Narrow bone ridge: Before implantation the bone is built up with
a block transplant ( fig. 1). Smaller defects are filled during
implantation with bone chips or bone substitutes (fig. 2-4).

Frequently the height or width of the jawbone is reduced by bone atrophy, leaving the existing bone volume insufficient to support an implant. In this situation, bone augmentation is necessary. It can be done before or at the same time of implantation. The best material for bone build-up is the patient's own bone (autologous bone) taken for example from the mandible. Only in extreme cases of bony atrophy a bone graft from an extraoral donor site is needed (for example from the hip). The bone graft is taken as a block and fixed with small titanium screws or is ground into granules and covered with a special membrane. After 6 months, the bone is integrated and the implant can be inserted.

A “Sinus Lift” is so-called a Sinus Floor Elevation. A special kind of bone augmentation is the sinus lift. In the molar region of the upper teeth, the large sinus cavity provides less bone volume, which can make implantation impossible. Here the sinus lift procedure can help: Through an operative access from the mouth, the sinus floor is exposed and the covering mucosa membrane is carefully lifted. The new formed cavity is then filled with bone chips or synthetic bone material. In case of sufficient height of the alveolar bone, the implants can be immediately placed. If the bone volume is insufficient for a stable anchorage of the implant, the bone is first built up and implants are placed after six months into the reconstructed bone.

In the meantime, the high success rate of implants is well documented. In routine cases, 10 years after implantation, over 90% of implants placed by a professional surgeon, are still in function. These are encouraging numbers that not all medical fields can offer. Nevertheless, with careful planning and execution, failures sometimes occur:

Implants or bone build-ups can be lost by bacterial infection or overload. Rarely, sensory nerves or neighbouring teeth can also be affected.

Risk factors for implant loss are:

• Bad oral hygiene
• Heavy smoking
• Pronounced osteoporosis
• Poorly regulated diabetes
  

The durability of implants has been studied for about 30 years. The results prove that with good oral hygiene and regular check-ups, implants set by an expert surgeon can last a lifetime.

Generally speaking, yes, except for some rare case. The patient's age does not play a role. Implants in older patients have the same good prognosis as in young patients, if they are maintained with good oral hygiene.

The healing time required for an implant before the crown/prosthesis is placed, depends on the bone quality and the number, length and diameter of the implants: In ideal cases when several implants are involved the prosthesis can be immediately placed, but it is not recommended as the implants cannot be loaded due to the fact that it is not integrated with the surrounding bones and may lead to dislodgement of the implants. Otherwise it takes normally 6-12 weeks until the implants can be uncovered and loaded. If a bone augmentation is necessary, it lengthens the healing period up to about 6 months.

Today it's known that heavy smokers (more than 10 cigarettes/day) have a higher risk to loose implants than non-smokers. The major risk for smokers is complications involving bone augmentation.

There are many implant-producing companies on the market, but only few have long-term studies to support their products. We use implants from well-known and widely accredited companies with international standard. Furthermore, these market leaders guarantee the component supply even after many years. This is extremely important when, for example, after ten years a connecting screw must be replaced.

Promises made in advertising are not always reality. The immediate load of implants, meaning, the immediate connection of a fixed prosthesis on freshly placed implants, brings the patient a relevant advantage of time and comfort. However, in every individual case these advantages must be weighed against the potential risks, which are not inconsiderable. It is important that the surgeon has a solid experience of this new technique. We perform immediate load procedures only if the advantage for the patient clearly prevails.

The rules for implants are the same as for natural teeth. Good oral hygiene is recommended and beneficial. The use of interdental brushes is helpful to keep clean between implants. Our dentists can give you instruction for a correct cleaning technique.