and extensive courses for ongoing education of dentists from Germany, Austria, Sweden, Switzerland, and Belgium.
Screw implants have classic form and are most widespread. They are used when the bone tissue is healthy. They look like grub screws with rough surface (to improve connection with bone). To prevent screw twisting, it is equipped with special grooves, anchor lugs, and sockets. The most optimal material for production of screw implant is titanium – a bioinert metal. However, titanium can be different, and some producers offer alloys with other elements instead. Sometimes vanadium is added to screw implants, which reduces its price at the cost of implant survival and duration. Peculiarities of screw construction should also be noted. The best implants, for instance, products from Straumann company, not only go through sandblasting, but also have pores to take better. MIS is another worthy dental implant brand that features marking and serial number on every screw. Patients and dentists also leave positive reviews about European products of Camlog brand: they are made by special bioengineering ROOT-LINE 2 Implants technology (it allows installing the implant even in thin bone tissue). Nobel Biocare implants have very high survival rate of 99.3%, and Alpha-Bio screw implants are affordable and yet reliable.
*Straumann® Implant – leader in screw implantation
Straumann implants are produced by key modern technologies, such as Morse Taper and CrossFit®. Combined together they guarantee reliable fixation and precise placement between the implant and the abutment.
Straumann offers several modifications for flexible work in every personal case:
- standard implants with smooth cervix 2.8 mm high for one stage implantation;
- crown- apathetic Standart Plus implant 1.8 mm high that makes up for fast taking and high survival rate;
- Straumann Capered Effect for immediate restoration of lost tooth;
- Straumann Bone Level with 99.2% survival rate used together with jaw bone formation.
*Nobel Biocare – high level of survival
Production of Nobel Biocare brand deserves particular attention. It is based on discoveries and research made by Per-Ingvar Brånemark in the sphere of osteointegration and published in 1952. Nobel Biocare is a pioneer in the sphere of implantation, and the founder of such directions as individual CAD/CAM constructions, 3D diagnostics and planning of further surgical treatment based on obtained data.
Key benefit of Nobel Biocare products is a high level of implant survival (99.3%) that is reached by unique “common system” approach.
The company offers ready solutions for dental implantation including:
- screw implants;
This is a complex system, which means the product match with each other, they’re durable, clinically efficient and affordable.
Intramucosal implantation is a modern way of dental post fixation used when bone tissue is too thin. It’s not a fully-fledged implant, because it’s fixed in gums only and looks like a button for installation of temporary implants. The main benefit of such construction is low weight and compact sizes. Intramucosal implants don’t cause discomfort, and don’t affect function of taste receptors. They can be installed, if thickness of mucous membrane exceeds 2.2 mm. One of the most well-established producers of intramucosal implants is German company Bio3 Implants GmbH.
*Bio3 Implants GmbH – genuine German quality
Bio3 Implants GmbH – is a German manufacturer that specializes on premium-class dental solutions.
Major benefits of Bio3 Implants:
- highly precise taper connection;
- anodized hydrophilic surface;
- lifetime guarantee.
Brand uses the following special technologies:
- Taper system Bio3 Implants that ensures tight connection between implant and abutment, long-term osteointegration, simplicity of penetration into bone tissue, and high level of fixation.
- Bio3 Implants surface with hydrophilic porous structure that stimulates active growth of bone tissue on the entire implant surface.
- Anti-Rotation fissuras are made on the apical part of implants – that prevents damage of anatomical part of bone tissue.
Implant models for complicated dental cases
Subperiostal can also be translated as “subperiosteal”, and the name justifies its peculiarity. Such implant does not touch the bone, it is installed in a thin layer of periosteal coverage – a film that surrounds the bone and performs a lot of functions including bone formation. This method of implantation requires absolute precision of design and installation, so the procedure is performed in the best dental centers of Germany, Austria and other countries with advanced medicine. The method is used in cases when patient’s jaw bone is too thin for installing a screw implant, and dental plates cannot fix the new tooth properly. One-stage implantation is also impossible. During installation of subperiostal implants, bone tissues should be separated from the periosteal coverage, teeth imprint is made and the future implant is produced. Then a fixing operation follows, and a person needs to go through 10-day rehabilitation course while being examined by specialists. Since the technology of subperiostal implantation is sophisticated, and every case is individual, this is a pretty expensive operation.
Endodontal stabilized implants
This is a peculiar type of implants – the principle of work reminds of nail and hammer. Dental post does not replace a tooth, but helps to fix it in bone going through a healthy tooth. This procedure is required when a patient had some part of tooth removed, and it resulted into instability. To solve this problem, doctors use endodontal stabilized implants that “nail” the tooth back to the bone foundation. This is an methods of express implantation, also called as one-moment implantation.
