Dr. Rebekka Hueber on the advantages of ceramic implants, in particular SDS implants
Which aspects convinced the experienced oral surgeon of the SDS system?
Dr. Rebekka Hueber is a specialist in oral surgery and successfully completed the curriculum “biological dentistry and ceramic implants”. She is also head of the dental department at the SWISS BIOHEALTH CLINIC and will in this episode of SDS PODCASTS tells us how she came to ceramic implants and why she uses SDS implants exclusively.
Although Dr. Hueber came to the world of implant dentistry via titanium implants, as a practitioner she sees tremendous benefits from ceramic implants, especially SDS implants.
Dr. Hueber followed the classical path of dentistry and accordingly had to deal with various problems, such as peri-implantitis. Therefore, early in her professional career, she dealt with alternative materials such as ceramics, but had to realize that most implant forms, just like titanium, are still awkward and inconvenient to handle, as well as unsatisfactory in terms of results.
With the SDS ceramic implants she achieved immediate success. The handling, the biological drilling protocol, the easy possibility of immediate implant placement and the extremely good soft tissue behavior convinced her and her patients.
In the third episode, Dr. Rebekka Hueber and Coco Volz talk about the many advantages of ceramics and especially the SDS implants.
Today‘s Guest

Dr. Rebekka Hueber
Oral surgeon and specialist in “biological dentistry and ceramic implants”
Specialist in oral surgery and head of the dental department in the SWISS BIOHEALTH CLINIC, personally trained and educated by Dr. Ulrich Volz. Among other things, she is a member of the SWISS BIOHEALTH ACADEMY, where she is involved in current research with great commitment.

Dr. Rebekka Hueber – Specialist for Oral Surgery in the SWISS BIOHEALTH CLINIC

Dr. Rebekka Hueber – international Speaker
Carolina
Hello and welcome to the third episode of the SDS podcast. Today we will talk to Dr. Rebekka Hueber, who is a specialist in oral surgery as well as the head of the dental department at the SWISS BIOHEALTH CLINIC and who successfully completed the curriculum biological dentistry and ceramic implants. Dr. Hueber followed the classical path of dentistry and accordingly had to deal with various problems such as periimplantitis. Therefore, early in her professional career, she dealt with alternative materials such as ceramics, but had to realize that most implant forms, just like titanium, are still awkward and inconvenient to handle as well as unsatisfactory in terms of results. Dr. Hueber will tell us how she came to ceramic implants and why she uses SDS implants exclusively. Hello, Rebekka.
Carolina
Hi Coco.
Dr. Rebekka Hueber
I’m very glad to have you on our podcast.
Carolina
Yes, and thank you for the invitation.
Dr. Rebekka Hueber
So let’s get right into it. My first question for you is how did you get into ceramics?
Carolina
Well, that’s kind of a little bit of story. I did the classical path. I did my studies in Munich, and in a very early stage I realized that I love doing surgery. So I did the specialization for oral surgery in different dental offices, also in a referral practice where we got a lot of patients referred from other dentists. So I saw a lot and I also got referred many problems, especially also with titanium implants or infected teeth. And I had to deal a lot with periimplantitis. And that was kind of the start where I wondered if titanium implants are really the right therapy or why some patients with some patients it’s no problem and some patients really have problems with it. And afterwards I became the head of the surgical department of a dental clinic in Germany and the patients there were treated in very modern ways. The titanium implants were premium manufacturer. We did everything on the highest level, also the technicians. However, after some years with some patients we started to see the same problems, although everything was done on a very high level. In addition, I also always didn’t like the handling very much of titanium.
