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da Silva AMP, Horta Dos Santos FA, Mota RF, Teixeira MKS, Telles DM, Lourenço EJV. Clinical and radiographic outcomes of a two-piece ceramic implant: one year results from a prospective clinical trial. Clin Oral Investig 2024; 28:380. [PMID: 38886209 DOI: 10.1007/s00784-024-05783-3] [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: 12/28/2023] [Accepted: 06/11/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE To describe the clinical and radiographic performance and survival rate of a new two-piece ceramic implant system after at least 12 months of follow-up. MATERIALS AND METHODS Sixty-five implants were placed and followed up for at least 12 months (12.3 ± 1.5), in 50 patients. The implants were installed both in fresh extraction sockets and in healed sites and received provisional restoration when the clinical insertion torque was greater than 35Ncm. The primary results describe the survival rate of these implants. Clinical performance was evaluated through the evaluation of the Pink Esthetic Score (PES) and the degree of satisfaction of the patients. Bone loss was measured through radiographic measurements of the marginal bone loss in the mesial (MBLM) and distal (MBLD) sites. RESULTS The survival rate was 98.5%. The average MBLM was 0.24 mm (± 0.53) and the MBLD was 0.27 mm (± 0.57). A statistical difference was observed only when comparing immediate implants with delayed ones (MBLM - p = 0.046 and MBLD - p = 0.028) and when they received immediate provisionalization or not (MBLM - p = 0.009 and MBLD - p = 0.040). The PES before the intervention (T0) was 13.4 (± 0.8) and the PES at T2 (12-month follow-up) was 12.9 (± 1.5) (p = 1.14). CONCLUSION The new two-piece ceramic implant used in the present study showed predictable and reliable results, similar to those found with titanium implants after one year of follow-up. CLINICAL RELEVANCE These implants can be used as an alternative to titanium implants in terms of the marginal bone loss and the degree of patient satisfaction.
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Affiliation(s)
- Alexandre Marques Paes da Silva
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Boulevard 28 de Setembro 157, 2o Andar, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil
| | | | - Rodrigo Franco Mota
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Boulevard 28 de Setembro 157, 2o Andar, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil
| | - Mayla Kezy Silva Teixeira
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Boulevard 28 de Setembro 157, 2o Andar, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil.
| | - Daniel Moraes Telles
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Boulevard 28 de Setembro 157, 2o Andar, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil
| | - Eduardo José Veras Lourenço
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Boulevard 28 de Setembro 157, 2o Andar, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil
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Gul A, Papia E, Naimi-Akbar A, Ruud A, Vult von Steyern P. Zirconia dental implants; the relationship between design and clinical outcome: A systematic review. J Dent 2024; 143:104903. [PMID: 38437977 DOI: 10.1016/j.jdent.2024.104903] [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: 11/17/2023] [Revised: 02/09/2024] [Accepted: 02/26/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE To evaluate the clinical outcome of different designs of zirconia dental implants. DATA This systematic review adhered to the PRISMA checklist and followed the PICO framework. The protocol is registered in PROSPERO (CRD42022337228). SOURCES The search was conducted in March 2023 through four databases (PubMed, Web of Science, Cochrane Library, and Google Scholar) along with a search of references in the related reviews. Three authors reviewed on title, and abstract level and analysed the risk of bias, and all authors reviewed on a full-text level. STUDY SELECTION Clinical studies excluding case reports for patients treated with different designs of zirconia dental implants were included. From a total of 2728 titles, 71 full-text studies were screened, and 27 studies were included to assess the risk of bias (ROBINS-I tool) and data extraction. After quality assessment, four studies were included, and the remaining 23 excluded studies were narratively described. RESULT The included prospective studies with moderate risk of bias reported success and survival rates of one-piece implants that ranged between 95 and 98.4 % with no difference between different lengths and diameters. The acid-etched roughened surface showed higher clinical outcomes compared to other surface roughness designs. CONCLUSION Promising 5-year clinical outcomes were found for one-piece zirconia implants with no difference between different diameters and lengths. Concerning surface roughness, better outcomes were found when using the acid-etched implant surface. However, due to the limited available studies, further high-quality clinical studies comparing zirconia one-piece and two-piece implants with different diameters, lengths, and surface roughness are needed. CLINICAL SIGNIFICANCE Based on this systematic review, under suitable clinical situations, the one-piece zirconia implants with diameters of 4.0 mm, 4.5 mm, or 5.5 mm and lengths of 8 mm, 10 mm, 12 mm, or 14 mm have similar promising clinical outcomes. Additionally, the acid-etched roughened implant surface may be preferable.
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Affiliation(s)
- Abdulaziz Gul
- Department of Materials Science and Technology, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
| | - Evaggelia Papia
- Department of Materials Science and Technology, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Aron Naimi-Akbar
- Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Oral and Maxillofacial Surgery and Oral Medicine, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Amund Ruud
- Nordic Institute of Dental Materials, NIOM, Oslo, Norway
| | - Per Vult von Steyern
- Department of Materials Science and Technology, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden; Nordic Institute of Dental Materials, NIOM, Oslo, Norway
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Kiechle S, Liebermann A, Mast G, Heitzer M, Möhlhenrich SC, Hölzle F, Kniha H, Kniha K. Evaluation of one-piece zirconia dental implants: An 8-year follow-up study. Clin Oral Investig 2023:10.1007/s00784-023-04935-1. [PMID: 37277537 DOI: 10.1007/s00784-023-04935-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/25/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Long-term studies of modern zirconia implants are still insufficient. This prospective 8-year follow-up study investigated one-piece zirconia implants. MATERIALS AND METHODS Patients who had received a one-piece zirconia dental implant (PURE ceramic implant, Institut Straumann GmbH, Basel, Switzerland) were included in this study. Next to the implant survival and success rates, the radiographic and clinical implant parameters were assessed. RESULTS The overall survival rate of 67 zirconia implants in 39 patients was 100%. The overall success rate was 89.6%. Around the immediate zirconia implants, the success rate was 94.7%, and around the delayed implants, 87.5%. The immediate implants showed a significantly higher bone crest compared to the delayed implants (p = 0.0120). According to the pink esthetic score, the immediate implants revealed more favorable esthetic results compared to the delayed implants after an 8-year follow-up (p = 0.0002). CONCLUSIONS After 8 years, the one-piece zirconia implants presented an 89.6% success rate. Regarding the timing of implantation, in individual cases, immediate implantation can have slight advantages over delayed implantation. CLINICAL RELEVANCE Immediate implants can also be considered for zirconia implants and should not be excluded on principle.
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Affiliation(s)
- Stella Kiechle
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Anja Liebermann
- Department of Prosthetic Dentistry, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 32, 50931, Cologne, Germany
| | - Gerson Mast
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Marius Heitzer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, Germany
| | | | - Frank Hölzle
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, Germany
| | - Heinz Kniha
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
- Private Clinic for Oral Surgery, Dres. Kniha, Rosental 6, Munich, Germany
| | - Kristian Kniha
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, Germany.
- Private Clinic for Oral Surgery, Dres. Kniha, Rosental 6, Munich, Germany.
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Sales PHDH, Barros AWP, Oliveira-Neto OBD, de Lima FJC, Carvalho ADAT, Leão JC. Do zirconia dental implants present better clinical results than titanium dental implants? A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101324. [PMID: 36330865 DOI: 10.1016/j.jormas.2022.10.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The purpose of this systematic review is to determine if the zirconia implants present better clinical results when compared to titanium implants. METHODS Searches were conducted in 5 databases including, until March 2022, by 2 independent reviewers, according to the inclusion and exclusion criteria established in the study and according whit this question: Do zirconia dental implants present better clinical results than titanium dental implants? RESULTS 3235 studies were initially found in the researched databases. 03 randomized clinical trials were included in this systematic review and meta-analysis. A total of 71 patients with 192 implants (87 titanium and 105 zirconia) were evaluated, showing an effectiveness of 87,4% and 78,1% respectively and there was no statistically significant difference in terms of survival rate in the meta-analysis (P = 0.70; I2 = 0%). Still in the meta-analysis, there was no statistically significant difference between titanium and zirconia implants in relation to the pink esthetich score or bleeding on probing, however, a favorable difference was observed for titanium in relation to marginal bone loss (P = 0.001; I2 = 0%). None of the studies evaluated had a low risk of bias. CONCLUSION Oral rehabilitation with zirconia implants showed no advantages over titanium in this systematic review. However, the small number of studies included and the uncertain risk of bias may raise doubts in this interpretation and the results should be analyzed with caution. New studies with greater methodological rigor, follow-up time and number of interventions should be performed in order to safely determine the indication for the use of zirconia implants.
