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Ruiz Henao PA, Magrin GL, Caneiro-Queija L, Benfatti CAM, Leira Y, Liñares-González A, Blanco-Carrión J. Single-piece zirconia versus single-piece titanium, narrow-diameter dental implants in the anterior maxilla: 5-year post-loading results of a randomized clinical trial. Clin Oral Implants Res 2024. [PMID: 38940623 DOI: 10.1111/clr.14319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 05/20/2024] [Accepted: 06/02/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES The aim of this study was to evaluate esthetic parameters in the anterior maxillary region by comparing single-piece zirconia versus titanium narrow-diameter implants. Additionally, clinical, radiological and patient-reported outcome measures (PROMs) were analyzed. MATERIALS AND METHODS Thirty implants (tissue level implant) were placed in 30 patients in the maxillary esthetic sector. Depending on randomization, a zirconia (test) or titanium implant (control) was placed. Esthetic, clinical, and radiological parameters, including the implant crown esthetic index (ICAI), pink esthetic score (PES), probing pocket depth, bleeding on probing, plaque index, and marginal bone levels, were evaluated at 12, 36 and 60 months after loading. RESULTS Sixty months after crown placement, no significant differences were found between groups. The ICAI values were 5.25 ± 4.21 and 4.50 ± 2.98 for the test and control groups, respectively. The corresponding PES values were 7.44 ± 1.93 and 7.43 ± 1.74 for the test and control groups, respectively. There were no significant intergroup differences for the rest of the parameters evaluated. CONCLUSION It can be suggested that monotype zirconia implants may serve as a potential alternative to titanium implants in selected clinical scenarios. While the results demonstrated comparable esthetic, clinical, and radiological aspects for zirconia implants as compared to titanium implants after a 5-year follow-up period, further research with larger sample sizes and longer-term follow-up is recommended.
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Affiliation(s)
- Paula Andrea Ruiz Henao
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gabriel Leonardo Magrin
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Leticia Caneiro-Queija
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Cesar Augusto Magalhães Benfatti
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Yago Leira
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Antonio Liñares-González
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Juan Blanco-Carrión
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
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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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Aung LM, Lin JCY, Salamanca E, Wu YF, Pan YH, Teng NC, Huang HM, Sun YS, Chang WJ. Functionalization of zirconia ceramic with fibronectin proteins enhanced bioactivity and osteogenic response of osteoblast-like cells. Front Bioeng Biotechnol 2023; 11:1159639. [PMID: 37180046 PMCID: PMC10167021 DOI: 10.3389/fbioe.2023.1159639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/13/2023] [Indexed: 05/15/2023] Open
Abstract
Introduction: To overcome the genuine bioinert properties of zirconia ceramic, functionalization of the surface with the bioactive protein fibronectin was conducted. Methods: Glow discharge plasma (GDP)-Argon was first used to clean the zirconia surface. Then allylamine was treated at three different powers of 50 W, 75 W, and 85 W and immersed into 2 different fibronectin concentrations (5 µg/ml and 10 µg/ml). Results and Discussion: After surface treatment, irregularly folded protein-like substances were attached on the fibronectin coated disks, and a granular pattern was observed for allylamine grafted samples. Infrared spectroscopy detected C-O, N-O, N-H, C-H, and O-H functional groups for fibronectin treated samples. Surface roughness rose and hydrophilicity improved after the surface modification, with MTT assay showing the highest level of cell viability for the A50F10 group. Cell differentiation markers also showed that fibronectin grafted disks with A50F10 and A85F10 were the most active, which in turn encouraged late-stage mineralization activity on 21d. Up-regulation of osteogenic related mRNA expression from 1d to 10d can be observed in RT-qPCR data for ALP, OC, DLX5, SP7, OPG and RANK biomarkers. These physical and biological properties clearly indicate that an allylamine and fibronectin composite grafted surface significantly stimulated the bioactivity of osteoblast-like cells, and can be utilized for future dental implant applications.
