1. First visit involves a comprehensive consultation including medical history, clinical inspection, x rays, DVD scans and implant simulation. A detailed treatment plan including a breakdown of costs and schedule will be made.

2. At your 2nd visit implant placement and temporary restoration will be done.You will never leave our practice without temporary teeth whilst the implant osseointegrates (fuses to your bone). In a conventional implant procedure a healing abutment (unsubmerged healing) or cover screw (submerged healing, below the gums) is put on the implant. In immediate loaded implants a temporary crown is loaded onto the implant right after the implant placement (see immediate implantation).

3.The osseointegration phase (the healing in phase of your implants) takes around 3 months (complex cases involving bone or soft tissue replacement take longer).
At your 3rd visit we will take impressions which allow our technician to make your final implant supported tooth.

4. At your final visit your implant supported tooth (fixed implant crown) will be integrated (fine tuned) to your bite and mastication.

If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.

Replacing a single tooth with a single implant and a crown

Main benefits

• A fixed, stable & secure solution
• A long-lasting solution, often for life
• Healthy, neighbouring teeth are not part of the reconstruction like in a bridge

Installing a single tooth implant most times falls in the category of simple implant cases.

If you are missing several teeth, implant-supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

Main benefits of implant bridges

• A fixed, stable & secure solution
• A long-lasting solution, often for life
• Healthy, neighbouring teeth are not part of the reconstruction like in a bridge
• Dental implant bridges are the only fixed alternative in situations where no teeth are present in the molar region (free end gap) or where no natural neighbouring teeth are suitable as abutments (anchoring teeth) for a fixed bridge

First visit involves a comprehensive consultation including medical history, clinical inspection, x-rays, DVD scans and implant simulation. A detailed treatment plan including a breakdown of costs and schedule will be made.

Typical free end gap situation

At your 2nd visit implant placement and temporary restoration will be done.You will never leave our practice without temporary teeth whilst the implant osseointegrates (fuses to your bone). Implant bridges are normally done in a conventional implant procedure where a healing abutment (unsubmerged healing) or cover screw (submerged healing, below the gums) is put on the implant. Immediate loaded implant bridges, where a temporary bridge is loaded onto the implant right after the implant placement, can only be done if multiple implants have been placed.

The osseointegration phase (the healing in phase of your implants) takes around 3 months (complex cases involving bone or soft tissue replacement take longer).
At your 3rd visit we will take impressions which allow our technician to make your final implant supported teeth.

At your final visit your implant supported teeth (fixed implant bridge) will be integrated (fine tuned) to your bite and mastication.

Screw retained implant bridge

Cemented implant bridge

If you are missing all of your teeth, an implant-supported full arch bridge or implant retained full denture can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

Before the availability of dental implants - replacing all your teeth - meant removable full dentures. Dental implants are the solution that your next set of teeth are permanently fixed and look and feel like natural teeth. The placement of multiple strategical positioned implants around the jaw form the foundations for a full set of beautiful fixed teeth.

Each case must be carefully planned and considered on an individual basis. The amount and quality of bone must be measured with the help of DVD scans. In case of atrophied jaws (bone loss), the direction of any bone and soft tissue loss must be carefully evaluated. Availability of bone will finally decide the number of implants and implantation techniques, as well as the material and reconstructive kind of your new teeth.

Main types of full arch implant supported teeth replacement:

A) Full arch fixed implant supported bridge
B) Implant retained overdentures
C) All on 4 concept

full arch fixed implant supported bridge

For dental implants with dental bridges - the dental implants act as new tooth roots with a fixed dental bridge over these dental implants. With this dental implant teeth option - it is similar for the patient to having a new set of teeth, only this time on implant posts.

Main benefits of full arch implant bridges

• A fixed, stable & secure solution
• A long lasting solution, often for life
• no more loose dentures, especially in the mandible (lower jaw) – improved quality of life
• Full arch dental implant bridges are the only fixed alternative in situations where no teeth are present for anchoring.
  
  

A full arch fixed implant bridge is the closest to natural teeth and over time will just feel like natural teeth. They will provide you the comfort and natural look like a full set of natural teeth.

