Dental implants
Thanks to our experienced team with Dr Silvio Schütz, specialist dentist for oral surgery with an additional specialisation in dental implants (WBA oral implantology SSO), we have a great deal of routine, additional specialist knowledge and the necessary skills to make the procedure pain-free, efficient and pleasant for you and to enable a high chance of success for an aesthetically and functionally perfect dental prosthesis.
What are implants?
A dental implant is a screw, made of titanium or ceramic, which is surgically inserted into the jawbone and serves as a replacement for the tooth root. A dental prosthesis is then attached to this artificial abutment. With the implant technique
- replace a single tooth,
- fill a tooth gap (two or more teeth),
- supplement a shortened row of teeth,
- a completely edentulous jaw.
The advantage of an implant solution for single tooth replacement is that no healthy neighbouring teeth need to be ground down, which significantly improves the long-term prognosis of these teeth. Implant-supported bridges or dentures generally ensure better chewing function. Patients also feel more confident with them, as such dentures usually feel like their own teeth.
The lifespan of implants does not refer to the durability of the material – which does not wear out – but to the length of time an implant remains in the jawbone. Basically, the durability of an implant depends on the preservation of the jawbone. The most important success factor here is the absence of infection, which is why infection prophylaxis immediately after the surgical procedure and consistent aftercare and oral hygiene play a central role.
Several long-term studies have shown that modern dental implants have a long lifespan when used correctly by the implanting dentist and well cared for by patients: After ten years, the success rate is over 95%. However, the risk of loss can be significantly higher in high-risk patients, such as heavy smokers (≥ 10 cigarettes per day).
How does implant treatment work?
Before the treatment is planned, we will provide you with sufficient information so that you are fully informed and can consent to the treatment. The following aspects are clarified during the consultation:
- Indication for implant therapy, i.e. necessity of the procedure
- Type of procedure and possible risks
- Consequences if not treated
- Prosthetic solutions with implants
- Alternative treatment options
- Approximate duration and costs.
In complex situations, restorations with several gaps or total edentulism, it is important that the entire dentition is included in the planning.
Treatment begins with a careful and thorough assessment of the general and local situation, including the state of health and possible risk factors. We usually take an overview x-ray to clarify the bone availability (volume, bone quality, anatomy) for implants, to rule out pathological conditions and to assess the neighbouring structures. The risk factors must be weighted individually for each patient; depending on the degree of severity, implantation should be avoided.
After a thorough assessment, a personalised treatment plan is drawn up. Different treatment options are often possible, the advantages and disadvantages of which must be discussed.
After tooth loss or tooth extraction, it is possible to wait a varying amount of time before placing an implant.
- Immediate implantation: Immediately after tooth loss. It may only be used if the alveolus (the empty tooth socket) is free of inflammation after the extraction. It can be associated with an increased risk of loss.
- Early implantation: Takes place 4 to 8 weeks after tooth extraction. Healing of the soft tissue is largely complete.
- Implantation 3 to 4 months after extraction: The soft tissue has healed and the bone begins to heal.
- Late implantation: Performed after six months or more in completely healed bone.
What is the procedure for placing an implant?
During the procedure, we open the gums under local anaesthetic and prepare the jawbone, the so-called implant bed, with special drills. After preparing a hole in the bone that is approximately 3 to 6 mm wide and 10 to 15 mm deep, the implant is inserted and the mucous membrane over the implant is sutured back into place (the implant is therefore not visible at first). Depending on the number of implants, the procedure takes between 30 minutes and 2 hours and is usually painless thanks to local anaesthesia.
The discomfort after the operation is usually minor and is alleviated with painkillers. Depending on the surgical method and duration of the operation, the administration of antibiotics may be indicated.
In ideal conditions with plenty of bone volume, an implant can also be inserted without opening the gums, which causes practically no pain or swelling for the patient after the operation. However, these situations are rather rare overall (<10%).
In ideal conditions with plenty of bone volume, an implant can also be inserted without opening the gums, which causes practically no pain or swelling for the patient after the operation. However, these situations are rather rare overall (<10%).
Every surgical procedure harbours a certain risk of complications. The most common complications of implant surgery are
- Haemorrhage
- Swelling and haematoma (bruise)
- Infection
- Temporary sensory disturbance
- Impaired wound healing.
If the implant does not heal and has to be removed, a new implant can be planned after a waiting period of a few weeks to months if the condition of the bone allows this.
Implants can also be used in unfavourable bone and mucous membrane conditions. However, this requires additional surgical procedures – before, during or after the actual implantation – for example to build up the bone or to transplant mucous membrane.
We use the following methods for this:
- Bone augmentation
Small to medium bone deficits are filled with locally harvested bone chips and industrially produced bone replacement materials. - Sinus floor elevation (elevation of the floor of the maxillary sinus)
This method is used when the upper jaw in the posterior region is too low for an implant and this would protrude into the maxillary sinus. The floor of the maxillary sinus is raised and the resulting space is filled with bone and/or replacement material.
After 7 to 10 days, the wound is checked and the sutures removed. We will give you precise instructions on oral hygiene, which you should follow.
During the healing period, the soft tissue heals over or around the implant. The implant screw connects to the bone by growing directly onto the implant surface (osseointegration).
How does the implant treatment work?
Under normal circumstances, the implant makes firm contact with the bone after around 8 to 12 weeks, which is why this period is considered the recommended healing time for implants. During this time, any temporary restoration must not exert any pressure on the implants. A temporary restoration can also be dispensed with in the non-visible area.
In special cases, an immediate prosthetic restoration is possible after implantation: the implant-supported temporary restoration is inserted within 24 hours.
Once the bone has healed, the implant usually has to be exposed by means of a minor procedure. After uncovering the implant, we take an impression (conventional or digital with an intraoral scanner) so that the dental prosthesis can be produced in the dental laboratory. The final prosthesis is usually screwed onto the implant after a healing period of around 8 to 12 weeks.
How long does an implant treatment take from A to Z?
The duration of implant treatment depends on the type and extent of the dental prosthesis and the amount of surgery required. As a rule, 3 to 9 months are expected. If the jawbone has to be built up before the actual implantation or if a mucous membrane transplant is required, the treatment can rarely take longer than a year.
An average treatment schedule without separate bone augmentation can look something like this
- Preliminary examination, discussion, pre-treatment, planning: 1-8 weeks
- Operation, removal of stitches after 7 to 10 days: 1-2 weeks
- Healing time depending on bone quality: 8-12 weeks
- Exposure of the implant entrance after the healing period, impression taking for model fabrication: 2-3 weeks
- Fabrication of the denture: 1-3 weeks
Do you have any further questions? Make an appointment with us in Zurich Wiedikon and we will discuss everything about your implant treatment, individually and competently.
It is very important that each case is assessed correctly, as the spectrum ranges from relatively “simple” implants in the invisible area to complex situations (anterior teeth) or aggravating conditions (e.g. bone defect) as well as complex prosthetic restorations.
It is therefore our aim to advise you carefully and comprehensively, to discuss the advantages and disadvantages in detail, to inform you in detail about the duration and costs of implant treatment and also to present you with alternative treatment options.
You are in good hands with us, because our team with Dr Silvio Schütz, specialist dentist for oral surgery, with an additional specialisation in dental implants (WBA oral implantology SSO), has the necessary skills, experience and comprehensive diagnostic and planning knowledge to be able to carry out implant treatment successfully, with as little pain and complications as possible, even in complex situations.
