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Lv X, Pu Y, Zhang X, Jiang X, Zhang X, Shi J, Lai H. One-piece versus two-piece zirconia abutment supported single implant crown in the esthetic region: 3-Year results from a split-mouth randomized controlled clinical trial. Clin Oral Implants Res 2023; 34:1330-1341. [PMID: 37655630 DOI: 10.1111/clr.14173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/06/2023] [Accepted: 08/13/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVES To compare the clinical, radiographic, and immunological outcomes between one-piece versus two-piece zirconia abutments supported single implant crowns in the esthetic region. MATERIALS AND METHODS The study followed a split-mouth, double-blind, and randomized controlled clinical design for a duration of 3 years. Twenty-two eligible patients with 44 implants were randomly assigned to two groups: Group 1 (one-piece zirconia abutment with zirconia base, n = 22) and Group 2 (two-piece zirconia abutment with titanium base, n = 22). The primary outcome was the technical complication rate. Additionally, survival rates, cytokines concentrations in peri-implant crevicular fluid (PICF), peri-implant conditions, marginal bone loss, and pink/white esthetics score (PES/WES) were assessed as secondary outcomes. RESULTS Twelve of 22 patients attended the 1-year follow-up (due to the COVID pandemic), and 19 patients attended the 3-year examination. Two abutments in Group 1 were fractured after 10 and 12 months in function. Additionally, one screw loosening occurred in Group 1 at 1-year follow-up. The 3-year technical complication rate was significantly higher in Group 1 than that in Group 2 (15.79% vs. 0%, p < .001). The 3-year implant survival rate was 100% in both groups. The concentration of IFN-γ in PICF was significantly upregulated in Group 2 (p = .018). Furthermore, the IL-6 concentration was positively correlated with BOP% (p = .020). CONCLUSIONS Two-piece zirconia abutments exhibited superior technical performance compared to one-piece designs during a 3-year follow-up in the anterior region. However, further long-term research is necessary to verify the immunological stability of two-piece zirconia abutments.
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Affiliation(s)
- Xiaolei Lv
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yiping Pu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillo-facial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiaomeng Zhang
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xue Jiang
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiao Zhang
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Junyu Shi
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Hongchang Lai
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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He Q, Zhang W, Zhan X, Qin Y, Ye J. Enhanced bioactivity and hydrothermal aging resistance of Y-TZP ceramics for dental implant. J Biomed Mater Res B Appl Biomater 2023; 111:1824-1839. [PMID: 37255008 DOI: 10.1002/jbm.b.35288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 06/01/2023]
Abstract
Although yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) ceramics have been widely used as restorative materials due to their high mechanical strength, unique esthetic effect, and good biocompatibility, their general application to implant materials is still limited by their biological inertness and hydrothermal aging phenomenon. Existing studies have attempted to investigate how to enhance the bioactivity or hydrothermal aging resistance of Y-TZP. Still, more studies need to be done on the modification that combines these two aspects. In this study, Y-TZP was prepared by 77S bioactive glass (BG) sol and akermanite (AKT) sol infiltration and microwave sintering, which provided Y-TZP with high bioactivity while maintaining resistance to hydrothermal aging. Results of phase composition evaluation, microstructural characteristics, and mechanical property tests showed that modified Y-TZP specimens exhibited little or no tetragonal-to-monoclinic (t → m) transformation and maintained relatively high mechanical properties after accelerated hydrothermal aging treatment. The in vitro biological behaviors showed that the introduction of 77S BG and AKT significantly promoted cell adhesion, spreading, viability, and proliferation on the surface of modified Y-TZP ceramics. Therefore, this modification could effectively enhance the bioactivity and hydrothermal aging resistance of Y-TZP ceramics for its application in dental implant materials.
