Thirty years of gathered knowledge: how Dr Trampuš approaches the most difficult cases

Some dental problems do not fit into a standard appointment. A patient who has lost most of the bone in the upper jaw, someone who has worn an ill-fitting denture for years, a person told elsewhere that nothing more can be done: these are the situations that Dr Zdenko Trampuš has spent three decades learning to solve. Over that time he has trained across Europe and in the United States, from Austria to Los Angeles, and brought those techniques back to Ortoimplant DENTAL SPA in Zagreb.

What follows is less a list of services and more a look at how we think about difficult work: the setting, the surgical philosophy, and the honest limits of what implants can and cannot do.

A calmer setting for an anxious moment

Many people carry a genuine unease into a dental practice. We designed our space with that in mind. Instead of a clinical waiting room, patients arrive at the Zuu Bar, a quieter and warmer environment. As Dr Trampuš puts it: “We keep the patient away from anything that creates negative emotions when visiting a dental office.” The aim is straightforward, not to promise that treatment is effortless, but to lower the tension around it, which often makes the clinical work itself go more smoothly.

Why complex cases became the focus

Dr Trampuš gravitated towards one of the more demanding areas of dentistry: rehabilitating patients who have lost all or most of their teeth, often alongside significant loss of jawbone. “My passion is to implement innovative methods in dental practice,” he says, adding candidly, “I don’t think that makes me a better doctor.” That measured tone matters to us. Advanced technique is a tool for solving a specific problem, not a claim of superiority.

For patients with severe bone loss, the classic answer used to be lengthy bone grafting. Today there are alternatives that can avoid or reduce grafting, including techniques we use for people who have been told they have too little bone for conventional implants:

• All-on-4 and All-on-6 full-arch restorations
• Zygomatic implants, anchored in the cheekbone rather than the resorbed jaw
• Pterygoid, subperiosteal and transnasal implants for selected anatomies
• Guided implantology planned from a CBCT scan

These are not right for everyone, and part of the first consultation is deciding honestly whether they apply to you. Where they do, the published evidence is reassuring. A systematic review of the All-on-4 concept reported an implant survival rate above 99% at more than two years of follow-up.³ For the most atrophic upper jaws, a systematic review of zygomatic implants found cumulative success of roughly 96% beyond five years, which is why the technique has become a recognised option when bone height is severely limited.² Survival is not the same as a guarantee, and individual outcomes depend on health, healing and maintenance, but these figures show why we consider such approaches predictable rather than experimental. You can read more in our overview of All-on-4 and All-on-6 and Zygoma implants for patients without bone.

Fixed teeth in a single day, where it is appropriate

For suitable candidates, we can place implants and fit a fixed temporary bridge within twenty-four hours, so the patient leaves with fixed teeth rather than a gap or a removable plate. Whether immediate loading is advisable depends on bone quality and the stability achieved during surgery, and we say so plainly when it is not. Procedures range from around forty-five minutes to several hours depending on complexity, and can be carried out under analgosedation for patients who prefer it. More detail is available in our guide to fixed teeth in 24 hours.

Recovery supported by the DENTAL SPA

Surgery is only half of the outcome; recovery is the other half. Before an operation we may use lymphatic drainage of about an hour, and afterwards we favour cooling masks over ice, which can otherwise slow lymphatic flow. For patients travelling from further afield, an on-site apartment allows an overnight stay close to the team.

Our DENTAL SPA recovery protocol can include ozone therapy, magnetotherapy, hyperbaric oxygen, IV support and lymphatic drainage. We describe these as comfort and recovery measures that many patients find helpful, not as cures, and we use them selectively rather than routinely. More on this in DENTAL SPA recovery and sedation.

The most common problem is still preventable

For all the attention that complex surgery attracts, Dr Trampuš is quick to point at something simpler. “Periodontitis is still the most common problem among my patients,” he notes. His advice is deliberately unglamorous: “The universal and most important advice is: brush your teeth, and go for regular check-ups.” The wider evidence backs this up. Severe periodontitis was the sixth most prevalent condition worldwide in a global burden analysis, affecting around one in ten adults, and it remains a leading cause of tooth loss.¹ Much of the difficult surgical work we do could have been avoided years earlier with consistent home care and check-ups.

Where dentistry is heading

Dr Trampuš is optimistic but realistic about the field. “I think that over the next twenty to fifty years there will be an increasing need for these skills,” he says, reflecting an ageing population and rising expectations of keeping fixed teeth for life. For us the measure of success is quieter than any slogan: “A new smile is a great mutual satisfaction that brings trust, and even friendship.”

Your first step

The first check-up at Ortoimplant DENTAL SPA is free. It is an unhurried conversation and examination, usually including or leading to a CBCT scan, where we look at your situation and set out the realistic options, including the option of doing less. We are located at Ilica 283 in Zagreb.

Frequently asked questions