Dental implants are artificial tooth roots usually made of ceramic or titanium. They are used to replace one or more missing teeth. Implants are anchored in the jawbone so that dental prostheses can be securely attached to these artificial roots. Therefore, dental implants possess various advantages that clearly set them apart from conventional solutions. With proper and regular care, dental implants can last a lifetime.

Artificial roots can be implanted in both the upper and lower jaw. They can replace individual teeth and entire groups of teeth. In cases of particularly severe tooth loss, dental implants can even be used to replace a complete set of teeth. Typical application areas include:

• Replacement of missing teeth: After the dental implant has been inserted and has fully healed, it is fitted with a crown. The gap between one or more teeth is filled by an artificial tooth.
• Fitting of bridges: Dental implants can be used as bridge abutments on which dental bridges with a maximum of five units can be securely fixed. If there are extensive gaps between the teeth, several bridges can also be fitted in this way.
• Third teeth: Dental implants can also be used to restore a completely edentulous jaw. During this treatment – the pinnacle of modern implantology – the entire jaw is provided with a full jaw implant bridge.
• Fixation of removable dental prostheses: Implants serve as a modern retention system. The “Locator” prosthesis is simply attached to the jaw with a “click.” As a result, the prosthesis sits firmly and securely, even when eating or speaking.

In contrast to conventionally fixed dental bridges, implants are a gentle alternative. They offer a convenient and secure option for firmly attaching dental prostheses. However, dental implants are also more expensive. In the long run, however, they are still worthwhile: they save a great deal in terms of follow-up costs for conventional dental prostheses, significantly reduce the risk of bone loss, require less frequent touch-ups, maintain their aesthetics over a long period of time and, above all, enable stable dental prostheses that fit securely in the jaw.
Another major advantage of implants is that they preserve the natural tooth structure. In contrast to conventional methods, adjacent teeth do not have to be ground down first. The constant pressure that dental implants exert on the jawbone also reduces the risk of bone loss, which would otherwise be greatly increased by the lack of pressure and the resulting regression of the bone. For the anterior region, we usually recommend ceramic implants to our patients: No dark tooth margin is visible with these artificial tooth roots and they thus ensure an aesthetically pleasing tooth appearance.

Other advantages of implants:

• Aesthetics: Visually appealing solutions that provide a radiant smile and are barely distinguishable from natural teeth
• Phonetics: Clear pronunciation through a secure and perfectly fitting grip
• Durability: Dental implants are characterized by a long service life
• Secure grip: Prostheses attached to artificial tooth roots are more secure
• Improved chewing power
• Increase in abutments
• Total prostheses: perfect fixation options for “cover denture prostheses”
• Partial dental prosthesis: a protected oral mucosa thanks to reduced pressure
• Complete bridges: Stable, permanent third teeth in an edentulous lower and/or upper jaw

There are currently two options for the production of dental implants: titanium and all-ceramic implants. Other materials have not yet been able to prove their worth.

Titanium implants

Dental implants made of titanium are the current standard. Unlike in orthopedics, for example, this is pure grade IV titanium. This has a very high level of biocompatibility and is therefore generally well tolerated by the human body. Titanium hypersensitivity occurs in less than 2% of all cases. In this case, the metal does not trigger an allergic reaction, but it can lead to an inflammatory foreign body reaction and thus become an interference field. In extremely rare cases, an antenna effect occurs in electrosensitive patients. Another disadvantage of titanium implants is that dark edges of the implants become visible in the oral cavity during the age-related recession of the gums. Depending on the system used, titanium implants often have to be uncovered after the healing period.

All-ceramic implants

These dental implants have significantly better aesthetic properties and even higher tolerance in comparison. They are made of zirconium dioxide, which is why they have a biocompatibility of almost 100% and no antenna effect can occur. In addition, all-ceramic implants do not have to be uncovered after the healing period.
The disadvantage of all-ceramic implants, however, is that their surface structure is quite smooth, which reduces the hold in the jawbone. Ceramic implants are therefore less stable than titanium implants. Therefore, some dentists refuse to use such implants. In our practices in Kaiserslautern and Landstuhl, however, we offer our patients the solution to this problem: we offer specially manufactured all-ceramic implants with a rough surface.

Most dental implants are rotationally symmetrical, i.e., they are circular when viewed in cross-section. Screw implants are also popular. They are characterized by the fact that the implant cavity – i.e., the cavity into which the implant is to be placed – is prepared using rotary instruments. Therefore, the dental implant can be screwed in and is immediately stable. Therefore, this form is considered to be particularly rapid and with few complications in its healing phase.