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Affiliation(s)
- Qixuan He
- School of Material Science and Engineering, South China University of Technology, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou, China
| | - Wenmin Zhang
- School of Material Science and Engineering, South China University of Technology, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou, China
| | - Xiaozhen Zhan
- Hospital of Stomatology, the First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yanping Qin
- School of Material Science and Engineering, South China University of Technology, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou, China
| | - Jiandong Ye
- School of Material Science and Engineering, South China University of Technology, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou, China
- Key Laboratory of Biomedical Materials of Ministry of Education, South China University of Technology, Guangzhou, China
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Halim FC, Pesce P, De Angelis N, Benedicenti S, Menini M. Comparison of the Clinical Outcomes of Titanium and Zirconia Implant Abutments: A Systematic Review of Systematic Reviews. J Clin Med 2022; 11:jcm11175052. [PMID: 36078982 PMCID: PMC9456707 DOI: 10.3390/jcm11175052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 01/07/2023] Open
Abstract
Background: Dental implants are widely used and in order to answer to esthetic demands, zirconia has been introduced as an abutment material as an alternative to titanium. Several studies have been published on this topic, but the results have been often inconsistent. The objective of the present study is to systematically analyze the existing literature comparing clinical outcomes of titanium and zirconia implant abutments. The study was designed as a systematic review of systematic reviews. Methods: This systematic review is in accordance with the Transparent Reporting of Systematic Reviews and Meta-analyses. A MEDLINE/PubMed, Cochrane Database of Systematic Reviews and SCOPUS literature search was performed up to and including June 2021. Data were extracted independently by two reviewers and tAMSTAR2 was used to assess the quality of the systematic reviews. Results: The electronic search identified 1146 papers, and 175 duplicates were removed. After manual screening, 954 studies were excluded and the final analysis was conducted on 11 papers. Both mechanical and esthetic outcomes and biological complications were analyzed. Conclusions: It can be concluded that titanium abutments have a better mechanical resistance than zirconia ones. Plaque accumulation is reported to be slightly higher on titanium but without any significant inflammatory process. The esthetic outcomes seem to be more related to the thickness (>3 mm) of the soft tissues than to the abutment material.
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Affiliation(s)
| | - Paolo Pesce
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Nicola De Angelis
- Division of Restorative Dentistry and Endodontics, Department of Surgical Sciences (DISC), University of Genoa, 16126 Genoa, Italy
- Dental Department, University Tunku Abdul Raman, Sungai Buloh 47000, Malaysia
- Dental Department, University Trisakti, Jakarta 11440, Indonesia
- Correspondence:
| | - Stefano Benedicenti
- Division of Restorative Dentistry and Endodontics, Department of Surgical Sciences (DISC), University of Genoa, 16126 Genoa, Italy
| | - Maria Menini
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, 16132 Genoa, Italy
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Clinical and Radiographic Outcomes of Zirconia Dental Implants-A Clinical Case Series Study. MATERIALS 2022; 15:ma15072437. [PMID: 35407772 PMCID: PMC8999721 DOI: 10.3390/ma15072437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this clinical series was to evaluate the clinical and radiographic outcomes of 20 zirconia dental implants, with a minimum follow-up of two years. Patients with at least one zirconia dental implant were included, with a mean follow-up of 34.05 months. The patient complaints such as pain and foreign body sensation, as well as clinical parameters including peri-implant infections with suppuration, implant mobility, gingival index (GI), modified plaque index (mPI), modified sulcus bleeding index (mBI), probing depth (PD) and radiological distance between the implant shoulder to the closest mesial and distal bone-to-implant contact (BIC), were assessed. All zirconia implants were successfully integrated without any pain or foreign body sensation. No mobility was detected in any of the 20 implants. Clinical examination revealed a mean PD of 2.56 mm and a radiological mean distance between the implant shoulder and the initial site of visible bone-to-implant contact (BIC) of 1.44 mm. In addition, GI, mPI and mBI indicated minimal to no inflammation. Results obtained from this series suggest that one-piece zirconia dental implants achieve good clinical and radiographic outcomes over a mean follow-up of 34 months and may be deemed a good option in patients with favorable bone conditions.
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Liu M, Wang Y, Zhang S, Wei Q, Li X. Success Factors of Additive Manufactured Root Analogue Implants. ACS Biomater Sci Eng 2022; 8:360-378. [PMID: 34990114 DOI: 10.1021/acsbiomaterials.1c01079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Dental implantation is an effective method for the treatment of loose teeth, but the threaded dental implants used in the clinic cannot match with the tooth extraction socket. A root analogue implant (RAI) has the congruence shape, which reduces the damage to bone and soft tissue. Additive manufacturing (AM) technologies have the advantages of high precision, flexibility, and easy operation, becoming the main manufacturing method of RAI in basic research. The purpose of this systematic review is to summarize AM technologies used for RAI manufacturing as well as the factors affecting successful implantation. First, it introduces the AM technologies according to different operating principles and summarizes the advantages and disadvantages of each method. Then the influences of materials, structure design, surface characteristics, implant site, and positioning are discussed, providing reference for designers and dentists. Finally, it addresses the gap between basic research and clinical application for additive manufactured RAIs and discusses the current challenges and future research directions for this field.