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Affiliation(s)
- Pedro Henrique da Hora Sales
- Post-Graduated Program in Dentistry, Department of Prothesis and Oral and Maxillofacial Surgery, Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego 1235 - Cidade Universitária, Recife, PE 50670-901, Brazil.
| | - Ana Waleska Pessoa Barros
- Post-Graduated Program in Dentistry, Department of Prothesis and Oral and Maxillofacial Surgery, Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego 1235 - Cidade Universitária, Recife, PE 50670-901, Brazil
| | | | | | | | - Jair Carneiro Leão
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
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Rutkowski R, Smeets R, Neuhöffer L, Stolzer C, Strick K, Gosau M, Sehner S, Volz KU, Henningsen A. Success and patient satisfaction of immediately loaded zirconia implants with fixed restorations one year after loading. BMC Oral Health 2022; 22:198. [PMID: 35606734 PMCID: PMC9125844 DOI: 10.1186/s12903-022-02231-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/25/2022] [Indexed: 11/27/2022] Open
Abstract
Background There is limited evidence for the use of zirconium dioxide implants in immediate implant placement as well as for related immediate loading protocols. The aim of this retrospective study was to investigate the survival rate, success and patient satisfaction of immediately placed zirconia implants compared to delayed placed implants. Methods The study included 58 partially edentulous patients who were treated between 2013 and 2015 with immediate and delayed transgingival healing zirconium dioxide implants (SDS, Kreuzlingen/ Switzerland). In addition to survival and success rate, marginal bone loss was assessed using radiographs and soft tissue was evaluated using Pink Esthetic Score. Oral health-related quality of life was investigated prospectively using a modified OHIP questionnaire. Results The cumulative survival rate of all implants included was 92% with 88% classified as full success. No significant difference was found between the bone levels of immediately and delayed placed and immediately and delayed loaded implants. The mean Pink Esthetic Score after final prosthetic rehabilitation was 12.2/14 points indicating excellent esthetic clinical results. Analysis of the OHIP questionnaire showed a mean value of 0.54/100 points reflecting a high patient satisfaction. Conclusions Immediate and delayed placed as well as loaded zirconium dioxide implants showed excellent results regarding implant success and survival in this study. Zirconium dioxide implants may ensure excellent esthetic results and high patient satisfaction. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02231-0.
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Affiliation(s)
- Rico Rutkowski
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.,Division Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Leon Neuhöffer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Carolin Stolzer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Kilian Strick
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Susanne Sehner
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. .,Division Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
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Surface Structure of Zirconia Implants: An Integrative Review Comparing Clinical Results with Preclinical and In Vitro Data. MATERIALS 2022; 15:ma15103664. [PMID: 35629692 PMCID: PMC9143528 DOI: 10.3390/ma15103664] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 01/27/2023]
Abstract
Background: The purpose of this review was to analyze and correlate the findings for zirconia implants in clinical, preclinical and in vitro cell studies in relation to surface structure. Methods: Electronic searches were conducted to identify clinical, preclinical and in vitro cell studies on zirconia implant surfaces. The primary outcomes were mean bone loss (MBL) for clinical studies, bone-to-implant contact (BIC) and removal torque (RT) for preclinical studies and cell spreading, cell proliferation and gene expression for cell studies. The secondary outcomes included comparisons of data found for those surfaces that were investigated in all three study types. Results: From 986 screened titles, 40 studies were included for data extraction. In clinical studies, only micro-structured surfaces were investigated. The lowest MBL was reported for sandblasted and subsequently etched surfaces, followed by a sinter and slurry treatment and sandblasted surfaces. For BIC, no clear preference of one surface structure was observable, while RT was slightly higher for micro-structured than smooth surfaces. All cell studies showed that cell spreading and cytoskeletal formation were enhanced on smooth compared with micro-structured surfaces. Conclusions: No correlation was observed for the effect of surface structure of zirconia implants within the results of clinical, preclinical and in vitro cell studies, underlining the need for standardized procedures for human, animal and in vitro studies.
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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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Borgonovo AE, Ferrario S, Maiorana C, Vavassori V, Censi R, Re D. A Clinical and Radiographic Evaluation of Zirconia Dental Implants: 10-Year Follow-Up. Int J Dent 2021; 2021:7534607. [PMID: 35003263 PMCID: PMC8739170 DOI: 10.1155/2021/7534607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/17/2021] [Indexed: 12/02/2022] Open
Abstract
PURPOSE The aim is to evaluate the survival and success rates, as well as the marginal bone loss (MBL) and periodontal indexes, of zirconia implants with 10-year follow-up. MATERIALS AND METHODS 10 patients were selected and 26 one-piece zirconia implants were used for the rehabilitation of single tooth or partially edentulous ridge. After 10 years, a clinical-radiographic evaluation was performed in order to estimate peri-implant tissue health and marginal bone loss. RESULTS The survival and success rates were 100%. The average marginal bone loss from baseline to 120 months after surgery was 0.92 ± 0.97 mm. CONCLUSION One-piece zirconia dental implants are characterised by high biocompatibility, low plaque adhesion, and absence of microgap that can be related to the clinical success of these implants.
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Affiliation(s)
- Andrea Enrico Borgonovo
- Department of Esthetic Dentistry, Istituto Stomatologico Italiano, University of Milan, Milan, Italy
| | - Susanna Ferrario
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, University of Milan, Via Della Commenda 10, Milan 20122, Italy
| | - Carlo Maiorana
- Head Department of Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Della Commenda 10, Milan 20122, Italy
| | - Virna Vavassori
- Department of Esthetic Dentistry, Istituto Stomatologico Italiano, University of Milan, Milan, Italy
| | - Rachele Censi
- Department of Esthetic Dentistry, Istituto Stomatologico Italiano, University of Milan, Milan, Italy
| | - Dino Re
- Head Department of Esthetic Dentistry, Istituto Stomatologico Italiano, Milan 20122, Italy
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Immediate Restoration of Single-Piece Zirconia Implants: A Prospective Case Series-Long-Term Results after 11 Years of Clinical Function. MATERIALS 2021; 14:ma14226738. [PMID: 34832139 PMCID: PMC8621133 DOI: 10.3390/ma14226738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this prospective case series was to evaluate single-piece zirconia implants restored with lithium disilicate CAD/CAM crowns through a long-term follow-up. METHODS In this trial, 20 one-piece zirconia implants were placed in 20 patients. Implants were restored (i) immediately with lithium disilicate CAD/CAM provisionals, and (ii) permanently four months after surgery. Patients were followed for 11 years. Clinical parameters and radiological measurements of the zirconia implants were assessed. For the statistical analysis, paired t-test was applied. RESULTS Four implants were counted as implant failure due to the loss of implant stability, resulting in a Kaplan-Meier survival rate of 80% up to 11 years. The mean bleeding on probing values were 19.1% (SD ± 13.1) and 18.2% (SD ± 17.6) 96 and 11 years after implant placement, respectively. The plaque index revealed a significant decrease over time (p < 0.001) with a value between 25.9% (SD ± 5.7) and 12.6% (SD ± 10.0) at baseline and 11-years follow-up respectively. The marginal bone level revealed a significant decrease 4, 8, and 11 years after implant insertion (p = 0.001, p = 0.019, and p = 0.027, respectively). CONCLUSIONS Immediately loaded zirconia single-piece implants showed a suitable success rate in clinical and radiographic outcomes.