For some jaw problems, such as insufficient bone height or advanced jaw degeneration, alternatives are used that vary in implant length and diameter and thus allow a solution for each individual case. If, for example, the bone material in the lower or upper jaw is too narrow or too flat for a regular dental implant made of titanium, forms adapted to the individual case can be used instead.

Almost all adults can use dental implants. Before this, however, an initial examination must first determine whether you also meet the requirements for the use of implants. The following factors are decisive here:

• Previous illnesses: If there are gum and/or bone diseases such as caries or periodontitis, they must first be treated by a dentist.
• Teeth grinding: We recommend that patients who grind their teeth wear a splint that has been specially adapted for this purpose
• Bone stability: In order to guarantee the secure fixation of the dental implant, prior bone augmentation may be necessary.

In principle, the jaw conditions must also be suitable to ensure satisfactory and successful implant placement.

It should be noted that dental implants cannot be used in children and adolescents because their jaws are still growing.

We do not recommend the use of dental implants in the following medical conditions or concomitant circumstances:

• Unrestored dentition
• Certain bone diseases of the jaw, jaw tumors, Paget’s disease, osteoporosis, and any disease for which the patient is taking bisphosphonates
• Severe immune impairments
• Obesity
• Cachexia
• Pre-existing hematologic conditions such as hemophilia, anemia, or thrombocytopenia
• Specific and serious cardiovascular diseases
• Condition after radiotherapy for osteogenesis imperfecta
• Collagen diseases such as Sjögren’s (Sicca) syndrome or scleroderma

In simplified terms, regular all-ceramic or titanium implants are fitted in four steps:

1. Preliminary examination: First of all, both periodontal health and the jawbone must be examined and checked in detail. For these purposes, a panoramic X-ray and, if necessary, a 3D X-ray (DVT) are taken. In extremely rare cases, a computed tomography (CT) scan is consulted. In addition, the occlusion – i.e., the load on the jaw when the teeth are clenched – is checked. Finally, it is considered whether there is already sufficient bone mass in the jaw or whether bone augmentation must be performed in advance.
2. Insertion of the implant: The second step is a surgical procedure that is performed under local anesthesia. Here the implant is placed in the jawbone. The operation is completely painless due to the anesthetic. After the artificial tooth root has been successfully and firmly secured in the jaw, the attending physician places either a protective healing cap over the dental implant or a plastic tooth as a long-term temporary solution. After the treatment, slight pain may be experienced after the anesthesia wears off. However, this can be easily managed with simple painkillers. There may also be slight swelling in the treated area in the first three to five days after the implantation. Bruising, on the other hand, is extremely rare.
3. Healing phase: After three to six months, the new dental implant is fully healed and securely seated in the jawbone.
4. Insertion of the required dental prosthesis: After the healing phase has been successfully completed, the implant may need to be exposed first for further treatment. In addition, the stability of the dental implant is carefully checked. Only when the implant is really secure is the artificial root fitted with the required dental prosthesis – for example, a crown, a bridge or a prosthesis. To guarantee perfectly fitting dental prostheses, either a cast is made in advance or the implant is digitally scanned. A perfectly complementary implant is then selected and individually produced in the dental laboratory. The abutment thus produced is screwed onto the artificial tooth root with extreme care and controlled force, and the dental prostheses is then cemented in place. This completes the treatment. After a few months, however, a check-up should be carried out.

There must be sufficient bone mass in the jaw to allow the new dental implant to integrate in a stable and secure manner. If the available bone supply is too low, even special implants cannot remedy the situation. However, the bone can be built up by means of various procedures. A special form of such bone augmentation is, for example, the sinus lift.

Anyone who wants a long-lasting, healthy dental implant should pay attention to diligent and regular care. In addition to conventional tooth brushing, we recommend using interdental brushes for this purpose. They efficiently remove food residues in the gaps between the teeth. Oral irrigators with a fixed and pulsating jet are also well suited for care. In addition, we advise our patients to have their teeth professionally cleaned every six months and have their dental implants checked by a professional in order to avoid peri-implantitis.

Implant care should never be underestimated. If consistent and thorough oral hygiene is neglected over a longer period of time, there is the possibility of losing the dental implant prematurely.

If the implant has been integrated into the jawbone by an experienced specialist and the implant is then diligently and regularly cared for, then artificial tooth roots can last a lifetime. Studies based on the current state of knowledge show that even after more than five years, the durability rate of implants is over 95%; after ten years, this rate has only dropped to an amazing 90%

In most cases, a dental implant integrates into the jawbone without any problems. However, to guarantee complication-free implantation, the experience and expertise of the treating implantologist are of particular importance. To avoid problems, a dental implant must be correctly implanted. In addition, the healing phase must be taken into account; under no circumstances should the artificial root be subjected to pressure too early. The most common treatment complications are wound inflammation and/or implant integration issues. Smokers and diabetics in particular face an increased risk in this respect. We therefore recommend refraining from smoking for several weeks before the planned treatment and also during the entire healing phase, as well as maintaining very thorough oral hygiene.