Combined type dental implants
Implants of combined type may consist of screw and plate constructions. Dental clinics apply them in cases when a patient has thin bone tissue, so classic dental post cannot be installed, and plates also cannot solve the problem. Combines type implant often has a shorter post that is compensated by additional plates. The most well-known type of combined implant is Ramus-Frame. Its construction consists of a titanium plate and several cylindrical screws. The implant is installed inside the bone and compensates lack of bone tissue for performing other restorative operations.
Materials used for implants
Dental implantation in Germany is performed with innovative dental implants that are made of high-quality titanium allows. German clinics also offer their clients to choose between ceramic and zirconium implants. The materials used for dental implantation in Germany are absolutely safe for patients and don’t cause allergy or other side effects.
Practice shows that titanium implants are the most optimal for dental prostheses. They are durable, and have a high biocompatibility level. Yet clients who pay utmost attention to the cosmetic aspect of implantation are recommended to use zirconium implants, because they do not show through the mucous coat unlike other materials. Besides, zirconium implants are often used when tissues around teeth are too thin.
Computer 3D modeling
Planning of dental implantation in Germany requires several stages to be completed. First, digital volumetric tomograph (highly precise diagnostic device) is used to make round X-ray images and get 3D image of high and low jaw bones, surrounding tissues and localization of nervous canals and the state of maxillary sinus cavity.
Thanks to professional skills and rich practice, specialists of German clinics use their knowledge for working with new equipment and getting precise results.
Dental implantation in Germany is performed according the principle of reverse consequence according to the implied results. First, a modeled structure is produced to get the complete image of what implant should look like. This method allows fixing implant in tissues around the tooth and minimizing damage of surrounding structures. The success of dental implantation is ensured on the stage of preparation.
Dental implantation in Germany is a modern direction in advanced medicine. Only innovative equipment and the latest dental technologies are used. German clinics offer qualified help in solving problems with teeth and gums.
German Medical Group is a company that helps patients from all over the world to find worthy European clinics. We organize everything connected with your treatment in dental clinics: starting from the choice of medical center and finishing by your trip and accommodation. Our team can take care of the minutest details of your medical travel, so you won’t have to worry about anything. We guarantee that treatment in Germany will be efficient and pain-free for you. Besides, we also provide “second opinion” service: a distant consultation from qualified and skilled European doctors.
The unique All On Four technology is a special dental prosthetics method, which makes it possible to restore the lost row of teeth regardless of their location. This method involves placing of four implants on one jaw: the first pair is installed on the front side, the second — on the fifth teeth at 45 degrees angle. In this method the load is spread evenly on all implants, thanks to the direct installation of dental crowns, and the finished dental arcade allows the patient to lead their usual lifestyle, making it possible to eat solid food and to deal with usual mechanical stresses.
Advantages of All On Four Method
Key advantages of the innovative method:
- Moderate price due to the decreased usage of materials (4 implants against 12 dentures made separately) and high installation speed.
- The operation is less traumatic. The procedure does not require to build up the bone tissue if it is not thick enough, sinus lifting is not necessary thanks to the angular pin installation.
- High comfort for the patient: the functions of chewing muscles are completely restored in 2-3 days, the ready dental arcade looks aesthetically pleasing and natural.
- Reliable fastening of dentures, durability: the installation of titanium units guarantees smooth operation for 10-20 years.
- The procedure takes less than a day. In the All on 4 method there are no pauses between the installation of the root, the abutment, and the crown.
- The body recovers only in 3-4 days, the risk of swelling, inflammation, bleeding is minimal.
- The number of general and relative contraindications is small, the prosthetics are suitable even for diabetic patients.
Disadvantages of All On Four Method
The new technology has the following drawbacks:
- In some cases, the four implants cannot cope with constant mechanical pressure.
- The prosthetics can be made only from plastic, which reduces the service life of the products.
- There is risk of spreading of bone atrophy in an area with no dentures which can deform the position of the implant after 6-12 months.
- This type of teeth replacement is not suitable for people suffering from periodontitis, smokers.
The minimum number of drawbacks of the technology makes it possible to use it for dental prosthetic rehabilitation at any age. The cost of the operation is relatively small, so the method is affordable to a wider range of patients.
All On Four Technology: Main Features
The main indication to use the technology: the lack of the "own" teeth on the upper/lower jaw or on both jaws at once. The method is applicable for restoration of the dental arcade lost in due to age-related changes, physical trauma, diseases. The prosthesis with 12-14 implants is placed on four rods distributing the load. The main stages of the All On Four method:
- Preparatory process: oral cavity sanitation, examination of mucous membranes, tooth holes. It is important to adhere to sterility conditions.
- Installation of the supporting implants: the first two are installed into the frontal part of the row, the second pair is placed on a location of the fifth molars, under the 45 degrees angle. The length of the lateral implant does not allow it to touch the maxillary sinuses, thus reducing the risk of injury.