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Pjetursson BE, Sailer I, Latyshev A, Rabel K, Kohal RJ, Karasan D. A systematic review and meta-analysis evaluating the survival, the failure, and the complication rates of veneered and monolithic all-ceramic implant-supported single crowns. Clin Oral Implants Res 2021; 32 Suppl 21:254-288. [PMID: 34642991 PMCID: PMC9293296 DOI: 10.1111/clr.13863] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 12/28/2022]
Abstract
Objective To assess the survival, failure, and complication rates of veneered and monolithic all‐ceramic implant‐supported single crowns (SCs). Methods Literature search was conducted in Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials until September 2020 for randomized, prospective, and retrospective clinical trials with follow‐up time of at least 1 year, evaluating the outcome of veneered and/or monolithic all‐ceramic SCs supported by titanium dental implants. Survival and complication rates were analyzed using robust Poisson's regression models. Results Forty‐nine RCTs and prospective studies reporting on 57 material cohorts were included. Meta‐analysis of the included studies indicated an estimated 3‐year survival rate of veneered‐reinforced glass‐ceramic implant‐supported SCs of 97.6% (95% CI: 87.0%–99.6%). The estimated 3‐year survival rates were 97.0% (95% CI: 94.0%–98.5%) for monolithic‐reinforced glass‐ceramic implant SCs, 96.9% (95% CI: 93.4%–98.6%) for veneered densely sintered alumina SCs, 96.3% (95% CI: 93.9%–97.7%) for veneered zirconia SCs, 96.1% (95% CI: 93.4%–97.8%) for monolithic zirconia SCs and only 36.3% (95% CI: 0.04%–87.7%) for resin‐matrix‐ceramic (RMC) SCs. With the exception of RMC SCs (p < 0.0001), the differences in survival rates between the materials did not reach statistical significance. Veneered SCs showed significantly (p = 0.017) higher annual ceramic chipping rates (1.65%) compared with monolithic SCs (0.39%). The location of the SCs, anterior vs. posterior, did not influence survival and chipping rates. Conclusions With the exception of RMC SCs, veneered and monolithic implant‐supported ceramic SCs showed favorable short‐term survival and complication rates. Significantly higher rates for ceramic chipping, however, were reported for veneered compared with monolithic ceramic SCs.
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Affiliation(s)
- Bjarni Elvar Pjetursson
- Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland.,Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Andrey Latyshev
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Maxillofacial, Oral and Plastic Surgery, Faculty of Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Kerstin Rabel
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Duygu Karasan
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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Does immediate loading of a single implant in the healed anterior maxillary ridge improve the aesthetic outcome compared to conventional loading? BDJ Open 2021; 7:30. [PMID: 34385413 PMCID: PMC8360987 DOI: 10.1038/s41405-021-00083-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/02/2021] [Accepted: 07/13/2021] [Indexed: 11/19/2022] Open
Abstract
Background Immediate loading is an attractive option for avoiding secondary surgery. However, it is unclear whether it provides a better aesthetic outcome compared to conventional loading with implants placed in healed ridges. Aims To compare the aesthetic outcomes of immediately and conventionally loaded single implants in healed anterior maxillary ridges. Methodology A systematic review using PICO was conducted. EMBASE, MEDLINE and DoSS databases were searched. The Cochrane Risk of Bias tool for Randomised Controlled Trials and the Effective Public Health Practice Project tool for other study designs were used for quality appraisal. A narrative synthesis was undertaken. Results A total of 622 articles were identified. After screening, a total of five papers were included. Results indicated no statistically significant difference in pink or white aesthetic scores between the immediate and conventional loading groups at 1- and 5-year review and the Papilla Index at the 1-year review. Conclusion Within the limitations of this review, immediate loading of single implants provides a comparable aesthetic outcome to conventional loading in healed ridges of the anterior maxillary.
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Comisso I, Arias-Herrera S, Gupta S. Zirconium dioxide implants as an alternative to titanium: A systematic review. J Clin Exp Dent 2021; 13:e511-e519. [PMID: 33981400 PMCID: PMC8106941 DOI: 10.4317/jced.58063] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 12/26/2020] [Indexed: 01/11/2023] Open
Abstract
Background This systematic review evaluates the available scientific literature to demonstrate the aesthetic and clinical benefits and to determine the survival and the success of zirconium dioxide implants concerning titanium implants.
Material and Methods The electronic databases were searched until January 2020. Outcome measures were pink aesthetic score (PAS), white aesthetic score (WAS), bleeding on probing (BOP) and probing depth (PD). The addressed PICO question was: In partially edentulous patients in the upper-anterior sector, do zirconium dioxide implants provide aesthetic benefits over conventional titanium implants?
Results In the 15 articles included after the screening were evaluated respectively, the pink aesthetic score, white aesthetics score, the peri-implant, and crown index, bleeding on probing, plaque index, probing pocket depth, radiographic bone loss, papilla height, and survival and success rate. The results show how the aesthetic and clinical benefits and the survival and success rate of zirconium dioxide implants are, in general, better than titanium implants.
Conclusions Despite the optimal aesthetics, clinical and survival results obtained in the review, more studies are needed to confirm these data. Key words:Ceramic dental implants, zirconia implants, esthetics, zirconium dioxide and zirconia.
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Affiliation(s)
- Ivana Comisso
- Universidad Europea de Valencia. Faculty of Health Sciences. Department of Dentistry
| | - Santiago Arias-Herrera
- Universidad Europea de Valencia. Faculty of Health Sciences. Department of Dentistry.,Clinical and Applied in Implant-Prosthetics (ICAI) Research Group, Universidad Europea de Valencia. Faculty of Health Sciences. Department of Dentistry
| | - Saurabh Gupta
- Zirconia Implant Research Group, Silver Spring, MD, 20910, USA.,Master Dental Science, Universitat Jaume I, Castellón, Spain
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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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15
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Iijima N, Homma S, Nakano R, Hayashi S, Hirano T, Iijima T, Yajima Y. Fatigue properties of hollow zirconia implants. Dent Mater J 2021; 40:885-893. [PMID: 33692224 DOI: 10.4012/dmj.2020-248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The objective of this study was to clarify the fatigue behavior of hollow yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) specimens assuming its use for two-piece implants. The fatigue properties of a solid specimen (which simulated a one-piece implant) and 3 types of hollow specimens (which simulated two-piece implants) were evaluated. Specimens were either solid with a diameter of 4.0 mm (S) or hollow with an inner diameter of 3.0 mm and outer diameters of 4.0 mm (H0.5), 4.5 mm (H0.75), or 5.0 mm (H1.0). For each group, 25 specimens were prepared followed by blast and acid etch treatment. Static fracture and cyclic fatigue tests were conducted by modifying the methods provided in ISO6872. Fracture modes were determined by observing the surfaces under a scanning electron microscope. As a result, the cyclic fatigue load of S and H1.0 were similar, and hollow specimens with outer diameters greater than 0.75 mm displayed the ability to withstand molar occlusal forces.
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Affiliation(s)
- Noriko Iijima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Shinya Homma
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Ryotaro Nakano
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Shota Hayashi
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Tomoki Hirano
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Toshihiko Iijima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Yasutomo Yajima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
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16
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Lorusso F, Noumbissi S, Francesco I, Rapone B, Khater AGA, Scarano A. Scientific Trends in Clinical Research on Zirconia Dental Implants: A Bibliometric Review. MATERIALS 2020; 13:ma13235534. [PMID: 33291827 PMCID: PMC7730252 DOI: 10.3390/ma13235534] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/29/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022]
Abstract
Background: The clinical use of zirconia implants has been shown to increase steadily due to their biological, aesthetic, and physical properties; therefore, this bibliometric study aimed to review the clinical research and co-authors in the field of zirconia dental implant rehabilitation. Methods: We searched Scopus and Web of Science databases using a comprehensive search strategy to 5 October 2020, and independently paired reviewers who screened studies, and collected data with inclusion criteria restricted to clinical research only (either prospective or retrospective). Data on article title, co-authors, number of citations received, journal details, publication year, country and institution involved, funding, study design, marginal bone loss, survival rate, failure, follow-up, and the author’s bibliometric data were collected and evaluated. Results: A total of 29 clinical studies were published between 2008 and 2020 as 41.4% were prospective cohort studies and 48.3% originated from Germany. Most of the included studies had been published in Clinical Oral Implant Research (n = 12), and the most productive institution was the Medical Center of University of Freiburg. The author with the largest number of clinical studies on zirconia implants was Kohal R.J. (n = 10), followed by Spies B.C. (n = 8). Conclusions: This study revealed that zirconia implants have been more prominent in the last ten years, which is a valuable option for oral rehabilitation with marginal bone loss and survival rate comparable to titanium dental implants.
