Prof. Ewers on Implants: "The Longer, the Better" Has Had Its Days

Ultra-Short Implants

Ultra-short implants have a significantly better durability than expected by experts - with lower costs, treatment times, and complications.

Susanne Amrhein, PRIMO MEDICO


A standard implant has a length between 10 and 15 mm and a diameter of 3.3 - 5 mm. The implant usually has the shape of a screw. Implants up to 8 mm and "ultra-short" implants with a length of less than 6 mm are referred to as "short". Professor Dr Rolf Ewers of the CMF Implant Institute Vienna/Austria considers the fact that these are only used in emergencies with hardly any jawbone left in the jaw to be fundamentally wrong: "I often meet desperate patients who have already undergone many unsuccessful consultations, have lost dental prostheses, have hardly any jawbone left and are also financially limited. Since 2010 I have been using the latest system of ultra-short implants, of which I have already inserted well over 1000 with excellent results. Ultra-short implants do not require complex and unpleasant bone augmentation where bone has to be removed from the hip, for example and implanted into the jaw. This procedure reduces the risk of complications, treatment time, and costs". 


How Do Ultrashort Implants Grip?

Prof. Ewers often treats patients who want a fixed, implant-supported restoration but at the same time suffer from a greatly reduced bone supply. "With 6 to 7 mm bone height, it is impossible to screw in a long implant," explains Prof. Ewers. The bone would break and not endure the strain. "The ultrashort implants I use are not screwed in, but pressed in and they heal according to the "callus principle". This means that lamellar bones with Haver's bone morphology are formed instead of supporting bones, as is the case with screw implants. The ultrashort implants we use are implants with a tapered connection that guarantees bacterial sealing. This prevents peri-implantitis (inflammation of the implant bed) and subsequent bone resorption.  The beveled implant shoulder and plateau design, which contains growth chambers for the formation of new bone, ensure problem-free "ingrowth". When the implants are inserted, blood runs into the cavities of the chambers, which can be seen as small, lateral fins or the cantilevers of a propeller. In three of his own studies, Prof. Ewers has not only found excellent durability with his method - which is by no means inferior to standard implants - but also another astonishing phenomenon: "With standard implants, injuries often lead to the death of bone and tissue or the development of inferior bone material offering little support. The special shape and guided loading of the ultra-short implants forms firm, lamellar bone, which enables the excellent function and durability of the ultra-short implants". According to his experience, ultra-short implants work with single-tooth prostheses and bridges. Whenever possible, Prof. Ewers uses three implants instead of four: "A three-legged chair cannot wobble", explains the MKG physician.


How Long Does the Treatment Take?

After an analysis of the existing bone material and precise implant planning, the implants are first inserted into the jaw. These are then closed with a polyethylene cap and let alone to heal in peace and quiet without stress. "Patients usually do not even need painkillers. The small wound is able to heal without any problems: In the lower jaw this takes about 8 weeks and in the upper jaw about 12 weeks. However, I prefer to wait three to six months. The implant or bridge can then be fully strained immediately after insertion," emphasizes Prof. Ewers. "The durability is equivalent to a standard implant placed after bone augmentation. In lectures I like to show pictures of a patient who has been living with ultra-short implants for 33 years, which work wonderfully and show no loosening.


Are Ultra-Short Implants the Dentures of the Future?

Prof. Ewers already exclusively uses short or ultra-short implants for new restorations. His patients find this less invasive method a great relief. He firmly believes that the development of shorter implants will increasingly become the focus of dentistry. "However, short alone is not enough," warns Prof. Ewers. "It is the conical shape and bacterial density that make the success of ultra-short implants possible. He himself often uses the opportunity to present the successful system of ultra-short implants at congresses and also offers regular training courses for colleagues at home and abroad. He was very pleased with the recommendation of the Federal Association of Dentists Working in Implantology in Europe, BDIZ EDI. A guideline states: "The use of short, angulated or reduced diameter implants with reduced bone availability is a reliable therapy option". However, the prerequisite is that the implanting dentist and the prosthetic dentist have received appropriate training.

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