- Rehabilitation lasts for 2 to 4 hours. At the end of the rehabilitation period the doctor places a permanent prosthetic designed according to the patient's jaw, fully corresponding to their specific anatomical features.
- Installation of a fixed prosthesis. The procedure takes less than an hour, the patient can leave the clinic on the day of procedure.
The "All On Four" implantation method allows the patient to begin leading their usual life after only 3-4 days, as healing process takes a minimum amount time. The procedure is recommended for people with reduced volume of bone tissue with no possibility or desire to grow it.
Laser dental implantation – modern methods
Survival rate of dental implants depends not only on used materials and types of implants, but also on the type of operation. Swelling and destructive inflammatory process affecting the soft and hard tissues surrounding dental implants can be avoided by using surgical laser. Such procedure is more expensive than usual implantation, but this method has the following considerable advantages:
- laser implantation is a one stage procedure that takes up to 30 minutes;
- laser is a safe and precise instrument with spare effect on body;
- laser procedure does not cause bleeding, so the specialist can get better vision of the mouth cavity;
- laser also has disinfectant effect which reduces complications caused by infections and bacteria.
Before dental implantation
One stage prosthetics is performed in the following cases:
- damage of dental root;
- injuries (chipping, huge cracks);
- destruction of the crown (complication of periodontitis, deformation caused by mechanical load);
- chronic periodontitis, absence of treatment or an incorrectly used method.
A doctor can define whether one stage prosthetics is possible. He evaluates all indications, contraindications, and individual peculiarities of patient’s body. After installation, the dentist will evaluate the possibility to put load on the new implant. If there are any absolute contraindications, prosthesis won’t be installed.
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Stages of dental implantation
Installation of artificial teeth is a complicated process that requires preparation, and post-surgery manipulations even in case of one stage procedures. Every stage has its own peculiarities, it requires doctor’s attention and strict following to doctor’s recommendations. If a doctor has implemented stages of dental implantation correctly, it guarantees fast recovery, and reduces the risk of side effects and complications.
This process is obligatory regardless of treatment method, and it lasts up to 2 months.
The doctor does the following:
- collection of medical background and information to get the complete clinical presentation;
- definition of indications and absolute and relative contraindications for the surgery;
- visual examination of mouth cavity, X-ray, tomography, professional cleaning and removal of tartar and calculus;
- complete physical examination of body systems to define abnormalities preventing surgical invasion;
- analyses (general blood analysis, blood sugar, HIV, sexually transmitted diseases, hormonal content).
If a patient has chronic diseases, he or she will have to go through additional examinations made by specialists and, probably, treat these conditions. If any of the above mentioned analyses show abnormalities, they should be eliminated first. At the same time, a doctor will define the stages of surgical invasion and appoint dates of surgeries.
How dental implantation is performed: peculiarities of surgeries?
An oral surgeon/dentist performs the following manipulations:
- Installation of implant – the element that serves as artificial foundation. A dental post can look like a real root; technologies of installation differ. Prior to installation, anesthesia is administered, and the area is disinfected. Then a special site is made in bone tissue. The implant is installed, and a cap is fixed above. The mucous membrane of gums is stitched. Installation lasts for 30-50 minutes, and total adhesion finishes within 12 months maximum.
- Installation of abutment – a special superstructure that is located in the middle of an artificial tooth. The process is performed only when an implant takes. The doctor cuts the gums, opens an artificial element and installs a forming detail to shape gum tissues. After 2-3 days, the forming detail is put off, and abutment is installed.
- Installation of dental implant (prosthesis). A doctor makes a pickup impression of patient’s jaws, and models of artificial crowns are formed in laboratory. Later on, they are installed on the abutment.
If bone tissue is too thin, it is built up before surgical invasion: a doctor puts synthetic/natural bone tissue up on it, which helps to make the layer thicker and strengthen the structure. The surgery lasts for 4-5 hours, and tissue recovery takes 1-3 months.
Dental implantation finishes with a post-surgery stage. Swelling and minor bleeding can take place in the first days after the surgery. In case of severe inflammation, doctors recommend using pain-killers (pills and ointments). Initial stage takes up to 10 days, and a patient should clean prostheses daily. After 10 days, a dentist should be visited: the doctor will check oral hygiene, evaluate prostheses. If there are no side effects and complications, a doctor will remove stain and plaque and give recommendations concerning oral care.
Patients should visit dentist every six months. If the specialist reveals some side effects (inflammation, hematomas, gap in stitches), patient is administered drugs, mouthwash and compresses. In rare cases, implants can be rejected. Depending on the level of tissue damage, the doctor will define the way to treat the problem (artificial tooth can be removed). If there are no problems, implants take within 2-3 months after operation.