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Affiliation(s)
- Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy; (F.L.); (S.N.)
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20910, USA
| | - Sammy Noumbissi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy; (F.L.); (S.N.)
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20910, USA
| | - Inchingolo Francesco
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Biagio Rapone
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Ahmad G. A. Khater
- Faculty of Oral and Dental Medicine, Ahram Canadian University, 6th of October City, 8655 Giza, Egypt;
| | - Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy; (F.L.); (S.N.)
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20910, USA
- Correspondence: ; Tel.: +39-0871-355-4084; Fax: +39-0871-355-4099
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17
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Suksod N, Kunavisarut C, Kitisubkanchana J. Accuracy of computer-guided implantation in the placement of one-piece ceramic dental implants in the anterior region: A prospective clinical study. PLoS One 2020; 15:e0237229. [PMID: 32925962 PMCID: PMC7489525 DOI: 10.1371/journal.pone.0237229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/21/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose Placement of one-piece ceramic dental implants requires precision, which can be enhanced by using a computer-guided system. This prospective clinical study examines the accuracy of partially guided implantation in the placement of one-piece ceramic implants in the anterior region. Materials and methods One-piece ceramic dental implants were placed in 20 patients who were missing a central or lateral incisor. Partially guided dental implant placements were performed in all cases. The deviations in the implant positions were analyzed by superimposing post-operative cone beam computed tomography images over pre-operative treatment planning images. The results were reported as deviations (mean ± standard deviation) for three aspects (3D offset, mesio-distal, labio-lingual, and apico-coronal) and in three dimensions (the angle, coronal, and apical parts). Results Implants were successfully placed in 20 patients. The mean angular deviation was 4.23±1.84°, whereas the mean coronal 3D offset was 0.98±0.48 mm, and the mean apical 3D offset was 1.57±0.46 mm. Conclusions A prospective clinical study involving 20 patients was conducted to measure the accuracy of computer-guided implantation of one-piece ceramic dental implants. Accuracy was determined by comparing the planned implant position to the actual position. Greater accuracy can be expected at the coronal part than at the apical part. The coronal 3D offset was found to be the most accurate.
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Affiliation(s)
| | - Chatchai Kunavisarut
- Faculty of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
- * E-mail:
| | - Jira Kitisubkanchana
- Osaka University Graduate School of Dentistry, Osaka, Japan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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18
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Joos M, Sailer I, Filippi A, Mukaddam K, Rosentritt M, Kühl S. Stability of screw-retention in two-piece zirconia implants: An in vitro study. Clin Oral Implants Res 2020; 31:607-614. [PMID: 32181927 DOI: 10.1111/clr.13597] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/05/2020] [Accepted: 03/12/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare the stability of a screw-retained connection in a novel two-piece zirconia implant to a conventional titanium-based connection in an in vitro chewing simulation including artificial ageing. MATERIAL AND METHODS Incisor (I) and molar (M) shaped monolithic zirconia crowns were screw-retained on either two-piece zirconia (test) or two-piece titanium (control) implants resulting in 4 groups of 8 samples (titanium implants with incisor-shaped crowns (T-I), titanium implants with molar-shaped crowns (T-M), zirconia implants with incisor-shaped crowns (Z-I) and zirconia implants with molar-shaped crowns (Z-M). These were subjected to artificial ageing by thermal cycling (TC: 2 × 3000 × 5°C/55°C cycles of 2 min) and mechanical loading (ML: 1.2 × 106 cycles of 50 N, f = 1 Hz). Surviving samples additionally underwent a fracture force test. Kaplan-Meier plots were drawn, and two-way ANOVA was calculated taking anatomical localisation and material variables as factors. RESULTS The mean corresponding survival times were lower for T-M (0.86 × 106 ± 0.31 × 106 cycles) and Z-I (0.84 × 106 ± 0.21 × 106 cycles) compared to T-I (1.14 × 106 ± 0.10 × 106 cycles) and Z-M (1.20 × 106 ± 0.10 × 106 cycles). In one-way ANOVAs for survival time dependent on either location or material, no statistically significant differences could be found (location: p = .31; material: p = .62) in one-way ANOVAs. The interaction of location and material showed significant differences (F = 21.3, p < .001). CONCLUSION The connection of the tested screw-retained zirconia crowns in two-piece zirconia implants is comparable to standard titanium implants in the specific in vitro testing.
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Affiliation(s)
- Marc Joos
- Department of Oral Surgery, University Center for Dental Medicine Basel (UZB), Basel, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Occlusion, University of Geneva, Geneva, Switzerland
| | - Andreas Filippi
- Department of Oral Surgery, University Center for Dental Medicine Basel (UZB), Basel, Switzerland
| | - Khaled Mukaddam
- Department of Oral Surgery, University Center for Dental Medicine Basel (UZB), Basel, Switzerland
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, University Medical Center Regensburg, Regensburg, Germany
| | - Sebastian Kühl
- Department of Oral Surgery, University Center for Dental Medicine Basel (UZB), Basel, Switzerland
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19
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Koller M, Steyer E, Theisen K, Stagnell S, Jakse N, Payer M. Two-piece zirconia versus titanium implants after 80 months: Clinical outcomes from a prospective randomized pilot trial. Clin Oral Implants Res 2020; 31:388-396. [PMID: 31944420 DOI: 10.1111/clr.13576] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To prospectively evaluate, as part of an ongoing randomized pilot trial, the clinical outcomes of two-piece zirconia implants in comparison with titanium implants 80 months after delivery of all-ceramic (lithium disilicate) single-tooth restorations. MATERIAL AND METHODS The original sample included 31 (16 zirconia and 15 titanium) implants in 22 healthy patients. In addition to evaluating implant survival and success, a number of clinical or radiographic parameters were statistically analyzed: plaque index (PI), bleeding on probing (BOP), pink esthetic score (PES), and marginal bone loss (MBL). Both implant groups were compared using a Mann-Whitney U test. RESULTS Three implants (2 zirconia and 1 titanium) had been lost, so that 28 implants (14 zirconia and 14 titanium) in 21 patients could be evaluated after a mean of 80.9 (SD: 5.5) months. All surviving implants had remained stable, in the absence of any fixture or abutment fractures and without any chipping, fracture, or debonding of crowns. The zirconia implants were associated with PI values of 11.07% (SD: 8.11) and the titanium implants with 15.20% (SD: 15.58), the respective figures for the other parameters being 16.43% (SD: 6.16) or 12.60% (SD: 7.66) for BOP; 11.11 (SD: 1.27) or 11.56 (SD: 1.01) for PES; and 1.38 mm (SD: 0.81) or 1.17 mm (SD: 0.73) for MBL. CONCLUSIONS No significant differences were found between the clinical outcomes of two-piece zirconia and titanium implants based on the aforementioned parameters after 80 months of clinical service. Our results should be interpreted with the limited sample size in mind.
