Dental Implants: Procedure & Durability 2026 — for patients in Munich

A dental implant is an artificial tooth root that is inserted into the jawbone, where it provides permanent support for a replacement tooth. Unlike a bridge, which uses healthy adjacent teeth as abutments, and a removable denture, which rests on the gums, an implant anatomically and functionally replaces the tooth root.

A complete implant consists of three components:

• Implant body — the actual artificial root, usually made of titanium, less often of zirconia. It is screwed into the jawbone and, over the course of 2 to 6 months, fuses firmly with the bone. This process is called osseointegration and is decisive for long-term stability.
• Abutment — the connecting piece between the implant body and the crown; it is placed on the implant after healing and extends through the gum.
• Suprastructure — the visible restoration: a single crown, an implant-supported bridge, or a fixed denture on several implants.

The decisive biological advantage over a bridge or conventional denture: the implant transmits chewing forces into the jawbone like a natural tooth root, thereby preventing the bone loss that regularly sets in after tooth loss. With a bridge, the two adjacent teeth must also be ground down — with an implant, the surrounding tooth substance remains untouched.

In modern dentistry, given sufficient bone volume and healthy periodontium, the implant is considered the first choice for replacing individual teeth.

An implant is always the dentally highest-quality solution when a natural tooth can no longer be preserved and there are no medical reasons against it. We make this decision based on a clinical examination, a 3D CBCT (DVT) scan to evaluate the available bone, and your overall health.

Typical indications:

• Single-tooth gap in the anterior or posterior region — the implant replaces a single tooth without grinding down adjacent teeth.
• Bounded gap (a gap between two teeth) — an alternative to the bridge, especially when the adjacent teeth are healthy and uncut.
• Free-end situation (missing molars at the end of the jaw) — here, a conventional bridge has no rear abutment, and the implant is the treatment of choice.
• Edentulous jaw — 4 to 6 implants carry a fixed bridge (All-on-4 concept) or a removable but securely anchored denture.

Contraindications to be clarified before implantation:

• Active periodontitis — must be successfully pre-treated; otherwise, inflammatory bone loss (peri-implantitis) threatens the implant too.
• Heavy smoking — significantly increases the healing risk and long-term failure rate.
• Uncontrolled diabetes mellitus — delayed wound healing and increased risk of infection.
• Ongoing bisphosphonate therapy (e.g., for osteoporosis or tumors) — risk of jaw necrosis; coordination with an internist required.
• Patients under 18 years — the jaw is still growing; the implant would remain in place while adjacent teeth continue to shift.

Compared to a bridge, the implant spares the adjacent teeth (a bridge requires grinding down the abutment teeth). Compared to a removable denture, it prevents bone loss and restores more chewing power.

Choosing the right implant depends on the material, the system manufacturer, and the treatment protocol. For the vast majority of patients, titanium in the two-piece standard protocol is the safest and best-documented choice.

Material: titanium or zirconia?

• Titanium, representing over 95 percent of all implants placed worldwide, is the gold standard. Titanium has a unique property: its surface fuses biologically with the bone (osseointegration). There is more than 30 years of scientific documentation with robust long-term data. Allergies to pure titanium are extremely rare.
• Zirconia (ceramic implant) is metal-free, white, and therefore aesthetically advantageous with thin gums in the anterior region. Disadvantages: long-term data do not yet reach as far back as for titanium, and in some systems the prosthetic restoration is less flexible. An option for patients with a metal-free preference or documented titanium intolerance.

System manufacturers. Established manufacturers with a long tradition and a solid research database include Straumann (Switzerland), Nobel Biocare (Sweden/USA), and Camlog (Germany). All three systems offer decades of available spare parts and prosthetic components — an important aspect if a crown needs to be replaced in 15 years.

One-piece or two-piece?

• Two-piece implants (standard): implant body and abutment are separate. The body heals covered under the gum, and the abutment is attached only after healing. Advantage: protected healing, flexible prosthetics.
• One-piece implants: body and abutment are one piece. Used less often, mostly in special situations with limited bone volume.

Immediate implant vs. standard protocol. With an immediate implant, the implant body is placed into the fresh alveolus directly after tooth extraction — possible under ideal conditions (absence of inflammation, stable bone volume). The standard protocol provides 2 to 3 months of healing of the extraction wound before implantation. The choice depends on the specific clinical findings; we decide this together after CBCT evaluation.

From the initial consultation to the final crown, implant treatment typically takes 3 to 9 months. The timeframe depends mainly on whether bone grafting is necessary and in which jaw the implant is placed (the lower jaw heals faster than the upper jaw).

1. Consultation and 3D CBCT (DVT) diagnostics (30 to 45 minutes): Detailed discussion of your situation, clinical examination, cone beam computed tomography (CBCT / DVT) for precise measurement of bone height, bone width, and proximity to anatomical structures (inferior alveolar nerve canal in the lower jaw, maxillary sinus in the upper jaw). Followed by informed consent, material choice, and treatment and cost plan (HKP).
2. Bone grafting if required (optional, 3 to 6 months of waiting): If bone volume is insufficient, augmentation is performed first (sinus lift, bone block, graft material). After augmentation, the bone needs 3 to 6 months to mature into a load-bearing base. Details in the bone-grafting section.
3. Implantation (30 to 60 minutes per implant): Under local anesthesia — on request also with twilight sedation or general anesthesia — the gum is opened, the bone bed is prepared step by step using drills of defined sizes, and the implant body is screwed in. Finally, sutures are placed. The procedure itself is completely pain-free.
4. Healing / osseointegration (3 to 6 months): During this phase, the implant fuses stably with the bone. In the lower jaw, this usually takes 2 to 3 months; in the upper jaw, 3 to 6 months due to the softer bone structure. A temporary restoration protects the gap during this time.
5. Exposure and abutment placement (15 minutes): After successful healing, the gum over the implant is opened and the abutment is screwed on. A minor procedure under local anesthesia. Afterwards, 1 to 2 weeks for gum margin shaping.
6. Impression and crown (2 appointments over 2 to 3 weeks): Digital scan or conventional impression, laboratory fabrication of the crown, try-in, and definitive screwing or cementing. Externally, the implant crown is indistinguishable from a crown on a natural tooth.