Implant retained overdentures

An implant-supported overdenture is a full denture that is supported by a variable number of dental implants.
Especially in lower jaws or highly bone atrophied upper jaws full dentures that only rest on the gums, where no supporting teeth are left, tend to fit less firmly and come loose easily.
Implant supported overdentures are provided with special attachments that retain them on implants providing more stability and therefore a more carefree life with dentures.

Benefits of Implant retained Dentures

• Implant retained overdentures provide you with more stability in comparison to conventional dentures
• allows you to eat nearly all kind of food and avoids uncomfortable situations while speaking
• upper jaw overdentures no longer have to cover the palate of your mouth
• dental implant overdentures are the financially economic alternative in comparison to full fixed bridges

Types of Implant Supported Overdentures

Basically there are two types of implant retained overdentures - dental implants with a bar or ball overdenture. The overdenture is removable and can be cleaned.

Bar-retained: The normally placed implants are connected by a thin metal bar that follows the curve of your jaw. A minimum of two (up to five implants) have to be inserted in your jawbone – the more implants the better the resulting stability of your denture. Various other attachments can be fitted into the bar to heighten denture stability.

Ball-retained: The inserted implants are fitted with ball shaped or similar attachments that fit into the counterpart in the overdenture.

all on 4 concept

The All on 4 dental implant treatment is a revolutionary cost-effective technique that enables us to replace all your teeth with just 4 implants.
It has been developed for patients who lack sufficient bone volume and are not willing to undergo a cost and time consuming bone grafting procedure prior to implant placement.
The All on 4 makes maximum use of your bone in the anterior jaw and by tilting the two posterior implants at a 45° angle an immediate function prosthesis can be provided on the same day – also known as 'teeth in one day'.

Who benefits most from All on 4

• Patients who have loose fitting full or partial dentures, due to severe lack of bone, will get back a quality of life like with a full set of natural teeth - for most patients an overwhelming, positive experience.
• Patients with severe periodontitis affected teeth
• Patients with only a few badly infected/decayed teeth left

What means 'Teeth in a day':

The All on 4 immediate function technique can be done in one day:

• remaining teeth can be extracted before implant placement (all in one surgery)
• fixed (non removable) acrylic provisional denture is provided on the day of the surgery

The all on 4 bridge/denture replaces not only your teeth (like in a fixed implant bridge in patients with an abundant bone situation) but also your missing jaw bone and gums (the pink part of the bridge).

If indicated a guided surgery can be done

The provisonal acrylic bridge of the surgery day should be replaced after a healing in time (osseointegration of your implants) of about 3 - 6 months by a definitve long term all-on-4 bridge solution. The better the material of the reconstructive solution - the better can be created a look and feel like sensation like with natural teeth – starting from a metal reinforced high impact acrylic bridge, to solutions involving titanium and zirconium hybrid bridges.

All on 6 dental implants: the same as all on 4 but with one additonal implant in the pterygoid region of the upper jaw.

After the loss of a tooth or multiple teeth the supporting tissues like bone and gums begin to diminish rapidly. In the first 3 months the biggest soft and hard tissue reorganization takes place – therefore the longer implant placement is postponed the more tissue gets lost. That's why it is normally best to replace teeth that need to be extracted immediately or after 4 to 6 weeks with dental implants when no socket preservation (see bone grafting) is done.
Since the first introduction of implants into dentistry, technology (implant thread design and surface texture) and our understanding behind implant osseointegration has changed dramatically. Given good bone conditions - modern implants, in many cases, can be loaded immediately (to place a crown on the implant) following implant placement.

This means teeth straight away after implant placement or also known as teeth in a day.

In most immediate dental implant cases an immediate tooth replacement by a temporary crown can be achieved.

Of course, careful evaluation of bone quality and quantity must be done in every single case, but immediate placement and restoration with a crown is done nowadays much more often than in the past.

Advantages of immediate replacement:

• realisation of your desire to fill gaps as soon as possible
• usually better gum management around dental implants
• only one surgical appointment
• often a less invasive surgery, which allows for quicker healing

When teeth are lost, the bone and gums around them begin to diminish rapidly. Successful and long lasting implants require sufficient bone and healthy soft tissues/gums at the dental implant placement site. Bone volume can be affected by various factors but especially periodontitis, acute infections and the length of time after the loss of teeth are most critical.