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Affiliation(s)
- Martin Koller
- Division of Preventive and Operative Dentistry, Endodontics, Periodontology, Prosthodontics, Restorative Dentistry and Implantology, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
| | - Elisabeth Steyer
- Division of Preventive and Operative Dentistry, Endodontics, Periodontology, Prosthodontics, Restorative Dentistry and Implantology, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
| | - Kerstin Theisen
- Division of Preventive and Operative Dentistry, Endodontics, Periodontology, Prosthodontics, Restorative Dentistry and Implantology, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
| | - Sami Stagnell
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
| | - Norbert Jakse
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
| | - Michael Payer
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
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Jung S, Park C, Yang HS, Lim HP, Yun KD, Ying Z, Park SW. Comparison of different impression techniques for edentulous jaws using three-dimensional analysis. J Adv Prosthodont 2019; 11:179-186. [PMID: 31297177 PMCID: PMC6609757 DOI: 10.4047/jap.2019.11.3.179] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/19/2019] [Accepted: 04/09/2019] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The purpose of this study was to compare two novel impression methods and a conventional impression method for edentulous jaws using 3-dimensional (3D) analysis software. MATERIALS AND METHODS Five edentulous patients (four men and one woman; mean age: 62.7 years) were included. Three impression techniques were used: conventional impression method (CI; control), simple modified closed-mouth impression method with a novel tray (SI), and digital impression method using an intraoral scanner (DI). Subsequently, a gypsum model was made, scanned, and superimposed using 3D analysis software. Mean area displacement was measured using CI method to evaluate differences in the impression surfaces as compared to those values obtained using SI and DI methods. The values were confirmed at two to five areas to determine the differences. CI and SI were compared at all areas, while CI and DI were compared at the supporting areas. Kruskal-Wallis test was performed for all data. Statistical significance was considered at P value <.05. RESULTS In the comparison of the CI and SI methods, the greatest difference was observed in the mandibular vestibule without statistical significance (P>.05); the difference was < 0.14 mm in the maxilla. The difference in the edentulous supporting areas between the CI and DI methods was not significant (P>.05). CONCLUSION The CI, SI, and DI methods were effective in making impressions of the supporting areas in edentulous patients. The SI method showed clinically applicability.
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Affiliation(s)
- Sua Jung
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Chan Park
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Hong-So Yang
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Hyun-Pil Lim
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Kwi-Dug Yun
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Zhai Ying
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Sang-Won Park
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
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Oishi M, Tsutsumi Y, Chen P, Nakaishi M, Ashida M, Doi H, Hanawa T. Surface characterization of commercially available yttria-stabilized tetragonal zirconia polycrystalline in water and Hanks' solution using X-ray photoelectron spectroscopy. Dent Mater J 2019; 38:496-504. [PMID: 31068553 DOI: 10.4012/dmj.2018-299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To elucidate the mechanism of adhesion of soft and hard tissues to yttria-stabilized tetragonal zirconia polycrystalline (Y-TZP), Y-TZP and titanium disks were immersed in ultrapure water and in Hanks' solution, and the changes in the surface compositions and chemical states were characterized using X-ray photoelectron spectroscopy. After immersion in ultrapure water for 60 days, the concentration of hydroxyl groups on the Y-TZP surface increased. In addition, only phosphate ions were incorporated into the surface during immersion in Hanks' solution, while other ions did not react. On the other hand, the surface of Ti was also hydrated in ultrapure water; however, calcium phosphate formed on it during immersion in Hanks' solution. Therefore, the reactivity of Y-TZP with electrolytes was lower than that of Ti. We conclude that the formation of the phosphate on the Y-TZP surface in physiological conditions possibly enhances the adhesion of soft and hard tissues to Y-TZP.
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Affiliation(s)
- Makoto Oishi
- Graduate School of Medical and Dental Science, Tokyo Medical and Dental University
| | - Yusuke Tsutsumi
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University
| | - Peng Chen
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University
| | - Michiko Nakaishi
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University
| | - Maki Ashida
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University
| | - Hisashi Doi
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University
| | - Takao Hanawa
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University
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Rabel K, Spies BC, Pieralli S, Vach K, Kohal RJ. The clinical performance of all-ceramic implant-supported single crowns: A systematic review and meta-analysis. Clin Oral Implants Res 2019; 29 Suppl 18:196-223. [PMID: 30306684 DOI: 10.1111/clr.13337] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This review aimed at evaluating the survival and technical complication rates of all-ceramic implant-supported single crowns (SC). MATERIAL AND METHODS Three electronic databases were searched for clinical studies conducted at ≥ 15 patients examining implant-supported all-ceramic SCs over ≥ 12 months. Survival rates of implants and restorations plus technical complication rates of SCs were calculated and tested for statistical correlation with confounding variables. Statistical analysis was performed using a negative binomial distribution model to calculate 5- and 10-year survival and complication estimates. RESULTS Forty-one included studies reported on implant-supported SCs made of veneered and monolithic high-strength oxide ceramics, monolithic, and veneered glass-based ceramics and of a monolithic resin-nano-ceramic (RNC). Survival estimates for SCs of 93% (95% CI: 86.6%-96.4%) after 5 years and 94.4% (95% CI: 91.1%-96.5%) after 10 years were calculated, corresponding values for implant survival were 95.3% (95% CI: 90.6%-97.7%) and 96.2% (95% CI: 95.1%-97.1%). Technical complication rates after 5/10 years were as follows: chipping 9.0% (95% CI: 5.4%-14.8%)/2.7% (95% CI: 2.1%-3.5%), framework fractures 1.9% (95% CI: 0.7%-4.9%)/1.2% (95% CI: 1%-1.5%), screw loosening 3.6% (95% CI: 1.6%-8.4%)/5.2% (95% CI: 3.6%-7.5%), and decementations with 1.1% (95% CI: 0.4%-2.8%) after 5 years. Some confounding variables influenced the above-mentioned estimates significantly. CONCLUSIONS All-ceramic implant-supported SCs showed-with the exception of a RNC material-high survival rates. However, failures and technical complications occurred which have to be considered when informing patients on the treatment with implant-supported all-ceramic SCs.
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Affiliation(s)
- Kerstin Rabel
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Benedikt Christopher Spies
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefano Pieralli
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
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Lopez CAV, Vasco MAA, Ruales E, Bedoya KA, Benfatti CM, Bezzon OL, Deliberador TM. Three-Dimensional Finite Element Analysis of Stress Distribution in Zirconia and Titanium Dental Implants. J ORAL IMPLANTOL 2018; 44:409-415. [DOI: 10.1563/aaid-joi-d-16-00109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Zirconia has been presented as an alternative biomaterial to titanium, commercially presented as a single-body implant and/or as an abutment, demonstrating clinically biocompatible favorable results in white and rose esthetics. However, the number of long-term in vivo studies and mechanical tests evaluating the response of stress distribution compared with titanium implants is still limited. The aim of the study was to compare the principal peak stresses in the peri-implant bone around titanium and zirconia implants using the finite element method. Four groups of 3-dimensional models were constructed for the tests: G1, external hexagon titanium implant with a zirconia abutment; G2, zirconia implant with a zirconia abutment; G3, single-body titanium implant; and G4, single-body zirconia implant. Axial and oblique loads of 100 N at 45° were simulated in the prosthetic crown. The bone results showed that the peak stresses decreased by 12% in zirconia implants with 2 parts for axial load and 30% for the oblique load. In single-body implants, the peak stresses decreased 12% in the axial load and 34% in the oblique load when a zirconia implant was used compared with a titanium implant. Although the stress values in megapascals are similar, it can be concluded that the zirconia implants decrease the stress peaks at the peri-implant bone area around the implant platform when compared with titanium implants.