After dental implantation
In most cases, prosthetics is very successful, and an implant takes within 5-10 days depending on patient’s individual physical peculiarities. However, many patients face side effects during rehabilitation: swelling after implantation, pain, numbing, bleeding, etc. Some symptoms are normal, while the others mean that the procedure was performed incorrectly, or a patient didn’t follow the rules of hygiene. Such consequences can be eliminated with the help of drugs and mouthwash. Less often, doctor’s help is required.
Rehabilitation after dental implantation: main problems and reasons
The duration of recovery depends on individual anatomic peculiarities, absence or presence of complicating factors, contraindications, surgeon’s skills, following doctor’s recommendations and other aspects. Maximum recovery period for upper jaw – half a year, for lower teeth – 4 months.
Basic types of possible complications:
- Problems that happen immediately after prosthetics: if a patient has pain in jaw, or there’s a light/medium swelling, it’s an individual reaction to surgical invasion. These symptoms usually pass within 1-3 days.
- Problems caused by incorrect treatment and failure to follow doctor’s recommendations. These include hematomas, severe bleeding, inflammation of stitches, high temperature, pain after implantation. These symptoms start occurring from 5-7th day and may persist within 3-5 days. Without medical help, complications may develop (purulent process, weakening of bones and gums, loosening of the implant).
- Problems with implant survival. The way to treat the problem depends on severity of case (prescription of drugs, therapy of bone tissue, implant removal, implant replacement).
Which antibiotics are prescribed after implantation?
The main aim of post-surgery care is to minimize the risk of catching infection and bacteria via stitches. Pretty often, antibiotics are prescribed after implantation: they ensure antiviral protection when there’s lack of bone tissue, a person has deep cuts, or the operation was pretty complicated.
Doctors prescribe broad-spectrum medications that contain penicillin. Such drugs include Amoxiclav, Amoxycillin, and cephalosporins. These antibiotics ensure fast effect, they’re safe for patient’s body and kill the majority of infections. Treatment requires 4-8 days, less often – up to 2 weeks. The doctor defines dosage and duration of treatment in every individual case. Antibiotics should be used responsibly, because people may often experience:
- allergy and individual intolerance of penicillin and additional components;
- disbacteriosis and stomach upset;
Pain and temperature after implantation: how to deal with it?
Pain and swelling of soft tissues often occur after implantation. Although being pretty disturbing, these conditions pass within a few days. Symptoms can be relieved the following ways:
- Cold compress. If a person suffers from swelling after dental implantation, it’s recommended to apply ice to the affected zone and keep it for 5-15 minutes. Such treatment can be performed within 2-4 days.
- Mouthwash with herbal essences and herbal products containing chamomile flowers and leaves, extract of oak bark, salvia, etc. The procedure should be performed accurately so that not to damage the new implant. Mouthwash should be made 2-3 times a day. Together with herbal infusions, a person may also use chlorhexidine: it relieves swelling and disinfects tissues preventing contamination with bacteria.
- Anti-inflammatory ointments, gels and injections. To improve recovery after implantation, doctors often prescribe nimesulide, analgin and diclofenac. People with problems of gastrointestinal tract (ulcers, gastritis) should use them carefully.
- More serious problems – severe bleeding and loosening of implant. If a gap develops in stitches, a person should get immediate medical help: the specialist will disinfect the wound, check how rigid the implant is, and put the new stitches.
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How long does it take for different implant systems to take?
The implant will take only if it can bond with bone tissues, and the process of osteointegration takes place. During normal bone regeneration, bone recovery is pretty quick, and the location of implant (in the upper or the lower jaw) and quality of implant system play crucial role in that. Pretty often, dentist can define the quality and quantity of patient’s own bones during the operation, and decide whether implant can be installed on it, and how long it will last. Despite all possible peculiarities, average time of implant taking is the following:
|Type of implantation
||Recovery process in months
|Upper jaw (without augmentation)
|Lower jaw (without augmentation)
|Upper jaw with augmentation (Sinuslifting)
|Lower jaw with augmentation (Plastics)
When it comes to implantation, the rule says: the easier operation is, the faster wounds will recover
If a surgeon performed implantation on the upper jaw, more time for full recovery of tissues around the implant is required. That is caused by the fact that the bone of the upper jaw is less solid that in the lower jaw.
Recovery process is very long, if implantation of both upper and lower jaws has been performed. The more is the scope of operation, the longer recovery phase takes.
Complications are typically classified according to the time of appearance:
- Complications during implantation: severe bleeding, bone perforation into Highmore's sinus, overheating of tissue because of mechanical processing (by a drill or a dental engine). The main reason of complications is low professional skills of a surgeon and lack of experience. Modern multifunctional equipment allows reducing all these risks to a zero, even if it’s used by a doctor with minor experience.