To reduce the risk of inflammation, the procedure must of course be performed under absolutely sterile conditions. All surfaces and areas in contact with the instruments as well as the surgical area must be covered with sterile cloths.

The implantation of implants is expensive and complex. Therefore, the treating dentist needs to have extensive specialist knowledge. Only sufficient practice and a wealth of experience can guarantee satisfactory and, above all, consistent quality of treatment. Therefore, the implantologist should be able to provide evidence of several certifications and continuing education explicitly in the field of dental implantology. We also recommend that all patients speak to their dentist directly about their expertise and credentials.

To further increase the success of treatment, there are now also various “multimodal” concepts, which are usually offered in special dental clinics or larger group practices. It is not a single doctor who carries out the complete treatment, but a team of dental specialists who work together to develop an overall concept for the individual patient. Each of these experts undertakes the treatment steps that fall within their expertise and areas of focus: preliminary examination and determination of the occlusion, tooth extraction or implant placement, root canal treatments, placement of the dental prosthesis. Such teamwork has repeatedly proven to be advantageous.

It is essential to pay attention to the occlusion. The teeth of the upper and lower jaw must fit together perfectly so that the teeth and dental prosthesis do not wear out too early and cause subsequent problems. Chronic jaw pain and/or headaches can be one of many possible consequences of a neglected occlusion. Therefore, it is generally advisable to plan and carry out extensive tooth replacement treatments holistically. It is therefore essential that the treating dentist or team is able to take such “gnathological” aspects into account. For this purpose, the jaw must be measured as part of a functional analysis and then the planned dental prosthesis must be manufactured and integrated accordingly.

In principle, the following also applies: Only dental implants from the EU or the US should be used. These countries subject these products and the materials from which they are made to strict quality controls. Other countries, however, such as Thailand or China, do not impose such stringent standards. However, inferior materials can pose significant health risks. This is one of the reasons why the use of branded implants is generally recommended. Even in the EU, some inexpensive “cheap implants” are approved. However, these often betray themselves by the lack of a lifetime product warranty. Also, these dental implants have not yet been adequately tested in long-term studies.

In our practices in Landstuhl and Kaiserslautern, we offer a standard guarantee of 2 years on dental implants. If you wish, the guarantee can be increased to 5 years for an additional charge.

Dental implants are significantly more expensive than other solutions for the existing dental problem. However, the long-term costs must also be considered in this calculation: Well placed and cared for dental implants are usually associated with significantly lower follow-up costs.

In general, the final costs of a dental implant can only be determined after a complete examination. For this purpose, X-rays and models must be evaluated, on the basis of which the correct treatment method is selected.

Those with statutory health insurance must bear the costs of an implant themselves, but they are subsidized by their health insurance. This allowance covers the costs that would also be incurred for conventional treatment, such as the provision of bridges or removable dental prostheses.

Private patients, on the other hand, must check the plan offered by their insurance company. Depending on the contract and insurance, the costs for dental implants could be fully covered. Other private health insurance companies, on the other hand, only cover a certain proportion of the costs incurred or do not contribute at all. Therefore, we generally recommend that you clarify this point with your health insurance company in advance. If there is indeed an insurance gap, this can often be closed with supplementary dental insurance. 

Patients who are members of the US military are reimbursed 50% of the costs incurred under the US TRICARE health insurance plan.

Any costs for temporary treatments are added to the total bill. The situation is similar with more complex treatments that may be necessary: bone augmentation or maxillary sinus floor augmentation, for example. The material used also plays a major role. The blanket assertion that all-ceramic implants are generally more expensive than titanium implants is not true.

Finally, the number of treatment steps must be taken into account when determining the price. The more efficiently the treating implantologist plans, the more cost-effective the treatment itself will be.

The costs of a dental implant are therefore highly individual. We only use high-quality branded implants in our practices. Before the start of treatment, you will always receive a detailed and non-binding cost estimate. You can then submit this treatment and cost plan to your health insurance company to check which costs will be covered.

Our dental practices in Kaiserslautern and Landstuhl have specialized in dental implants for many years. Our unique advantage is a regular, long-lasting supply. We offer you:

• Dental implants from A–Z
• Over 30 years of experience with approx. 1200 implants per year
• High-quality branded implants
• Bone augmentation / sinus lift
• DVT X-ray
• Our own implantologists
• High healing success rate
• If required: good and yet inexpensive dental implants
• Up to 5 years guarantee on request
• Complementary orthodontics in house
• Piezosurgery with ultrasound
• Financing