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ePaper created 2017-11-09, 09:28:26 | version 1.38.0
| overview How to successfully place ceramic implants Dr Dominik Nischwitz, Germany At present, ceramic implants (Fig. 1) are routinely used by only a few dentists: This is also evident in the small number of scientific studies compared to titanium im- plants. Therefore, the empirical facts resulting from the practical use of ceramic implants are particularly more important at this stage. The benefits of ceramic implants with regard to its biocompatibility, soft tissue reaction and the aesthetic result are now undisputed. Ceramic implants react differently to conventional tita- nium implants. This poses the requirement to learn to “think in ceramic”. In this context, both the nature and bi- ology of the body as well as the basic principles of immu- nology and biochemistry as well as bone and tissue regen- eration are very important. Unlike titanium implants, ceramic implants only heal in absolutely healthy bone. The body recognises them as neutral and osseointegrates them during the bone regeneration phase. By comparison, titanium implants heal by means of inflammatory activa- tion. Local inflammatory mediators remain constantly ac- tive depending on how prone the patient is to inflammation (high/low responder). To successfully insert ceramic im- plants, there are important basic rules to follow. surgical procedures to support the body’s own regenera- tion. At least 14 days prior the planned operation, it is cru- cial that the nutrients are consumed precisely according to this protocol. Poor nutrition with too much sugar, wheat and cow’s milk products as well as a lack of sunlight de- pletes the body of important vitamins and minerals: mainly vitamin D3 (lack of sun), zinc, magnesium and omega-3 fatty acids. This deficiency frequently causes the body to become overwhelmed with healing processes—it is al- most in a state of “hibernation” and is not able to build new tissue as the nutrients to do so are simply not there. Therefore, the patient’s diet, at least at this stage, should be as hypoallergenic and nutritious as possible. Common nu- tritional allergies and all compromising food additives are to be strictly avoided so that the immune system can concen- trate on its most important task of constructing bone- and soft-tissue. A gluten and cow’s milk-free diet is recommended. Alcohol, tobacco and caffeine should be kept to a minimum and sugar, sweeteners, flavor enhancers, trans fats and other compromising food ingredients and additives should be com- pletely avoided. Proteins, healthy fats and vegetables should be consumed. It is also important for the patient to drink plenty of fluids (daily consumption of 2 to 3 litres of still water). Systemic preparation for the operation (obligatory) Bone quality The Bone Healing Protocol (BHP® according to Dr Dominik Nischwitz) has proven effective for the periopera- tive support of bone regeneration and is used ahead of all According to university doctrine, there are four bone density categories that classify the ratio of mineralised bone substance to bone volume. As our experience has Fig. 1 Fig. 2 Fig. 3 Fig. 1: Ceramic implants. Fig. 2: Diseased bone. Fig. 3: Healthy bone. 18 implants 1 2017