- Complications of a post-surgery period. During the first 5-10 days after a surgery, a patient can experience persisting pain in jaws. The reasons of complications can be different: individual peculiarities of body, technical inaccuracy during preparation, non-compliance with care recommendations.
- Problems with survival of prosthesis. During this period, inflammatory processes can occur around the implanted tooth; if there’s no proper treatment, inflammation destroys jaw tissue and weakens fixation of prosthesis. The main cause of inflammation is bleeding and rotting of soft tissues, incorrect preparation of bone site, or violation of sterility. To solve this problems, doctors cut the abscess out, disinfect the area to prevent bacterial and viral contamination and improve oral hygiene. If it doesn’t help, the implant is removed. Treatment is aimed at restoration of jaw bones.
- Rejection of prostheses is another problem that can happen during implant taking, or later on. It’s a rare case that is characterized by inflammation, overheating of bone tissues, and formation of granules that hinder prosthesis survival. Rejection can happen in people with osteoporosis that can develop because of difficulty with blood flow. Bones tissues don’t develop and cannot hold the implant. Therefore, it has to be removed.
During two stage implantation, the following problems can occur:
- Twisting of root prosthesis: this is the first stage of rejection that occurs when survival process goes wrong. If there are no inflammatory processes accompanying it, the implant can be installed back, and drug therapy with calcium is administered – it stimulates growth of tissues. When an inflammation develops, antibiotics are prescribed. In more complicated processes, prosthesis is removed.
- A prosthesis advances into maxillary antrum. While complications after implantation of lower teeth are less dangerous, such phenomenon is serious. It usually occurs when the implant doesn’t take, or a doctor makes a mistake. In this case, implants should necessarily be removed, jaw bones are to be restored, and bone tissue should be built up.
- Excessive growth of hard tissues over an implant. This isn’t a serious complication that’s easy to eliminate. A dentist simply removes overgrowth.
In well-established clinics, the risk of such problems doesn’t exceed 1-2%, and prosthetic surgeries are mostly successful. This is a fact proved officially.
Why do I have a high temperature after dental implantation?
Raise of temperature after dental implantation is a normal body reaction to a foreign body. In some cases, during 2-3 days after the procedure, a person may experience some unpleasant symptoms, including raise of temperature up to 37.5 °C. If a high temperature persists and/or is accompanied by purulent discharge, this is an inflammatory process that requires invasion of specialists.
As it has been mentioned, in most cases, patients suffer from subfebrile temperature after implantation. The body spends all powers to heal the wound which triggers reddening and swelling. The last condition also causes active blood flow to the tissues around the implant.
However, there can be some other reasons for poor well-being:
- stitches were put incorrectly and a gap developed, which caused dirtying and development of purulent areas;
- bleeding and hematoma developed near the new tooth;
- low-quality material of implant has been rejected by body tissues, which caused a high temperature and swelling;
- destructive inflammatory process affecting the soft and hard tissues surrounding dental implants (peri-implantitis).
The last condition happens when a surgery is performed incorrectly. Unfortunately, there’s lack of qualified and talented doctors in low-budget clinics. This is why in some dental clinics, dentists cut the dental site incorrectly, oral cavity is not disinfected properly, or an implant is fixed incorrectly, or it overheats. Overheating of implant takes place when the area is not moisturized sufficiently. Some dentists moisturize only a dental drilling machine, but not the treated area – it’s a big mistake.
As the result of doctor’s mistakes, patient can develop atrophy. A patient can start feeling unwell, swelling develops, and temperature rises.
Sometimes such symptoms are accompanied by development of sinusitis (if maxillary sinus cavity was affected during implantation). Removal of implant and anti-inflammatory medications can be necessary for treatment.
More and more people with dental implants start complaining about inflammatory processes around artificial teeth. Gums start swelling and bleeding after minor touches, and purulent processes also take place. Inflammation of soft tissues around the implant is called “mucositis”. Progressive destruction of bones and lack of fixation from the soft tissues leads to development of periimplantitis (destructive inflammatory process affecting the soft and hard tissues surrounding dental implants), which can lead to loss of implant. The causes of both diseases are bacterial deposits, so-called “plaque”. Other provoking factors are smoking, diabetes, and residues of cement under dental prostheses.
The doctor decides whether surgical or conservative treatment is preferable.
Removal of biofilm
The main aim of non-surgical treatment is to reduce the signs of inflammation in mouth. Bacterial film on implants is removed with the help of special instruments, or an apparatus with special powder (air-abrasive technology). Repetitive procedures lead to positive results.
Local treatment with medications. Injection of drugs, ointments and mouth rinsing without additional removal of biofilm will not reduce inflammation.
This therapy does not only eliminate the signs of inflammatory process, but creates better conditioned to prevent reoccurrence of disease.