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Affiliation(s)
- Minyan Liu
- Department of Industry Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Yanen Wang
- Department of Industry Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Shan Zhang
- Department of Industry Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Qinghua Wei
- Department of Industry Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Xinpei Li
- Department of Industry Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
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Qu Y, Liu L. Zirconia Materials for Dental Implants: A Literature Review. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.687983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Titanium is currently the most commonly used material for manufacturing dental implants. However, its potential toxic effects and the gray color have resulted in increasing requests for metal-free treatment options. Zirconia is a type of ceramic materials that has been extensively used in medicine field, such as implant abutments and various joint replacement appliances. Amounts of clinical evaluations have indicated good biocompatibility for zirconia products. Besides, its toothlike color, low affinity for plaque and outstanding mechanical and chemical properties have made it an ideal candidate for dental implants. The aim of this study is to review the laboratory and clinical papers about several kinds of zirconia materials and zirconia surface modification techniques. Although there are plenty of literatures on these topics, most of the researches focused on the mechanical properties of the materials or based on cell and animal experiments. Randomized clinical trials on zirconia materials are still urgently needed to validate their application as dental implants.
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Kim JC, Yeo ISL. Bone Response to Conventional Titanium Implants and New Zirconia Implants Produced by Additive Manufacturing. MATERIALS 2021; 14:ma14164405. [PMID: 34442927 PMCID: PMC8401228 DOI: 10.3390/ma14164405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 12/18/2022]
Abstract
The aim of the present study was to evaluate the in vivo bone response to an additively manufactured zirconia surface compared to osseointegration into titanium (Ti) surfaces. Scanning electron microscopy, confocal laser scanning microscopy, and electron spectroscopy for chemical analysis were performed to assess the surface characteristics of implant specimens. For the in vivo evaluation, eight Ti implants and eight 3D-printed zirconia implants were used. The surface of four Ti implants was sandblasted, large-grit, and acid-etched (Ti-SLA group), while those of the other four Ti implants were left untreated (Ti-turned group). The zirconia implants had no further surface modification. Implants were placed into the tibiae of four rabbits; two received the Ti-SLA and zirconia implants and the other two received Ti-turned and zirconia implants. The experimental animals were sacrificed after four weeks of surgery, and the undecalcified microscopic slides were prepared. The bone–implant interface was analyzed by histomorphometry to evaluate the bone response. The degree of surface roughness showed that Ti-SLA was the highest, followed by zirconia and Ti-turned surfaces. The 3D-printed zirconia surface showed similar bone-to-implant contact to the Ti-turned surface, and Ti-SLA had the most bone-to-implant contact. The additively manufactured zirconia implant surface is biocompatible with respect to osseointegration compared to the commercially pure Ti surface.
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Affiliation(s)
- Jin-Cheol Kim
- Department of Prosthodontics, Seoul National University School of Dentistry, Seoul 03080, Korea;
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-2072-2661; Fax: +82-2-2072-3860
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Vilor-Fernández M, García-De-La-Fuente AM, Marichalar-Mendia X, Estefanía-Fresco R, Aguirre-Zorzano LA. Single tooth restoration in the maxillary esthetic zone using a one-piece ceramic implant with 1 year of follow-up: case series. Int J Implant Dent 2021; 7:26. [PMID: 33821399 PMCID: PMC8021669 DOI: 10.1186/s40729-021-00308-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 02/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background Oral implants have helped clinicians to improve the quality of life for many patients. The material of choice for dental implants currently remains titanium type IV, whose mechanical and biological properties have been proven throughout the history of implantology. Yet, this material is not exempt from complications. For these reasons, ceramic alternatives to titanium have emerged. Thus, the purpose of this study is to evaluate peri-implant hard and soft tissue stability with the use of a one-piece ceramic implant (Straumann® PURE Ceramic Implant) during 1 year of follow-up. Study design One-piece all-ceramic zirconia (ZrO2) implants were placed to replace single missing teeth in the esthetic zone. Six to 8 weeks after the procedure, the definitive prosthesis was fabricated. At the time of prosthesis, placement (T0) photographs and periapical radiographs were taken, and the following clinical parameters were recorded: probing depth (PD), plaque index (PI), bleeding on probing (BOP), suppuration on probing (SOP), distance from gingival margin to incisal edge (GM-IE), and Jemt papilla index (JPI). Follow-up appointments were scheduled at 4 (T4), 8 (T8), and 12 (T12) months, when the same parameters were recorded. In addition, plaque control was reinforced and prophylaxis was carried out. In this last appointment, a final periapical radiograph was taken to assess marginal bone loss. Results A total of 32 zirconia implants were placed in 28 patients (16 women and 12 men, aged between 34 and 67 years). The survival and success rate were 93.75%. The increase in probing depth from baseline to 12 months was 0.78 mm. Assessments of plaque index and bleeding on probing showed a slight increase throughout the study. Conclusions The results obtained with the Straumann® PURE Ceramic implants show them to exhibit very good clinical behavior. The survival rate of the implants of our pilot study was 93.75%. For these reasons, we can say that zirconia implants could be an alternative to titanium implants in the esthetic zone.