Dr. Rebekka Hueber
I thought it was a little bit complicated. It includes many steps. So you have a gingiva former gingiva former you have to do the exposure of the implant after some time impression, you have abutment parts, so there are many steps and until you can place the final crown. So that’s something that also I didn’t really like. And I took a lot of trainings in how to treat periimplantitis. But I also realized that there’s no real solution for this problem. And on congresses you often can also hear from leaders of periodontitis or prosthetic departments that we are facing a tsunami of periimplantitis in the next years due to the corrosion process that is happening in the mouth. And that can cause a loss of bone and infection. And that’s what made me search in the end for an alternative material. And I found ceramics. I tried different manufacturers, but what I didn’t know back then, but what I know now, is that often the shape of ceramic implants is the same like titanium. And that’s still a problem because the handling was complicated. I also had losses and I found the handling of these implants not very satisfactory. I didn’t have that much success in the beginning and also immediate implant placement. What I had started with titanium did not really work with these implants. But yeah, I didn’t want to give up. And the ceramic itself is really an interesting material. So yeah, that’s how I found to it. And then I found the SDS ceramic implants and that changed a lot.
Carolina
But how did you specifically get interested in the SDS ceramic implants?
Dr. Rebekka Hueber
Basically, I learned about SDS through a hint from a colleague. He told me you should go to Switzerland and have an educational course there. So I traveled to the education center and I was hooked right away. So not only by the people I met there, but I could really feel that they had understood how ceramic works and also how you should respect the biology of the bone. And it was very impressive that there was a high practical experience with ceramic implants over 20 years. So I learned that this company had placed ceramic implants over 25,000 ceramic implants in the last 20 years, and that they learned by doing that. That was really interesting. And I was also very enthusiastic about the training I got there because the material was explained in detail. And you get a combination with the SWISS BIOHEALTH CONCEPT where the thing is unique because everything that is explained there also matched my own clinical experience. For example, that different metals in the mouth can trigger symptoms or chronic inflammation, the jawbone even. And even if an inflammation doesn’t hurt, it can affect the immune system via the blood system of the patient and so much more. I learned a lot about medical staff and medical therapies, the physiology of the bone. And these were things I had never learned like this at the university or at my specialization for an oral surgeon. And I also learned how to better prepare my patients for procedures, avoid complications and support them in healing. And that was the first really, education where I understood what is important about ceramics. How can I treat my patients that they don’t have a lot of swelling, that they have a better healing? How can I prepare them for their surgical interventions? And that’s how I got hooked by SDS.
Carolina
You are now head of the dental department of the SWISS BIOHEALTH CLINIC. How did that come about?
Dr. Rebekka Hueber
Yeah, after I did the educational program, which I can really recommend, because you really have to think different when it comes to ceramics. So you get a lot of support and you will have faced a lot less failures once you start. So I started to place ses influence in the clinic where I worked. And the success came quickly. The handling was much easier. I had happy patients because they had less interventions, and the soft tissue results were amazing. So I did not have any infected tissue around the implants. And I also like the drilling, according to bone classes, very much so, yeah. Actually, I started to have fun in my surgical experiences with the SDS implants and in my clinic, unfortunately, the implant system could not be changed easily. They had their own manufacturers they worked with. And I just wanted these successes. I just wanted to see these successes going on and work completely with SDS implants. And that’s why I applied to the clinic. And it was basically it was the best decision of my life. Because here I can specialize in ceramic implants, bone graft in combination with ceramic implants. And I have also improved my surgical skills very fast because I can work with a specially, really highly skilled team that works here. And yeah, that’s unique. And also the combination with the medical department where the patients are really treated after their surgical interventions. They don’t have any swelling, no pain. You know, they’re in good hands. And that makes me feel relaxed about what I do, because we do huge interventions. We do ALL IN ONE treatments here, and that needs a special care afterwards.
Carolina
Yes, for sure. Yeah. So today you place ceramic implants every day, but you came into the world of implant dentistry via titanium. Where do you see the advantages of ceramic implants as a practitioner and in particular of SDS implants?