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Affiliation(s)
- Lwin Moe Aung
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jerry Chin-Yi Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - Eisner Salamanca
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Fan Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Hwan Pan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
- School of Dentistry, College of Medicine, China Medical University, Taichung, Taiwan
| | - Nai-Chia Teng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Haw-Ming Huang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Sui Sun
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wei-Jen Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Dental Department, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
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Aldebes A, Al-Khanati NM, Abou Nassar J, Kharboutly NAD, Aldamman F. Effect of restoration material on marginal bone resorption around modified anatomic zirconia dental implants: A randomised controlled trial. Ann Med Surg (Lond) 2022; 80:104313. [PMID: 36045765 PMCID: PMC9422372 DOI: 10.1016/j.amsu.2022.104313] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022] Open
Abstract
Objective The primary aim of this study was to determine the effect of implant-supported porcelain-fused-to-metal (PFM) and indirect-composite-resin (ICR) fixed dental prostheses on peri-implant marginal bone resorption (MBR) in custom-made anatomic modified zirconia dental implants. Methods A prospective randomized controlled clinical trial was conducted. Participants with premolars indicated for dental extractions were recruited into this study to receive a single-unit implant-supported fixed dental prosthesis. Modified anatomic zirconia implants with thorny-retentive surfaces were placed and loaded randomly after 3 months with either PFM or ICR crowns. Participants were recalled after 12 and 18 months for radiographic evaluation of peri-implant MBR. Implants survival was also reported. Results 18 out of 20 zirconia implants were included in all study phases. 18-month survival rate was 90%. After 12 months of implant placement, the mean MBR values were 0.53 (±0.21) mm and 0.60 (±0.14) mm in the ICR group compared to 0.67 (±0.16) mm and 0.61 (±0.27) mm in the PFM group. In the 18-month follow-up, the mean MBR values were 0.61 (±0.27) and 0.67 (±0.16) mm in the ICR group compared to 0.77 (±0.29) and 0.77 (±0.27) mm in the PFM group. No significant differences were found in MBR mean values between study groups at 12- and 18-month follow-up points. Conclusion This study showed that PFM and ICR crowns were viable zirconia-implant-supported restorations with no preference regarding MBR after 18 months. Nevertheless, long-term evaluations are warranted. Custom-made zirconia implants with new design of their macro-retentive features (thorns) were used in this clinical study. They showed success rate of 90% with all failures occurred early before loading. Peri-implant marginal bone resorption (MBR) ranged within acceptable values after 12 and 18 months. No significant differences in MBRs were seen between implant-supported metal-ceramic and indirect composite restorations.
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Affiliation(s)
- Alaa Aldebes
- Department of Fixed Prosthodontics, Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Nuraldeen Maher Al-Khanati
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Damascus University, Damascus, Syria
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria
- Corresponding author. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, P.O. Box 36822, Damascus, Syria. ,
| | - Jihad Abou Nassar
- Department of Fixed Prosthodontics, Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Nour Al-Deen Kharboutly
- Department of Fixed Prosthodontics, Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Feras Aldamman
- Department of Fixed Prosthodontics, Faculty of Dental Medicine, Damascus University, Damascus, Syria
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Full Digital Model-Free Maxillary Prosthetic Rehabilitation by Means of One-Piece Implants: A Proof of Concept Clinical Report with Three-Years Follow Up. PROSTHESIS 2022. [DOI: 10.3390/prosthesis4020020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Implant rehabilitation is a daily practice in dentistry, and patients often have heightened expectations regarding both the functional and the aesthetic outcome. Implant–abutment connection (IAC) is involved in the long-term aesthetic quality of the rehabilitation. The use of one-piece implants for fixing dentures may prevent the mechanical and biological implication of the implant–abutment interface, resulting in a better quality of hard and soft tissue maintenance. In this case report, we present a novel one-piece implant in a maxillary rehabilitation with a full model-free digital approach.
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