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Affiliation(s)
- Miren Vilor-Fernández
- Department of Stomatology II, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940, Leioa, Bizkaia, Spain
| | - Ana-María García-De-La-Fuente
- Department of Stomatology II, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940, Leioa, Bizkaia, Spain.
| | - Xabier Marichalar-Mendia
- Department of Nursing I, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940, Leioa, Bizkaia, Spain
| | - Ruth Estefanía-Fresco
- Department of Stomatology II, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940, Leioa, Bizkaia, Spain
| | - Luis-Antonio Aguirre-Zorzano
- Department of Stomatology II, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940, Leioa, Bizkaia, Spain
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Clinical performance of zirconia implants: A meta-review. J Prosthet Dent 2019; 123:419-426. [PMID: 31451193 DOI: 10.1016/j.prosdent.2019.05.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/17/2019] [Accepted: 05/17/2019] [Indexed: 12/11/2022]
Abstract
STATEMENT OF PROBLEM The clinical effectiveness of zirconia implants as an alternative to titanium implants is still controversial. PURPOSE The purpose of this analysis was to identify and evaluate systematic reviews reporting on the clinical outcomes of zirconia implants for oral rehabilitation. MATERIAL AND METHODS An electronic search was undertaken on MEDLINE, Embase, and the Cochrane Oral Health Reviews databases up to December 24, 2018, without language restriction. Eligible reviews were screened and assessed. The eligibility criteria were systematic reviews or meta-analyses, implant survival rate, implant success, marginal bone loss, peri-implant soft tissue status, and biologic and functional complications of zirconia implants. Two review authors independently evaluated the quality assessment of the secondary studies by applying the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool. RESULTS Nine reviews fulfilled the inclusion criteria and were evaluated. Seven reviews were classified as moderate and 2 as high quality. The overall AMSTAR's quality of these reports was moderate. In the primary studies contained in these reviews, zirconia implant clinical outcomes were found to be similar or inferior to those for titanium implants. The few primary clinical studies contained in these reviews were not homogeneous among each other, presented poor methodology, and only offered promising short-term outcomes due to the lack of long-term follow-ups. CONCLUSIONS Based on this meta-review, in spite of short-term promising results of zirconia implants, evidence with long term is lacking.
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10
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A prospective clinical study to evaluate the performance of zirconium dioxide dental implants in single-tooth edentulous area: 3-year follow-up. BMC Oral Health 2018; 18:181. [PMID: 30382850 PMCID: PMC6211599 DOI: 10.1186/s12903-018-0636-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 10/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Traditionally, dental implants have been made from titanium or titanium alloys. Alternatively, zirconia-based ceramic implants have been developed with similar characteristics of functional strength and osseointegration. Ceramic implants offer advantages in certain settings, e.g. in patients who object to metal dental implants. The aim of this study was to investigate the mid-term (36 months) clinical performance of a ceramic monotype implant in single-tooth edentulous area. METHODS This was a prospective, open-label, single-arm study in patients requiring implant rehabilitation in single-tooth edentulous area. Ceramic implants (PURE Ceramic Implant, Institut Straumann AG, Basel, Switzerland) with a diameter of 4.1 mm were placed following standard procedure and loaded with provisional and final prostheses after 3 and 6 months, respectively. Implant survival rate and implant success rate were evaluated and crestal bone levels were measured by analysing standardized radiographs during implant surgery and at 6, 12, 24 and 36 months. RESULTS Forty-four patients received a study implant, of whom one patient withdrew consent after 3 months. With one implant lost during the first 6 months after surgery, the implant survival rate was 97.7% at 6 months. No further implants were lost over the following 30 months, and 3 patients were lost to follow-up during this time frame. This led to a survival rate of 97.5% at 36 months. Six months after implant surgery 93.0% of the implants were considered "successful", increasing to 97.6% at 12 months and remaining at this level at 24 months (95.1%) and 36 months (97.5%). Bone loss was most pronounced in the first half-year after implant surgery (0.88 ± 0.86 mm). By contrast, between 12 and 36 months the mean bone level remained stable (minimal gain of 0.06 [± 0.60] mm). Hence, the overall bone loss from implant surgery to 36 months was 0.97 (± 0.88) mm. CONCLUSIONS In the follow-up period ceramic implants can achieve favourable clinical outcomes on a par with titanium implants. For instance, these implants can be recommended for patients who object to metal dental implants. However, longer term studies with different edentulous morphology need to confirm the present data. TRIAL REGISTRATION Registered on www.clinicaltrials.gov : NCT02163395 .