Laser therapy gives the same results as therapy with the help of air-abrasive apparatus
When periimplantitis is treated surgically, the hole near the implant is removed, which allows defending this area from bacteria, which prevents repetitive occurrence of disease. There are resection and augmentation therapies applied.
In case of resection therapy, deep periodental channels around the implant are removed. As the result, the most part of implant surface is available, and the patient can brush teeth more efficiently.
This therapy presupposes filling of defects with bone substance. In order to eliminate bone defect fully, the area should be cleaned and prepared properly. This therapy is only applied in case of minor bone defects.
Today, there is no general standard for treatment of inflammatory processes around implants. Better results can be reached with various therapeutic approaches. It should be noted that if conservative therapy is possible, a patient should resolve to it first and only then resort to surgical intervention.
How to care about the implants
In order to prevent diseases that provoke using implants in mouth cavity, a patient should have the implant fixed in mouth cavity correctly, which can guarantee proper and correct care after it.
It should be noted that implants require a high level of hygiene and regular dentist’s examination. A high-quality specialist can ensure optimal care about patient’s implants and prevent possible complications.
Regular examinations help to prevent development of periimplantitis.
How to avoid outcomes after dental implantation?
In order to protect yourself from complications and risks, you should follow the next recommendations:
- Don’t hurry to choose a clinic and a specialist. Read the reviews about medical center and the doctor thoroughly, check what his experience is like, look at the photographs showing the results of operations. Also check how the medical center is equipped. It should feature advanced devices with the main focus on safety.
- Right choice of material. Of course, it depends on patient’s budget mostly, but trying to save you should keep in mind that not all materials are equally compatible with bone tissues. Titanium, its alloys and zirconium have the highest survival rate, and the risk of rejection with such materials is minimal. Consult with your dentist before making a decision.
- Methods of implantation can also differ. The choice depends on overall health or mouth cavity and jaws. When bone tissues are too thin, some ways of implantation simply cannot be performed.
- Complications after implantation of the upper teeth are much harder to deal with. Therefore, if you are to go through such procedure, it’s crucial to figure out suitable materials for implants and the entire construction.
- It’s also important to follow doctor’s recommendations concerning methods of oral hygiene and cleaning.
- Minimal load on implants can be rendered after 2 weeks only.
Select a high-quality dental clinic
If you want to avoid the above mentioned problems, you should choose specialists who deserve your trust. Being a patient of a high-quality clinic you can be sure to get decent treatment without complications and side effects. However, if you didn’t manage to avoid complications and medical malpractice, contact with us, and we will find a good specialist for you.
Dental Implantation with Osteoporosis
Is it possible?
Everything depends on severity of osteoporosis and medical therapy that’s been assigned. Osteoporosis makes bones thicker and more fragile. Besides, inner bone trabecules also lose in volume. These factors are crucial, when it comes to bone loading. Becoming fragile, bone structures destroy and form hollow spaces. These changes are also typical of jaw bones, but destruction process can take years due to demineralization.
How treatment is organized?
In order to define the severity of osteoporosis, doctors use DEXA method (osteodensimetry). They measure the diameter of wrist bones. However, it should be noted that DEXA values cannot show for sure whether destructive process in jaw bones has started.
If a patient wants to go through implantation, 3D X-ray scanning should be performed. Thanks to special software, mineral contents of jaw bones can be evaluated. If moderate osteoporosis has been revealed, a dentist will use several methods allowing him to boost bone thickness around the implant.
Preparation to implantation
When preparing jaw bone to implantation, a dentist will drill it accurately according to the planned length of the implant. When the channel is widened with dental borer, the dentist leaves it pretty narrow to fix the implant tightly and fix it forever. The implant is screwed in the small channel that works by screw principle – it pushes extra bone tissue out which allows increasing thickness of bone around the implant.
Pushing of bone tissue
During preparation process, a dentist makes a small incision for the entire maximal length of implant. Using conic instruments with rounded end, a dentists pushes bone. If the instrument with the right diameter is used, a hole that’s ideal for the implant is made. In this case, bone tissue is not removed – it’s pushed outside. This method increases bone density and helps to avoid its destruction.
Mineral bone filler material can be injected into the inner wall of drilled channel and moved outside when the implant is being screwed. There are different paste-like materials that harden after being injected into the cavity. Depending on manufacturer, various forms and types of products are available. During many years, therapists and orthopedists have been using bisphosphonates to treat osteoporosis. This remedy prevents excessive loss of bone mass. Unfortunately, bisphosphonates also decrease bone regeneration, which leads to disorders in recovery and various complications after orthodontic surgeries. When bisphosphonate therapy is over, a surgeon injects products or uses them orally. The dosage is defined by dentist.
Neither light, nor severe form of metabolic osteoporosis is usually not a contraindication to dental implantation. In every individual case, dentist decides upon this method after diagnostics and examination. It’s crucial whether bisphosphonates were used for osteoporosis therapy, because use of this product can be a contraindication to implantation.