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Affiliation(s)
- Camilo Andres Villabona Lopez
- Department of Dentistry, Santo Tomás University, Bucaramanga, Santander, Colombia
- Faculty of Dentistry, SLMANDIC, Curitiba, PR, Brazil
| | - Marco Antônio Amorin Vasco
- Department of Oral Rehabilitation, University of São Paulo, Ribeirao Preto, Sao Paulo, Brazil
- Department of Bioengineering, University of Zaragoza, Zaragoza, Spain
| | - Edwin Ruales
- Center for Education and Research on Dental Implants (CEPID), Department of Implantology, Federal University of Santa Cataria, Florianópolis, Brazil
| | - Karin Apaza Bedoya
- Center for Education and Research on Dental Implants (CEPID), Department of Implantology, Federal University of Santa Cataria, Florianópolis, Brazil
| | - Cesar Magalhaes Benfatti
- Center for Education and Research on Dental Implants (CEPID), Department of Implantology, Federal University of Santa Cataria, Florianópolis, Brazil
| | - Osvaldo Luis Bezzon
- Department of Oral Rehabilitation, University of São Paulo, Ribeirao Preto, Sao Paulo, Brazil
- Department of Bioengineering, University of Zaragoza, Zaragoza, Spain
| | - Tatiana Miranda Deliberador
- Faculty of Dentistry, SLMANDIC, Curitiba, PR, Brazil
- Department of Dentistry, Positivo University, Curitiba, Paraná, Brazil
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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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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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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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Current status of zirconia implants in dentistry: preclinical tests. J Prosthodont Res 2018; 63:1-14. [PMID: 30205949 DOI: 10.1016/j.jpor.2018.07.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 07/18/2018] [Accepted: 07/26/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE This systematic review aimed to provide an overview of zirconia implants as well as regarding the outcome of the implant-restorative complex in preclinical studies. STUDY SELECTION An electronic search of the literature prior to July 2017 was performed to identify all articles related to preclinical research on zirconia implants. The search was conducted using MEDLINE (National Library of Medicine) and PubMed without restrictions concerning the date of publication. The search terminology included: zirconia implant, osseointegration, bone-to-implant contact, soft tissue, histology, histomorphometry, surface modification, surface roughness, surface characteristics, and restoration (connecting multiple keywords with AND, OR). RESULTS Fifty-seven studies were finally selected from an initial yield of 654 titles, and the data were extracted. The identified preclinical studies focused on several aspects related to zirconia implants, namely biocompatibility, mechanical properties, implant design, osseointegration capacity, soft tissue response, and restorative options. Due to heterogeneity of the studies, a meta-analysis was not possible. The most frequently used zirconia material for the fabrication of implants is yttria-stabilized tetragonal zirconia polycrystal. The resistance-to-fracture for zirconia implants ranged between 516-2044N. The mostly investigated parameter was osseointegration, which is compared to that of titanium. A lack of evidence was found with other parameters. CONCLUSIONS Due to its good biocompatibility as well as favorable physical and mechanical properties, zirconia implants are a potential alternative to titanium implants. However, knowledge regarding the implant-restorative complex and related aspects is still immature to recommend its application for daily practice.
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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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29
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Evaluation of peri-implant bone levels and soft tissue dimensions around zirconia implants—a three-year follow-up study. Int J Oral Maxillofac Surg 2018; 47:492-498. [DOI: 10.1016/j.ijom.2017.10.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/04/2017] [Accepted: 10/23/2017] [Indexed: 11/23/2022]
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30
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Oishi M, Tsutsumi Y, Chen P, Ashida M, Doi H, Hanawa T. Surface changes of yttria-stabilized zirconia in water and Hanks solution characterized using XPS. SURF INTERFACE ANAL 2018. [DOI: 10.1002/sia.6435] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- M. Oishi
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering; Tokyo Medical and Dental University; 2-3-10 Kanda-surugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - Y. Tsutsumi
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering; Tokyo Medical and Dental University; 2-3-10 Kanda-surugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - P. Chen
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering; Tokyo Medical and Dental University; 2-3-10 Kanda-surugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - M. Ashida
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering; Tokyo Medical and Dental University; 2-3-10 Kanda-surugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - H. Doi
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering; Tokyo Medical and Dental University; 2-3-10 Kanda-surugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - T. Hanawa
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering; Tokyo Medical and Dental University; 2-3-10 Kanda-surugadai, Chiyoda-ku Tokyo 101-0062 Japan
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ElHoussiney AG, Zhang H, Song J, Ji P, Wang L, Yang S. Influence of implant location on the clinical outcomes of implant abutments: a systematic review and meta-analysis. Clin Cosmet Investig Dent 2018. [PMID: 29520162 PMCID: PMC5834166 DOI: 10.2147/ccide.s143910] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose To compare the failure events and incidence of complications of different abutment materials in anterior and posterior regions. Failure was defined as complete loss of the abutment requiring replacement by a new abutment. Materials and methods Electronic searches using PubMed/Medline and Google Scholar complemented with manual searches were performed with specific search terms. Searches were restricted to publications in English between January 2006 and March 2016. Results A total of 863 and 1,264 implants were inserted in the anterior and posterior regions, respectively, in a total of 1,529 patients. No titanium abutments failed in anterior or posterior regions. On the other hand, 1.6% of zirconia abutments failed in the anterior region and 1.5% failed in the posterior region. Technical complications occurred mostly in the posterior region and mostly involved zirconia abutment. Meta-analysis was possible only for zirconia-abutment failure, due to considerable heterogeneity of studies and outcome variables. No significant difference in failure rate was found between anterior and posterior zirconia abutments (risk ratio 1.53, 95% CI 0.49–4.77; P=0.47). Conclusion This systematic review and meta-analysis showed similar outcomes of different abutment materials when used in anterior and posterior regions in terms of failure events and biological and aesthetic complications. The only significant finding was the increased incidence of technical complications in the posterior region, mostly involving zirconia abutments. Abutment-screw loosening was the most common technical complication.
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Affiliation(s)
| | - He Zhang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Jinlin Song
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Ping Ji
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Lu Wang
- Department of Prosthodontics
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Miranda RBDP, Miranda WG, Lazar DRR, Ussui V, Marchi J, Cesar PF. Effect of titania content and biomimetic coating on the mechanical properties of the Y-TZP/TiO 2 composite. Dent Mater 2017; 34:238-245. [PMID: 29183671 DOI: 10.1016/j.dental.2017.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 10/26/2017] [Accepted: 11/01/2017] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To investigate the effect of titania addition (0, 10 and 30mol%) on the microstructure, relative density, Young's modulus (E), Poisson's ratio (υ), mechanical properties (flexural strength, σf, and Weibull modulus, m) of a Y-TZP/TiO2 composite. The effect of the presence of a biomimetic coating on the microstructure and mechanical properties was also evaluated. METHODS Y-TZP (3mol% of yttria) and Y-TZP/TiO2 composite (10 or 30mol% of titania) were synthesized by co-precipitation. The powders were pressed and sintered at 1400°C/2h. The surfaces, with and without biomimetic coating, were characterized by X-ray diffraction analysis and scanning electron microscopy. The relative density was measured by the Archimedes' principle. E and υ were measured by ultrasonic pulse-echo method. For the mechanical properties the specimens (n=30 for each group) were tested in a universal testing machine. RESULTS Titania addition increased the grain size of the composite and caused a significant decrease in the flexural strength (in MPa, control 815.4a; T10 455.7b and T30 336.0c), E (in GPa, control 213.4a; T10 155.8b and T30 134.0c) and relative density (control 99.0%a; T10 94.4%c and T30 96.3%b) of the Y-TZP/TiO2 composite. The presence of 30% titania caused substantial increase in m and υ. Biomimetic coating did not affect the mechanical properties of the composite. SIGNIFICANCE The Y-TZP/TiO2 composite coated with a layer of CaP has great potential to be used as implant material. Although addition of titania affected the properties of the composite, the application of a biomimetic coating did not jeopardize its reliability.
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Affiliation(s)
| | - Walter Gomes Miranda
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Dolores Ribeiro Ricci Lazar
- Centro de Ciência e Tecnologia de Materiais, Instituto de Pesquisas Energéticas e Nucleares, São Paulo, SP, Brazil
| | - Valter Ussui
- Centro de Ciência e Tecnologia de Materiais, Instituto de Pesquisas Energéticas e Nucleares, São Paulo, SP, Brazil
| | - Juliana Marchi
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, Santo André, SP, Brazil
| | - Paulo Francisco Cesar
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, SP, Brazil.