Dr. Rebekka Hueber
First of all, for me, it’s the biocompatibility, because you don’t have any free electrons on Zirconia implants. You don’t see any allergies in the patients, no periimplantitis. If you see bone resorbing around ceramic implants, there was probably too much pressure on the cervical part during the insertion, but not due to particles of the ceramic or anything. You don’t have any corrosion with them. And second, the amazing soft tissue behavior. Also, from histolocigal pictures, we know that we have an epithelial gingival connection between the zirconia and the gingiva. So the gingiva directly grows and connects on the zirconia and closes the door into our body, into our neurological system. So you could say periodontitis and periimplantitis are comparable with leaky gut. The only difference is that we have a leaky gum. That means toxins from bacteria in our environment can entrance the body through our blood system. But that doesn’t happen with ceramic implants because it directly connects. And if you look at patients after surgery, the patient may have old restorations and then next to it, the ceramic implant. The gingiva looks perfect on the ceramic implant. And sometimes it’s a little bit inflamed on old restorations or metal restorations. So that’s really impressive. And SDS in particular, there are many points. First of all, it’s the intelligent drilling protocol, you only work with zirconia drills, which I could consider very important with other systems. I could just take the old drills, the steel drills. But from studies we know we still have a metal debris when we drill into the bone. And when patients ask for ceramics, they want to have pure ceramics. They don’t want to have a contact of seal or metal with the bone, of course. So it’s very important that you drill or prepare the implant bed with a zirconia drill. And then the drilling protocol, it’s not just divided into diameters. It really respects the bone class. So when you do the drilling, you have to feel the bone and decide. And that’s actually it makes so much more sense because the bone has different layers in the deep and the epical part, you have the spongeous bone that has more blood support, that is a little bit softer. On the upper part, you have cervical bone and cortical bone, that’s really hard bone, and it does not have so much blood support. So you have to treat that part of the bone different than the lower part. You can apply much more pressure on the soft bone than on the upper bone because the blood flow would just decrease if you put too much pressure on it. And so the drilling protocol exactly matches the implants and the bone physiology. The handling is amazing for me. They are really easy to place because they have a macro thread and a cutting thread on the epical part. So even in 1 millimeter bone, you get an absolute primary stability of 35 Newton centimeter and have very high strength values. And the cutting thread allows you to position the implants precisely, maybe even if you have drilled in another direction a lot. But you can still correct the direction with your implant with this macro thread. And I don’t know any similar system with which immediate implant placement is as easy. So therefore the patients also save money and time because they don’t need several surgical interventions. And that’s why I love immediate implant placement. But you really have to have a special implant implant shape. In addition, it’s a tapered implant, which makes absolutely sense when you look at the different layers of the bone, because you need the most stability in the epical part, in the region of the spongeous bone, and absolutely no pressure on the upper part, the cortical bone, because you have less blood vessels there. So it does not make sense to have a cylindrical implant that puts pressure, the same pressure on the cervical and on the apical part. But it’s important that you have a tapered implant with zirconia. And the micro thread also provides hollow spaces on the tip in which the blood clot can form and then transform into lamellar bone “de novo bone” is how we call it, and that’s the high quality bone.
Carolina
Does the shape also reduce the friction? Because I could imagine if it’s like a cylindrical shape.
Dr. Rebekka Hueber
Exactly. Yeah. What you need to know is that when you place zirconia, it’s not a good conductor of heat. So if you have a cylindrical implant, you have a high or when you insert it, there’s high heat on the whole bone. So it’s more important that the implant half falls in and only the last turns. You really get it stable and you apply a little bit of heat. As you say, you have pressure on the whole implant from first drilling in on the whole length of your implant bed and preparation. If you have a cylindrical and not with a tapered, the tapered just applies forces in the apical part. Yeah, that’s absolutely true. And in addition, the implants are available in one piece and two piece, but both are tissue level. That means you never have a gap on the bone. Bone level and ceramic implants, for me, actually doesn’t make any sense. And you have a high or a very high diameter tulip that supports the soft tissue so that it can really grow on the zirconia. And what I also like is that you can prep it like a tooth because it’s pure zirconia. There are no added or there’s nothing added in the material. Also, the surface is not changed. Some ceramic implants have biovirt coating or something like this in order to change the color. But then you cannot prep them because you change as soon as the materials change, you cannot prep it anymore. And it’s really easy to restore with a temporary because you just prep it like a normal tooth with a diamond bur, and then you place a temporary. And what I also like is that the implants are available with different prosthetic platforms. So when you place the implants, you have oval forms, you have balcony forms, you have wider oval shapes so that you can match them with the alveolar ridge or with the width of the alveolar ridge or the alveolas where you extracted the tooth. And that’s unique. I don’t know any systems. And what I love also had to work or what I really don’t miss is to work with removables, with prosthesis or something like that, because patients always had pain with them or pressure somewhere in soft tissue. So you have to correct them so often. So we don’t work with any removables. We just work with fixed prosthetics. On zirconia implants, you don’t have any dentures or anything. And that makes it for the patients much easier to handle their teeth. They are easy to brush and they don’t miss any tasting. Like when you have dentures often, you don’t taste that much. You cannot bite that well, and you don’t have any plaque adhesion on the implants and zirconia crowns. So that’s what I really love about these implants.
