Dental Implants - Overview over surgical methods

There are many ways to achieve a goal. That saying is also true in dentistry. With many different surgical methods for dental implants, there are various approaches that have stood the test of time. It is not easy for patients to keep track of all the possibilities. The following article is designed to help you understand the most common practices in modern implant technology.

The conventional safe implant treatment

This traditional method was developed for titanium implants in the 1960s. An accurate hole to fit the implant is drilled into the jaw bone. Once it is healed the implant is screwed in or pressure-inserted. If there is not enough bone mass, the bone structure can be built up at the same time. The titanium surface of the implant is roughened so that after about two months bone and implant will be close-knit. Bone and implant form a close and durable entity. Once this is achieved, the dental prosthesis is placed on the implant and you can chew with your new teeth.

Immediate implant installation

In immediate installation, an implant is plunged directly into the fresh wound after removing the tooth. For this method, it is essential to have a solid jaw bone free of inflammations, as the implant has to be fixed immediately in its final position. It is also possible to build up additional bone structure with this method though only to a minor degree. This method is recommended for treatment on the front teeth, as it maintains an aesthetic gum line better than other procedures. However, the price you have to pay is a higher risk of infections.

Immediate load

The immediate load procedure allows the dental prosthesis (or at least an interim solution) to be placed on the immediate installation implant. The advantage is that you will leave the dentist with the desired look or your complete row of teeth immediately after the old tooth has been removed. The disadvantage of this method is an even higher risk of losing the implant. Although this method looks quite fast, the bone still needs up to 8 weeks to grow onto the implant. This procedure requires the patient to be extra careful and self-disciplined because the new teeth have to be spared at first. That part is often left out in the press and in advertisement. An implant growing in smoothly without proper care is rather rare.

Implantation using CT-navigation

We use this particularly advanced method of implantation since 1996. Before or after removing the teeth, at a radiological center the jaw is scanned with computer-aided tomography (“CT”, “DVT”) using a prefabricated mold. This allows comprehensive planning: type, size, and the best location for the implants can be planned in advance on screen and in 3-D. During the operation session, a template (or in some cases the prosthesis) is used to transfer the planned position of the implants to the jaw so that the implants are placed precisely in their intended places. If desired a prepared provisional dental prosthesis or even the final one can be inserted as outlined in the section "immediate load". This is definitely the fastest possible treatment and is therefore highly praised in the media. 

Latest technology in use

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Many even recommend this treatment because of the safety aspects: the 3-D view of the bone structure clearly indicates potentially vulnerable structures and allows to keep a safe distance. This does not mean, however, that all necessary precautions usually taken in implantology can be ignored, as the procedures also produce several minor inaccuracies.
This method saves time only if bone development is not necessary. Bone development is almost inevitable in most complex implantation cases, but it is exactly those cases where the elaborate procedures make sense. Consequently, bone development operations take place in a preceding session. After the healing period placing the implant follows as second step – now using CT-based navigation. Other than with the conventional safe implant method where only one operation is required (implantation and bone development at once), you need a second extensive operation. That is why we only use this method if it results in a real benefit for the patient thus completing the entire procedure in one go.