As you could see, there are many different kinds of implants and all of those types are only indicative, as every implantation is 100% tailored work and different types could be overcrossed in one restorative work. So it is difficult to give any price indication but to give at least an idea of restoration cost as a base normally is considered one tooth implantation plus all the other cost as dentist work, diagnostics, consultation etc.
Cost of Dental Implants in Germany
|Dental implantation cost, one tooth
||from 697 €
||from 800-1000 €
|Dental Crown, Composite
||from 597 €
|Dental Crown, Gold
||from 598 €
|Dental Crown, Porcelain
||from 1100 €
|Mid range dentures, per arch
||from 800 €
|Partial dentures, per piece
||from 400 €
*All the prices are based on a few estimations from different sites and could not be an offer. Please enquire to clinics for precise pricing
Above prices is only estimation based on comparison the prices from different sites but the final calculation is based on what you actually need.
For examples, with two stages implant system your treatment might include the following stages and costs.
|Dental Crown, Porcelain
In another case, a clinic could offer you free consultation and treatment plan designing, but probably you may need tomography instead of X-Ray; or you will be advised to have one stage implantation that reduces some stages; or you could choose composite crown that also affect final cost. So you should have understanding that every reconstruction is individual and only clinic could give you an offer in accordance with your real needs.
Please call to the clinics of your choice for quotation before applying via GMG. You have a great choice of the medical centers with different treatment and technologies and, for sure, you will find your clinic and your doctor.
How to choose a clinic for dental implant installation?
The choice of reliable dental clinic should be based on clients’ reviews and feedbacks. Don’t select small clinics without queues. Good doctors are always on demand, and they don’t have much free time. Besides, you should also pay attention to clinic’s equipment.
Worthy implantation centers are always equipped with advanced devices for fully-fledged examination of mouth cavity, modeling and installation of implants. Decent clinics and doctors use products of tried and tested brands. Avoid having low-quality implants installed – it can lead to complications.
Thorough consultation with the dentist or implantologist
To avoid risks when using implants, patients should be well advised and informed: Should one or more teeth be replaced with implants or should even a toothless jaw be treated? Which supply concept is suitable for my personal situation? Is a restoration with fixed dentures or rather with a removable prosthesis recommended?
Also important is the clarification of risk factors:
- Is there enough jawbone to give the dental implants a firm hold? Because there is already a bone loss, before the implantation first a bone structure must be made.
- Is there a periodontitis? In these cases, the disease of the dental bed must first be successfully treated in multiple individual sessions.
- As a patient, am I prepared to give up smoking? Because smokers are twice as likely to lose an implant again, as a non-smoker.
More safety and less risk through perfect planning
The greatest possible safety is provided by the 3D planning of the dental implants. Based on CBCT x-rays, the dentist can display the entire operating area in three dimensions using software and precisely plan the number, type and position of the implants prior to the procedure. Sensitive tissue is spared, the procedure is minimally invasive and virtually painless.
For complicated cases, a good implantologist also uses surgical guides. These navigate the procedure by precisely specifying the previously optimally planned drilling depths and drilling angles, thereby avoiding the risk of incorrect positioning or damage to nerves, neighboring teeth or bony structures.
"Dental implant without side effects"
The biggest risk is the loss of the dental implant due to inflammation of the implant, a so-called peri-implantitis. This risk can be minimized by a perfect education and prevention, a minimally invasive surgical technique and a perfect aftercare and implant care.
For dental implants "without side effects" patients should pay attention to these criteria when choosing your dentist.
German Medical Group helps patients to find the best dental clinics in Germany. We offer medical centers that may restore your healthy smile without risks and pain.
Dental implants: Did you know?
1 million dental implants per year
About one million dental implants are placed in Germany's practices each year. Two-phase implants are used, which are covered by the oral mucosa during the healing phase and are thus invisible or alternatively single-phase implants, which are visible during the healing phase. Which system is eligible, decide patient and implantologist individually.
Although there is a large manufacturer market, generally only systems should be used whose safety and durability could be proven in long-term studies and in which the supply of body parts is secured even after years.
Titanium or ceramics?
To date, titanium has been regarded as the gold standard by which new materials, such as ceramic implants, must be measured. Once before - in the 80s - dentists used ceramic implants, then made of alumina ceramics. But they healed badly, the loss rates were high and the implants broke frequently.
Zirconia ceramics are now the new hope. Experts certify the material a high fracture toughness and very good elasticity. The material is as biocompatible as titanium. However, it takes longer for the ceramic to form a firm bond with the bone. And while with titanium implants immediate loading is possible under certain circumstances, zirconia implants must heal under a splint under load. Likewise, the provisional prosthetic restoration of these implants is more complicated. Above all, long-term results on durability are lacking.