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11
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Roehling S, Schlegel KA, Woelfler H, Gahlert M. Performance and outcome of zirconia dental implants in clinical studies: A meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:135-153. [DOI: 10.1111/clr.13352] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/28/2018] [Accepted: 07/04/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Stefan Roehling
- Clinic for Oral and Cranio‐Maxillofacial SurgeryHightech Research CenterUniversity Hospital BaselUniversity of Basel Basel Switzerland
- Clinic for Oral and Cranio‐Maxillofacial SurgeryKantonsspital Aarau Aarau Switzerland
- Unit for Oral & Maxillofacial SurgeryMedical Healthcare Center Lörrach Lörrach Germany
| | - Karl A. Schlegel
- Private Clinic for Oral and Maxillofacial Surgery Prof. Schlegel Munich Germany
- Maxillofacial Surgery DepartmentUniversity Hospital ErlangenUniversity of Erlangen Erlangen Germany
| | | | - Michael Gahlert
- Clinic for Oral and Cranio‐Maxillofacial SurgeryHightech Research CenterUniversity Hospital BaselUniversity of Basel Basel Switzerland
- Private Dental Clinic PD Dr. Gahlert Munich Germany
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12
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Haro Adánez M, Nishihara H, Att W. A systematic review and meta-analysis on the clinical outcome of zirconia implant–restoration complex. J Prosthodont Res 2018; 62:397-406. [DOI: 10.1016/j.jpor.2018.04.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/20/2018] [Accepted: 04/26/2018] [Indexed: 11/26/2022]
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Pessanha-Andrade M, Sordi MB, Henriques B, Silva FS, Teughels W, Souza JCM. Custom-made root-analogue zirconia implants: A scoping review on mechanical and biological benefits. J Biomed Mater Res B Appl Biomater 2018; 106:2888-2900. [PMID: 30070423 DOI: 10.1002/jbm.b.34147] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/18/2018] [Accepted: 04/09/2018] [Indexed: 12/26/2022]
Abstract
The aim of this study was to conduct a literature review on the potential benefits of custom-made root-analogue zirconia implants. A PubMed and ScienceDirect bibliographical search was carried out from 1969 to 2017. The increased interest in zirconia-based dental structures linked to aesthetic and biological outcomes have been reported in literature. Recent technological advances have focused on novel strategies for modification of zirconia-based surfaces to accelerate osseointegration. However, only a few studies revealed mechanical and biological benefits of custom-made root-analogue zirconia implants and therefore further studies should investigate the influence of different design and surface modification on the performance of such implants. Custom-made root-analogue zirconia implants have become a viable alternative to overcome limitations concerning stress distribution, aesthetics, and peri-implantitis induced by biofilms. However, further in vitro and in vivo studies on surface-bone interactions and mechanical behavior of zirconia should be evaluated to reduce clinical issues regarding mechanical failures and late peri-implant bone loss. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2888-2900, 2018.
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Affiliation(s)
- Miguel Pessanha-Andrade
- Division of Oral Implantology, School of Dentistry, Universidade Fernando Pessoa (UFP), Porto, Portugal
| | - Mariane B Sordi
- Post-graduate Program in Dentistry (PPGO), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Bruno Henriques
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, Portugal
| | - Filipe S Silva
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, Portugal
| | - Wim Teughels
- Department of Oral Health Sciences, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Júlio C M Souza
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, Portugal
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Abstract
Systematic reviews of literature over the period between 2008 and 2017 are discussed regarding clinical evidence for the factors affecting survival and failure of dental implants. The factors addressed include publication bias, tooth location, insertion torque, collar design, implant-abutment connection design, implant length, implant width, bone augmentation, platform switching, surface roughness, implant coatings, and the use of ceramic materials in the implant body and abutment.