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Kohal RJ, Spies BC, Bauer A, Butz F. One-piece zirconia oral implants for single-tooth replacement: Three-year results from a long-term prospective cohort study. J Clin Periodontol 2017; 45:114-124. [DOI: 10.1111/jcpe.12815] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Ralf-Joachim Kohal
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Faculty of Medicine; University of Freiburg; Freiburg Germany
| | - Benedikt C. Spies
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Faculty of Medicine; University of Freiburg; Freiburg Germany
| | - Annalena Bauer
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Faculty of Medicine; University of Freiburg; Freiburg Germany
| | - Frank Butz
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Faculty of Medicine; University of Freiburg; Freiburg Germany
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Benic GI, Thoma DS, Sanz-Martin I, Munoz F, Hämmerle CH, Cantalapiedra A, Fischer J, Jung RE. Guided bone regeneration at zirconia and titanium dental implants: a pilot histological investigation. Clin Oral Implants Res 2017; 28:1592-1599. [DOI: 10.1111/clr.13030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Goran I. Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | | | - Fernando Munoz
- Faculty of Veterinary; University of Santiago de Compostela; Santiago Spain
| | - Christoph H.F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | | | - Jens Fischer
- Division of Dental Materials and Engineering; University of Basel; Basel Switzerland
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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Cionca N, Hashim D, Mombelli A. Zirconia dental implants: where are we now, and where are we heading? Periodontol 2000 2016; 73:241-258. [DOI: 10.1111/prd.12180] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Pieralli S, Kohal R, Jung R, Vach K, Spies B. Clinical Outcomes of Zirconia Dental Implants: A Systematic Review. J Dent Res 2016; 96:38-46. [DOI: 10.1177/0022034516664043] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- S. Pieralli
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center–University of Freiburg, Freiburg, Germany
| | - R.J. Kohal
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center–University of Freiburg, Freiburg, Germany
| | - R.E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - K. Vach
- Center for Medical Biometry and Medical Informatics, Institute for Medical Biometry and Statistics, Medical Center–University of Freiburg, Freiburg, Germany
| | - B.C. Spies
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center–University of Freiburg, Freiburg, Germany
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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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Hashim D, Cionca N, Courvoisier DS, Mombelli A. A systematic review of the clinical survival of zirconia implants. Clin Oral Investig 2016; 20:1403-17. [PMID: 27217032 PMCID: PMC4992030 DOI: 10.1007/s00784-016-1853-9] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/06/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The aim of this review was to evaluate the clinical success and survival rates of zirconia ceramic implants after at least 1 year of function and to assess if there is sufficient evidence to justify using them as alternatives to titanium implants. MATERIALS AND METHODS An electronic search in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Clinical Trials (CENTRAL) databases was performed in April 2015 by two independent examiners to retrieve clinical studies focusing on the survival rate of zirconia implants after at least 1 year of function. Implant survival was estimated using the overall proportion reported in the studies with a Clopper-Pearson 95 % confidence interval (random effect model with a Der-Simonian Laird estimate). RESULTS Fourteen articles were selected out of the 1519 titles initially screened. The overall survival rate of zirconia one- and two-piece implants was calculated at 92 % (95 % CI 87-95) after 1 year of function. The survival of implants at 1 year for the selected studies revealed considerable heterogeneity. CONCLUSIONS In spite of the unavailability of sufficient long-term evidence to justify using zirconia oral implants, zirconia ceramics could potentially be the alternative to titanium for a non-metallic implant solution. However, further clinical studies are required to establish long-term results, and to determine the risk of technical and biological complications. Additional randomized controlled clinical trials examining two-piece zirconia implant systems are also required to assess their survival and success rates in comparison with titanium as well as one-piece zirconia implants. CLINICAL RELEVANCE Zirconia implants provide a potential alternative to titanium ones. However, clinicians must be aware of the lack of knowledge regarding long-term outcomes and specific reasons for failure.
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Affiliation(s)
- Dena Hashim
- School of Dental Medicine, Division of Periodontology, University of Geneva, Rue Barthelemy-Menn 19, CH-1205, Geneva, Switzerland.
| | - Norbert Cionca
- School of Dental Medicine, Division of Periodontology, University of Geneva, Rue Barthelemy-Menn 19, CH-1205, Geneva, Switzerland
| | - Delphine S Courvoisier
- University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, CH-1205, Genève, Switzerland
| | - Andrea Mombelli
- School of Dental Medicine, Division of Periodontology, University of Geneva, Rue Barthelemy-Menn 19, CH-1205, Geneva, Switzerland
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Kniha K, Gahlert M, Hicklin S, Brägger U, Kniha H, Milz S. Evaluation of Hard and Soft Tissue Dimensions Around Zirconium Oxide Implant–Supported Crowns: A 1-Year Retrospective Study. J Periodontol 2016; 87:511-8. [DOI: 10.1902/jop.2015.150441] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Evaluation of stress distributions occurring on zirconia and titanium implant-supported prostheses: A three-dimensional finite element analysis. J Prosthet Dent 2016; 116:346-55. [PMID: 27063944 DOI: 10.1016/j.prosdent.2016.01.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/23/2016] [Accepted: 01/26/2016] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM Titanium implants have been successfully used to support fixed dental prostheses. Zirconia implants have been suggested as support for crowns, but information on their use to support partial fixed dental prostheses is limited. PURPOSE The purpose of this finite element study was to evaluate the maximum principal, minimum principal, and von Mises stresses and their distributions on zirconia and titanium implant-supported, partial fixed dental prostheses located in the anterior maxillary region. MATERIAL AND METHODS Zirconia and titanium implants (4 mm in diameter and 11. 5 mm in length) and prostheses made from 2 different materials (lithium disilicate and zirconia) were simulated, and 4 models were generated: Titan-IPS, Titan-Lava, Zircon-IPS, and Zircon-Lava. The maxillary bone was modeled as type 3 bone. The load was applied obliquely (534 N) and horizontally (76.5 N), and the stress values and distributions were examined. RESULTS Under horizontal loading, stresses generated on the cortical bone in the Zircon models were lower than those in the Titan models. Under oblique loading, stress values were similar in the same implant material and stress type. For all types of stress among the models, the stress values that occurred on the trabecular bone were found to be similar under both horizontal and oblique loading. The maximum stress values on the bones, implants, cores, and veneers did not exceed the strength of the structures. CONCLUSIONS Different stress values resulted from the different implant types. The prosthetic materials did not change the stress distributions in bone.
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Evaluation of alumina toughened zirconia implants with a sintered, moderately rough surface: An experiment in the rat. Dent Mater 2016; 32:65-72. [DOI: 10.1016/j.dental.2015.10.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 08/13/2015] [Accepted: 10/22/2015] [Indexed: 11/20/2022]
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Rohr N, Coldea A, Zitzmann NU, Fischer J. Loading capacity of zirconia implant supported hybrid ceramic crowns. Dent Mater 2015; 31:e279-88. [DOI: 10.1016/j.dental.2015.09.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 04/09/2015] [Accepted: 09/21/2015] [Indexed: 10/22/2022]
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Implant Supported Fixed Dental Prostheses Using a New Monotype Zirconia Implant-A Case Report. Dent J (Basel) 2015; 3:79-92. [PMID: 29567928 PMCID: PMC5851168 DOI: 10.3390/dj3030079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/04/2015] [Accepted: 09/10/2015] [Indexed: 11/24/2022] Open
Abstract
Currently, titanium or specific titanium alloys are the most often used materials for the fabrication of dental implants. Many studies have confirmed the osseointegrative capacity and clinical long-term performance of moderately rough titanium implants. However, disadvantages have also been reported with regard to peri-implant infections and the titanium metal properties. Tooth colored ceramic implants have attracted the interest of clinicians since the end of the 1960s. Initially, alumina was used for the fabrication of ceramic implants; however, due to the poor biomechanical properties, alumina implants are not commercially available any more. Since end of the 1990s, zirconia has been established in dentistry due to its superior biomechanical properties compared to other oxide ceramics such as alumina. Currently, zirconia is the material of choice for the fabrication of ceramic implants. Zirconia implants show superior biocompatibility compared to titanium and other metals. Additionally, it has been reported that zirconia implants with a micro-rough surface topography show at least a comparable osseointegrative capacity and similar clinical survival rates to moderately rough titanium implants. The present case reports a fixed implant-supported reconstruction of a large edentulous space with compromised local bone conditions using new monotype zirconia dental implants with a micro-rough surface topography.