The longer you wait before implant placement the more bone volume shrinks – especially in the aesthetic anterior region the inherent loss of gums can be irreversible.

As the needs of each person are different so each dental case/situation can be different. A critical and careful evaluation of the hard and soft tissues at missing teeth sites is essential for successful implant prosthetics.
Bone and soft tissue grafting techniques basically encourage the growth of bone and soft tissue where they have been lost. Bone grafting provides an optimum foundation for your dental implants and is essential in cases where aesthetics are most important.

REGENERATE WHAT HAS BEEN LOST

There are many grafting methods and materials to achieve a natural and long lasting result.
The idea behind any bone graft or transferred soft tissue graft is that it is eventually replaced by your own tissue to help support the foundations for your new teeth.

Soft tissue grafting is basically practised to optimize your gums around dental implant crowns. We want to see gum tissue (keratinized soft tissue that is naturally found on your palate and around your natural teeth) around your implants. Soft tissue grafts, either free gingival grafts or connective tissue grafts, are harvested from your tuberosity or palate. There are also various materials available that help to regenerate stable perimplant soft tissues.

Dental implant bone grafting is mainly used:

• to create new bone volume in defecient bone sites before or simultaneous with implant placement
• as a socket preservation immediately after extraction in order to prevent further bone loss
• to graft around implants in order to fill gaps or smaller defeciencies

There exist various types of bone grafting materials:

• Autogenous bone: bone harvested from other intraoral areas like the tuberosity, minimally invasive near the implantation site, the chin or in severe cases out of practice from the hip bone
• Xenografts: bone substitute processed from other species (bovine, …) most evidence based and most often used in our practice. For further information see also the most popular brand Bio Oss http://www.geistlich-na.com/en-us/
• Barrier membranes (often xenografts) are used to guide the generation of new bone and allow maturation of new bone by blocking out other faster growing cells from the regeneration site (epithelial and connective tissue cells)
• Alloplastic or synthetic bone graft materials: various materials with different resorbing times are successfully used here – normally some type of calcium phosphate
• Autotooth bone: grafting material processed out of your extracted teeth– very promising but we wait for more long term evidence – soon to come in our practice
• Allografts: bone substitute material processed out of the human species – various types eg demineralized freeze dried bone

Most often used types of bone grafting techniques in our practice:

• GBR (Guided Bone Regeneration) / Barrier Membrane Technique
• (see above: xenograft barrier membranes ), various kinds of membranes exist – most are resorbable like for example collagen membranes like BioOss or have to be removed at a later date
• Block bone grafts: (see also above: autogenous bone) are only done in cases of severe atrophy of the jaw bone – not only bone blocks are transferred here, various mixed techniques exist
• Sinus lift: The most often done bone augmentation in our practice for patients who wish for fixed teeth solutions and have not sufficient natural bone left in the posterior region of the upper jaw. The maxillary sinus (a paranasal sinus) is situated right above your upper molar teeth and if there is not sufficient bone left below the sinus an implantation is not possible without sinus augmentation. There are basically two different approaches (depending on the height of your natural bone left subantral (below) the sinus): the lateral (from the side of the sinus) and the percrestal or internal sinus lift where access is done over the implant site.

For full arch missing teeth, graftless dental implant solutions are available:

• Allon 4 dental implants (see all on 4)
• All on 6 dental implants: the same as all on 4 but with one additonal implant in the pterygoid region of the upper jaw

For dental implants with dental bridges - the dental implants act as new tooth roots with a fixed dental bridge over these dental implants. With this dental implant teeth option - it is similar for the patient to having a new set of teeth, only this time on implant posts.

Main benefits of full arch implant bridges

• A fixed, stable & secure solution
• A long lasting solution, often for life
• no more loose dentures, especially in the mandible (lower jaw) – improved quality of life
• Full arch dental implant bridges are the only fixed alternative in situations where no teeth are present for anchoring.
  