Carolina
Do you also see advantages in areas where the bone is already resorbed or patients have large inflammations in the jawbone.
Dr. Rebekka Hueber
Yeah, definitely what I told in the beginning. When it comes to ceramic, you really you can really think different. You can do more than with titanium. Titanium needs at least 1 millimeter of circular bone around. So usually you cut the alveolar ridge when it’s very thin, or you have first to do a bone graft, and then you can place the implant. With ceramics, it’s much easier. Bone augmentation possibilities are higher. We can combine techniques with the implant placement, for example, with a split bone technique where you screw bone shells on the alveolar ridge when you have a horizontal resorbtion. And, yeah, if you miss bone on the back of heart, you can just augment it, bone graft it directly. With the implant, you can do a bone split on the alveolar ridge very easily and still get a high primary stability. And you don’t need to cut down the allveolar ridge if it’s thin, you have to do that with titanium because it has a high elasticity module. That means it moves like the wings of a plane in the bone. It also moves a little bit in itself with every tooth contact. And if you don’t have enough bone around, the bone will absorb and zirconia is completely firm. You could not fly with zirconia wings, so they don’t move. And therefore, you can also have a thin alveolar ridge. You don’t have to worry that much about it. The upper part of the implant has a micro thread, small thread, because we don’t want to apply any forces on the upper bone. And even if the bone is very thin there on the micro thread and you see it a little bit, it’s no problem. You can grind it, and you don’t have any resorption or loss of bone over the time. And when it comes to the SDS system, there are also some additions. So SDS also offers three dimensional techniques for bone augmentation in vertical and horizontal dimensions. For example, the BISS or the Bone Implant Stabilization System. So if you, for example, don’t get the primary stability with an implant right away, you can fix it with that system on the bone. With Cortical screws, you can individualize this. It’s an osteosynthesis plate with a connection to the bone, but also to the implants. You can also use them without the implants and just augment your bone. It’s like the mesh technique, but you don’t close the tissue over it. You just keep it open and work with PRF, the rich fibrin and the blood concentrate and the OPEN HEALING technique of Professor Ghanaati. He’s the inventor of it. And we actually grow tissue and bone underneath. And, yeah, the possibilities are huge. And since I changed to ceramics, I just have a lot more fun during my surgeries and see better results, and I have greater patience and yeah, that’s really an advantage.
Carolina
That was very interesting for me as well. It was a very good learning lesson. And, yes, thank you so much for taking part
Dr. Rebekka Hueber
Thank you, too. It was very nice to be here, and yeah. I hope I could share a little bit my enthusiasm for ceramics.
Carolina
For sure. I definitely felt it, and now I’m enthusiastic as well. I might go back to Uni and study medicine.
Dr. Rebekka Hueber
It’s fun. Yeah. It’s really changed my life a little bit because I was not that with titanium. I just didn’t have that much fun. And when you see how healthy the patients become and how happy they are with the results, and that’s just amazing. And you start to like your profession again.
Carolina
Very nice. Thank you so much for being here, Rebekka, and see you soon.
Dr. Rebekka Hueber
Yeah. Bye. Bye.