"Ask the Expert" – “When we place an implant today, we influence the inflammatory burden of the entire organism.”
28.9.2026 · 5 min
Dr. Fabian Schick on osteoimmunology, zirconia implants, and the future of surgical implant dentistry
Von der Mechanik zur Osteoimmunologie
A Statement on Surgical Implant Dentistry
For a long time, implant dentistry rested on two pillars: mechanics and esthetics. Both have reached a high level of development. Osseointegration is now predictable, and esthetic outcomes can be virtually indistinguishable from a natural tooth. Now, a third important pillar is emerging: osteoimmunology.
It does not replace the existing model but expands it. For many years, osseointegration was primarily described as a process. Today, we understand healing as an organized immune response to a foreign body. This transforms what was once largely based on clinical experience into something more controllable: those who keep the tissue immunologically calm work with regeneration rather than against it.
Zirconia implants have become an established and valid treatment option in both national and international guidelines. Clinically, however, there is more to observe: a tissue-friendly surface and peri-implant mucosa that remains stable and healthy even after many years.
At the same time, surgery has taken a leap forward that I consider one of the most significant developments of recent years: asymmetric macrodesigns, whether triangular, oval, or featuring balcony structures. An extraction socket is not round. These designs achieve stability where bone is present while preserving space where soft tissue belongs. For immediate implant placement, this changes everything: the emergence profile is established on the day of extraction. In a metal-free one-piece implant, the structure extends seamlessly from bone to crown, leaving no entry point for bacterial leakage.
The benefit lies in the sum of these advances. An inflammation-free interface is the prerequisite for stable soft tissue conditions. Natural esthetics are no longer painstakingly created afterward but preserved from the very beginning. In addition, patients benefit from fewer surgical interventions, fewer appointments, and shorter treatment times.
As a result, the benchmark itself is changing. Alongside function and esthetics, immunological sustainability is becoming increasingly important. This is precisely where dentistry and medicine begin to converge again, and the body of evidence continues to grow. Alongside artificial intelligence, I believe this is the development that will shape our profession over the next ten years. When we place an implant today, we are not simply replacing a tooth. We are influencing the inflammatory burden of the entire organism.
FAQs – Osteoimmunology in Implant Dentistry
1. What is osteoimmunology?
2. What role does the immune response play in dental implant treatment?
3. Why are zirconia implants often associated with biological implant dentistry?
4. Why is an inflammation-free environment important in implant dentistry?
Note: The information provided is intended for educational purposes only and does not replace clinical judgment. Treatment decisions should be based on individual patient assessment and applicable clinical guidelines.