  

A full arch fixed implant bridge is the closest to natural teeth and over time will just feel like natural teeth. They will provide you the comfort and natural look like a full set of natural teeth.

An implant-supported overdenture is a full denture that is supported by a variable number of dental implants.
Especially in lower jaws or highly bone atrophied upper jaws full dentures that only rest on the gums, where no supporting teeth are left, tend to fit less firmly and come loose easily.
Implant supported overdentures are provided with special attachments that retain them on implants providing more stability and therefore a more carefree life with dentures.

Benefits of Implant retained Dentures

• Implant retained overdentures provide you with more stability in comparison to conventional dentures
• allows you to eat nearly all kind of food and avoids uncomfortable situations while speaking
• upper jaw overdentures no longer have to cover the palate of your mouth
• dental implant overdentures are the financially economic alternative in comparison to full fixed bridges

Types of Implant Supported Overdentures

Basically there are two types of implant retained overdentures - dental implants with a bar or ball overdenture. The overdenture is removable and can be cleaned.

Bar-retained: The normally placed implants are connected by a thin metal bar that follows the curve of your jaw. A minimum of two (up to five implants) have to be inserted in your jawbone – the more implants the better the resulting stability of your denture. Various other attachments can be fitted into the bar to heighten denture stability.

Ball-retained: The inserted implants are fitted with ball shaped or similar attachments that fit into the counterpart in the overdenture.

The All on 4 dental implant treatment is a revolutionary cost-effective technique that enables us to replace all your teeth with just 4 implants.
It has been developed for patients who lack sufficient bone volume and are not willing to undergo a cost and time consuming bone grafting procedure prior to implant placement.
The All on 4 makes maximum use of your bone in the anterior jaw and by tilting the two posterior implants at a 45° angle an immediate function prosthesis can be provided on the same day – also known as 'teeth in one day'.

Who benefits most from All on 4

• Patients who have loose fitting full or partial dentures, due to severe lack of bone, will get back a quality of life like with a full set of natural teeth - for most patients an overwhelming, positive experience.
• Patients with severe periodontitis affected teeth
• Patients with only a few badly infected/decayed teeth left

What means 'Teeth in a day':

The All on 4 immediate function technique can be done in one day:

• remaining teeth can be extracted before implant placement (all in one surgery)
• fixed (non removable) acrylic provisional denture is provided on the day of the surgery

The all on 4 bridge/denture replaces not only your teeth (like in a fixed implant bridge in patients with an abundant bone situation) but also your missing jaw bone and gums (the pink part of the bridge).

If indicated a guided surgery can be done

The provisonal acrylic bridge of the surgery day should be replaced after a healing in time (osseointegration of your implants) of about 3 - 6 months by a definitve long term all-on-4 bridge solution. The better the material of the reconstructive solution - the better can be created a look and feel like sensation like with natural teeth – starting from a metal reinforced high impact acrylic bridge, to solutions involving titanium and zirconium hybrid bridges.

All on 6 dental implants: the same as all on 4 but with one additonal implant in the pterygoid region of the upper jaw.

Today missing teeth in the anterior or posterior region of the jaw can be replaced safely and long lasting with implants.

Without dental implants, missing teeth have to be replaced with removable dentures and bridges on neighbouring teeth. But with dental implants healthy neighbouring teeth remain intact.

Do you want only fixed teeth?

Implants are the solution that allow me to provide you with a reliable long-term fixed solution for missing teeth.
With state of the art dental implant procedures it is now often possible to remove a hopeless tooth and insert an implant in just one surgical procedure (see immediate implantation) and replace the missing crown immediately (immediate loading).

Advantages of Dental Implants

• Your healthy, neighbouring teeth do not have to be treated
• Implants or implant crowns and bridges are fixed and do not need to be removed
• Removable dentures are often the cause of embarrassement – not implant retained dentures
• Feel save while speaking and eating – sometimes a real challenge with removable dentures
• The cost of a single implant restoration is comparative to having a 3 unit bridge
• Dental implants are a long term solution – most often a life long solution with the right after care (see implant prophylaxis / professional implant cleaning)
• A predictable restoration technique