Summing up: a simple case without bone grafting takes around 3 to 4 months; a complex case with augmentation, 6 to 9 months. We plan every step transparently and hand you a written schedule after the initial consultation.

Pain during implantation: The procedure itself is performed under local anesthesia and is completely pain-free for the patient. Many patients report afterwards that the implantation was considerably less stressful than a wisdom tooth extraction. On request, we also offer nitrous oxide, twilight sedation (intravenous sedation), or treatment under general anesthesia in cooperation with an anesthesiologist.

After the procedure: For 2 to 5 days, mild swelling and a pressure sensation in the surgical area are to be expected. Usually, ibuprofen 400 mg as per the package insert is sufficient for pain control. Cooling with a cold pack (10 minutes cooling, 10 minutes break) during the first 24 hours significantly reduces swelling. Soft food and avoiding physical exertion, nicotine, and alcohol for 3 to 5 days accelerates healing.

Risks in factual percentages:

• Wound infection: below 5 percent. Usually well managed with hygiene instructions and antibiotics if necessary.
• Nerve injury in the lower jaw (inferior alveolar nerve): below 1 percent when planned with 3D CBCT. The consequence would be a temporary numbness of the lower lip; permanent damage is very rare.
• Maxillary sinus perforation in the upper posterior region: also largely avoidable with CBCT-based planning. Small perforations usually heal without consequences.
• Peri-implantitis (inflammatory bone loss around the implant) — the most important long-term risk: roughly 10 to 20 percent over 10 years, significantly higher in smokers and with inadequate oral hygiene. Usually treatable when detected early.

Success rate. In non-smokers with a healthy periodontium and regular aftercare, the 10-year survival rate exceeds 95 percent. Smoking doubles to triples the risk of loss.

You should come back to see us if, after 5 days, pain increases, fever develops, a purulent taste arises, or the implant feels loose.

An implant needs sufficient bone volume to sit firmly. The minimum requirements are:

• Vertical bone height: more than 6 mm
• Buccolingual bone width (from the cheek to the tongue side): more than 5 mm

If these values fall short, bone grafting (augmentation) is necessary. A typical situation: a tooth was extracted many years ago without the gap being restored — the jawbone has resorbed over time (atrophy after tooth loss).

The main augmentation procedures:

• External sinus lift — in the upper posterior region, when the maxillary sinus extends deep down. The sinus membrane is lifted through a lateral bone access, and the resulting space is filled with bone replacement material.
• Internal sinus lift — minimally invasive through the implant bed, when only small height gains (up to about 3 mm) are needed. Often performed together with the implantation.
• Autologous bone transplantation — harvesting a small bone block from the patient's own jaw (usually retromolar behind the wisdom teeth or from the chin region). Considered the "gold standard" because the material heals in optimally.
• Xenogeneic material such as Bio-Oss — derived from animal bone, biocompatible, serves as a scaffold into which the patient's own bone grows.
• Synthetic bone replacement materials — made of hydroxyapatite or tricalcium phosphate, animal- and human-free.

Healing time: After augmentation, usually 3 to 6 months must pass before the implant can be placed. In some favorable situations (simultaneous augmentation), both can be combined in one session — we decide this based on the CBCT findings.

Risks of bone grafting: perforation of the sinus membrane during a sinus lift (usually without consequences, rarely maxillary sinusitis), delayed healing, rejection of the material (rare). In well-planned procedures, success rates are clearly above 90 percent.

Dental implants are among the most durable restorations in modern dentistry. Scientifically documented survival rates:

• After 10 years: approximately 95 percent
• After 20 years: around 90 percent

These figures apply to non-smokers with a stable periodontium and consistent aftercare. Smoking, untreated periodontitis, and inadequate oral hygiene significantly shorten the lifespan.

Factors for long-term success:

• Oral hygiene — brushing twice a day with a soft brush and fluoride toothpaste. At the implant margin, interdental brushes in the appropriate size are essential. Floss alone is often insufficient at an implant because the shape is different from a natural tooth.
• Semi-annual professional dental cleaning (PZR) — special instruments (plastic or titanium scalers) clean the implant neck without scratching the surface.
• Annual X-ray monitoring of the implant for the early detection of bone loss (peri-implantitis).
• Not smoking — the single factor with the greatest influence on long-term prognosis.
• Stable periodontal situation on adjacent teeth — gum disease also undermines bone around the implant.

Warning signs of incipient peri-implantitis:

• bleeding at the implant margin when brushing or probing,
• gum recession at the implant (exposed implant neck),
• pressure sensation, tension, or mild pain when chewing,
• sensation of loosening — this is already an advanced warning sign that requires an immediate check-up.

Anyone who notices these signs early and presents promptly generally has good chances of preserving the implant through conservative therapy (cleaning, rinsing, if necessary antibiotic therapy, regenerative procedures).