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Kohal RJ, Schwindling FS, Bächle M, Spies BC. Peri-implant bone response to retrieved human zirconia oral implants after a 4-year loading period: A histologic and histomorphometric evaluation of 22 cases. J Biomed Mater Res B Appl Biomater 2015; 104:1622-1631. [DOI: 10.1002/jbm.b.33512] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/30/2015] [Accepted: 08/14/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Ralf-Joachim Kohal
- Department of Prosthetic Dentistry; Center for Dental Medicine, Medical Center-University of Freiburg; Freiburg Germany
| | | | - Maria Bächle
- Department of Prosthetic Dentistry; Center for Dental Medicine, Medical Center-University of Freiburg; Freiburg Germany
| | - Benedikt Christopher Spies
- Department of Prosthetic Dentistry; Center for Dental Medicine, Medical Center-University of Freiburg; Freiburg Germany
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Spies B, Balmer M, Patzelt S, Vach K, Kohal R. Clinical and Patient-reported Outcomes of a Zirconia Oral Implant. J Dent Res 2015; 94:1385-91. [DOI: 10.1177/0022034515598962] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to determine the clinical, radiographic, and patient-reported outcomes of a 1-piece alumina-toughened zirconia implant restored with single crowns (SCs) or 3-unit fixed dental prostheses (FDPs) after 3 y of observation. Forty patients received 53 implants, placed in a 1-stage operation with immediate temporization. Finally, 50 implants were restored with 24 SCs and 13 FDPs. To evaluate peri-implant bone loss, standardized radiographs were taken at implant insertion, at final restoration delivery, and after 1 and 3 y. Additionally, several soft tissue parameters and patient-reported outcome measures were evaluated. Linear mixed models with random intercept for each patient and patients as clusters were used to compare subgroups. Three patients did not receive a SC due to early implant loss, and 1 patient died. As a result, 36 patients with 49 implants were followed-up for 3 y, giving a cumulative survival rate of 94.2%. The average marginal bone loss amounted to 0.79 mm (SCs, 0.47 mm; FDPs, 1.07 mm; P < 0.001). After the delivery of the final prosthetic restoration, further bone loss was not statistically significant (0.09 mm; P = 0.700). Probing depth, clinical attachment level, and modified bleeding index increased significantly at the implant sites, whereas gingival recession decreased significantly. Compared with the pretreatment questionnaires, the patient-reported outcome measures showed a permanently improved perception of function, aesthetics, sense, speech and self-esteem. The survival rate of the investigated ceramic implant system seems to be comparable to reported survival rates of titanium implants when immediately restored. The recorded parameters suggest its potential for clinical utilization.
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Affiliation(s)
- B.C. Spies
- Medical Center–University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany
| | - M. Balmer
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - S.B.M. Patzelt
- Medical Center–University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany
| | - K. Vach
- Medical Center–University of Freiburg, Center for Medical Biometry and Medical Informatics, Institute for Medical Biometry and Statistics, Freiburg, Germany
| | - R.J. Kohal
- Medical Center–University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany
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Jung RE, Grohmann P, Sailer I, Steinhart YN, Fehér A, Hämmerle C, Strub JR, Kohal R. Evaluation of a one-piece ceramic implant used for single-tooth replacement and three-unit fixed partial dentures: a prospective cohort clinical trial. Clin Oral Implants Res 2015. [DOI: 10.1111/clr.12670] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Philipp Grohmann
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Irena Sailer
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
- Division of Fixed Prosthodontics and Biomaterials; Clinic of Dental Medicine; University of Geneva; Geneva Switzerland
| | - Yann-Niclas Steinhart
- Department of Prosthetic Dentistry; Center for Dental Medicine; University Medical Center Freiburg; Freiburg Germany
| | | | - Christoph Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Jörg Rudolf Strub
- Department of Prosthetic Dentistry; Center for Dental Medicine; University Medical Center Freiburg; Freiburg Germany
| | - Ralf Kohal
- Department of Prosthetic Dentistry; Center for Dental Medicine; University Medical Center Freiburg; Freiburg Germany
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Linkevicius T, Vaitelis J. The effect of zirconia or titanium as abutment material on soft peri-implant tissues: a systematic review and meta-analysis. Clin Oral Implants Res 2015; 26 Suppl 11:139-47. [PMID: 26073346 DOI: 10.1111/clr.12631] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 11/29/2022]
Abstract
AIM The objective of this review was to analyze research with regard to the effect of zirconia or titanium as abutment material on soft peri-implant tissues. METHODS Clinical studies were selected via electronic and hand searches in English language journals until December 1, 2014. Only randomized clinical trials (RCTs) and prospective controlled clinical trials (CCTs) showing direct comparison between zirconia (Zr) and titanium (Ti) abutments in the same patient were considered. The outcome measures were (1) soft tissue color, (2) soft tissue recession, (3) peri-implant probing, (4) bleeding on probing, (5) esthetic indexes, (6) patient-reported outcome, (7) marginal bone level, and (8) biological complications. RESULTS Nine relevant studies (11 papers) were identified: 4 RCTs and 5 CCTs. Due to heterogeneity in the study design, statistical methods, and reported results, a meta-analysis of the data was feasible only for soft tissue color. The outcome was found to be significantly superior for Zr abutments. For the other outcome measures, a qualitative analysis of the selected articles was performed. The studies did not show any statistically significant differences between Zr and Ti abutments on soft tissue recession, probing depths, bleeding on probing, marginal bone level, and patient-reported outcome. One study reported significantly higher pink esthetic score (PES) scores at Zr implants with Zr abutments, compared to metal implants and Ti abutments. CONCLUSION Overall, the research does not support any obvious advantage of Ti or Zr abutments over each other. However, there is a significant tendency in Zr abutments evoking better color response of peri-implant mucosa and superior esthetic outcome measured by PES score.
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Affiliation(s)
- Tomas Linkevicius
- Faculty of Medicine, Institute of Odontology, Vilnius University, Vilnius, Lithuania.,Vilnius Mokslo Grupe, Vilnius, Lithuania.,Vilnius Implantology Center, Vilnius, Lithuania
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Patzelt SBM, Spies BC, Kohal RJ. CAD/CAM-fabricated implant-supported restorations: a systematic review. Clin Oral Implants Res 2015; 26 Suppl 11:77-85. [DOI: 10.1111/clr.12633] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 12/20/2022]
Affiliation(s)
| | - Benedikt C. Spies
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Freiburg Germany
| | - Ralf J. Kohal
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Freiburg Germany
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Crestal bone loss and periimplant inflammatory parameters around zirconia implants: A systematic review. J Prosthet Dent 2015; 114:351-7. [PMID: 26047803 DOI: 10.1016/j.prosdent.2015.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 03/25/2015] [Accepted: 03/26/2015] [Indexed: 01/28/2023]
Abstract
STATEMENT OF PROBLEM Zirconia implants have been used for oral rehabilitation; however, evidence of their ability to maintain crestal bone and periimplant soft tissue health is not clear. PURPOSE The purpose of this systematic review was to evaluate crestal bone loss (CBL) around zirconia dental implants and clinical periimplant inflammatory parameters. MATERIAL AND METHODS The focus question addressed was, "Do zirconia implants maintain crestal bone levels and periimplant soft tissue health?" Databases were searched for articles from 1977 through September 2014 with different combinations of the following MeSH terms: "dental implants," "zirconium," "alveolar bone loss," "periodontal attachment loss," "periodontal pocket," "periodontal index." Letters to the editor, case reports, commentaries, review articles, and articles published in languages other than English were excluded. RESULTS Thirteen clinical studies were included. In 8 of the studies, the CBL around zirconia implants was comparable between baseline and follow-up. In the other 5 studies, the CBL around zirconia implants was significantly higher at follow-up. Among the studies that used titanium implants as controls, 2 studies showed significantly higher CBL around zirconia implants, and in 1 study, the CBL around zirconia and titanium implants was comparable. The reported implant survival rates for zirconia implants ranged between 67.6% and 100%. Eleven studies selectively reported the periimplant inflammatory parameters. CONCLUSIONS Because of the variations in study design and methodology, it was difficult to reach a consensus regarding the efficacy of zirconia implants in maintaining crestal bone levels and periimplant soft tissue health.
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Thoma DS, Benic GI, Muñoz F, Kohal R, Sanz Martin I, Cantalapiedra AG, Hämmerle CHF, Jung RE. Marginal bone-level alterations of loaded zirconia and titanium dental implants: an experimental study in the dog mandible. Clin Oral Implants Res 2015; 27:412-20. [DOI: 10.1111/clr.12595] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Goran I. Benic
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Fernando Muñoz
- Department of Veterinary Clinical Sciences; University of Santiago de Compostela; Lugo Spain
| | - Ralf Kohal
- Department of Prosthodontics; Albert-Ludwigs-University; Freiburg Germany
| | | | | | - Christoph H. F. Hämmerle
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Ronald E. Jung
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
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