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Affiliation(s)
- Jason A Griggs
- Biomedical Materials Science, The University of Mississippi Medical Center School of Dentistry, 2500 North State Street, Room D528, Jackson, MS 39216-4505, USA.
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Surgical and Patient Factors Affecting Marginal Bone Levels Around Dental Implants. IMPLANT DENT 2017; 26:303-315. [DOI: 10.1097/id.0000000000000565] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
INTRODUCTION The use of zirconia in medicine and dentistry has rapidly expanded over the past decade, driven by its advantageous physical, biological, esthetic, and corrosion properties. Zirconia orthopedic hip replacements have shown superior wear-resistance over other systems; however, risk of catastrophic fracture remains a concern. In dentistry, zirconia has been widely adopted for endosseous implants, implant abutments, and all-ceramic crowns. Because of an increasing demand for esthetically pleasing dental restorations, zirconia-based ceramic restorations have become one of the dominant restorative choices. Areas covered: This review provides an updated overview of the applications of zirconia in medicine and dentistry with a focus on dental applications. The MEDLINE electronic database (via PubMed) was searched, and relevant original and review articles from 2010 to 2016 were included. Expert commentary: Recent data suggest that zirconia performs favorably in both orthopedic and dental applications, but quality long-term clinical data remain scarce. Concerns about the effects of wear, crystalline degradation, crack propagation, and catastrophic fracture are still debated. The future of zirconia in biomedical applications will depend on the generation of these data to resolve concerns.
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Affiliation(s)
- Yen-Wei Chen
- a Department of Restorative Dentistry , University of Washington School of Dentistry , Seattle , WA , USA
| | - Joelle Moussi
- a Department of Restorative Dentistry , University of Washington School of Dentistry , Seattle , WA , USA
| | - Jeanie L Drury
- a Department of Restorative Dentistry , University of Washington School of Dentistry , Seattle , WA , USA
| | - John C Wataha
- a Department of Restorative Dentistry , University of Washington School of Dentistry , Seattle , WA , USA
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Anssari Moin D, Hassan B, Wismeijer D. A novel approach for custom three-dimensional printing of a zirconia root analogue implant by digital light processing. Clin Oral Implants Res 2016; 28:668-670. [PMID: 27114184 DOI: 10.1111/clr.12859] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to explore the feasibility of fabrication of three-dimensional (3D)-printed zirconia root analogue implant (RAI) through digital light processing (DLP) technology. MATERIAL AND METHODS One partially edentulous mandibular human cadaver was scanned with a cone-beam computed tomography (CBCT) system. The scan volumes and data sets were used to create computer-aided design (CAD) model of the RAI. A high-end DLP 3D printing technology was used to fabricate the RAI from the CAD model. Within this approach, solid 3D objects are built using a DLP projector to translate voxel data so it is reproduced in liquid photopolymer dispersed with a commercial ceramic, thereby light polymerizing the resin to solid. Optical scanning technology was used to measure the tooth and 3D-printed RAI. To validate the accuracy of the printed zirconia RAI, the optical surface model of the original tooth and CAD model were superimposed. RESULTS The differences between the optical scans of the RAI and original tooth are most noticeable towards the apical foramen, showing a disparity for the RAI with a maximum deviation of 0.86 mm. When setting a maximum threshold of 0.5 mm for the 3D-printed RAI surface to be deviating from the original tooth model and CAD model, measurements show 1.55% and 4.86% of the surface areas are exceeding the threshold distance, respectively. CONCLUSION With the use of currently available technology, it is well feasible to 3D print in zirconia a custom RAI.
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Affiliation(s)
- David Anssari Moin
- Department of Oral Health Sciences, Section of Implantology and Prosthetic Dentistry, ACTA (Academic Centre for Dentistry Amsterdam), University of Amsterdam, Amsterdam, The Netherlands
| | - Bassam Hassan
- Department of Oral Health Sciences, Section of Implantology and Prosthetic Dentistry, ACTA (Academic Centre for Dentistry Amsterdam), University of Amsterdam, Amsterdam, The Netherlands
| | - Daniel Wismeijer
- Department of Oral Health Sciences, Section of Implantology and Prosthetic Dentistry, ACTA (Academic Centre for Dentistry Amsterdam), University of Amsterdam, Amsterdam, The Netherlands
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