Long-term success? The look in the statistics
Hold implants. In edentulous mandibles implanted implants, as proven by scientific studies, often after more than a decade still more than 90 percent functional, in the upper jaw to 80 to 85 percent.
The long-term success is endangered by heavy smoking or inadequate oral hygiene. Likewise, it can happen in rare cases that the titanium root in the healing phase does not connect to the bone. In a very small number of patients, the implant of the first loading phase does not withstand because its surface is not sufficiently fused with the bone tissue.
Essential for implant carriers is good oral hygiene so that the surrounding bone does not become inflamed. On average, five to ten percent of the implants are lost. If so, implant loss usually occurs during the healing phase.
Dental implants need the same care as natural teeth
"A dental implant needs to be cared for at least as well as your own teeth. This avoids inflammatory processes that can lead to the loss of the artificial tooth root. "This recommendation of the German Society for Implantology (DGI) for implant patients derives from the new international classification of diseases of the periodontium, which has now been published. For the first time, inflammation of the tissues around dental implants was also classified. The basis for this was provided by an international team of experts headed by DGI President Prof. Dr. Ing. Frank Schwarz from the University Hospital Frankfurt, informs the DGI.
Improved quality of life through implants
To close tooth gaps, dentists in Germany use an estimated one million dental implants per year. For example, it can be avoided that healthy neighboring teeth have to be ground to anchor a bridge. Numerous studies have shown that the majority of patients are satisfied with this type of dental prosthesis and that mouth-related quality of life improves after treatment.
However, as with natural teeth, the tissue can also become inflamed around a dental implant. As Swedish researchers found in a large follow-up of nearly 600 implant patients nine years after treatment, in one third of patients the mucosa around the implants was inflamed - dentists then speak of a mucositis. At 45 percent, this inflammation had already spread to the jaw bone - the bone tissue around the implant had been reduced by more than half a millimeter. Diagnosis: "peri-implantitis".
Diagnosis of peri-implantitis
The inflammation of the mucous membrane (mucositis) is caused by dental plaque, which forms in bad oral hygiene on dentures on implants as well as on their own teeth. "If this coating is removed thoroughly and the oral hygiene improves, the inflammation heals within a few weeks," says DGI President Prof. Dr. med. Frank Schwarz from the University Hospital Frankfurt. However, if nothing changes in the oral hygiene and the inflammation remains untreated, it can progress and spread to the deeper tissues.
In the past, peri-implantitis was considered a complication that can only occur many years after implantation. Today, the experts know that the disease can start at an early stage - two to three years after implantation. The tissue is then visibly inflamed, existing periodontal pockets have become deeper and bleed even with a gentle examination with a probe. The decline of the bone is visible on an X-ray.
Public survey on the subject of dental implants
The respondents are made up of 291 women (48.5%) and 309 men (51.5%). Of the female participants, 17.5% belong to the age group between 18 and 29 years, the majority of women are between 30 and 39 years old (30.2%). A good 20% are 40 to 49 years old and 50 to 59 years old. The age distribution among men is as follows: Around a quarter of the age groups 30 to 39, 40 to 49 and 50 to 59 years. Only 9.1% are 18 to 29 years old, 17.5% are 60 years old and older.
How many dental implants did the respondents use?
The majority of those questioned received an implant (61.7%). Two to four implants were used or planned in 36.3% of the respondents, more than five tooth implants only in 2% of the respondents. If you put age in relation to the number of dental implants, the 50- to 59-year-olds have the largest share within the group "two to four implants". The age group 30 to 39 years is most strongly represented in a dental implant (30.3%).
It’s not hard to lose or damage teeth – mechanic traumas, carious diseases, filling conditions may lead to permanent consequences that are too late to treat.
The main reason of tooth loss is periodontitis, not carious diseases, as many think.
Modern research shows that high-quality dental care and intense prophylactics of teeth help to avoid carious diseases at early age. In such case, older patients are prone to diseases caused mainly by periodontitis (gum inflammation). Besides, there is a clear connection between periodontitis and a higher risk of heart attacks, brain hemorrhage and diabetes development. Proper dental care at home should include cleaning of spaces between teeth and using prophylactic remedies against periodontitis. Besides, professional dental cleaning also helps to prevent development of periodontitis. If a patient already has periodontitis, professional cleaning together with periodontitis therapy will ensure efficient treatment in long terms.
A few years ago, above mentioned conditions could mean that a patient will either have a hole in jaw, or wear an overdenture solution. Today, things are different: you can use a high-quality dental implant – this is a state-of-art construction that replaces both tooth root and the visible part called crown.
Dental implantation is a leading sphere of modern dentistry that combines technologies of modern material production, sophisticated computer and software assistance and equipment for implant modeling. It goes without mentioning skilled specialists who work in advanced German clinics: you can definitely trust your health to these doctors.