Working with Zirconia Implants Requires a Different Approach

2021 ◽  
Author(s):  
Curd Bollen
Keyword(s):  
Titanium Implants ◽  
Product Portfolio ◽  
Metal Free ◽  
Ceramic Implants ◽  
Zirconia Implants

The use of ceramic implants has been on the rise in recent years. More and more dental clinicians add this option in their therapy concepts. Also, more and more implant companies add this kind implants to their product portfolio. As mean reason, the growing demand from patients for metal-free restorations can be identified. However, applying zirconia implants is surely not identical to the manipulation of titanium implants. Therefore, it is of utmost importance that practitioners are well informed and decently trained before starting to use these implants. This article gives an overview on the main differences between the 2 types of implants.

scholarly journals Clinical Longevity of Zirconia Implants with the Focus on Biomechanical and Biological Outcome

2020 ◽  
Vol 7 (4) ◽  
pp. 344-351
Author(s):  
Ralf-Joachim Kohal ◽  
David K. Dennison
Keyword(s):  
Systematic Reviews ◽  
Titanium Implants ◽  
Zirconia Ceramic ◽  
Published Data ◽  
Clinical Use ◽  
Short Term ◽  
Tissue Integration ◽  
Meta Review ◽  
Ceramic Implants ◽  
Zirconia Implants

Abstract Purpose of Review The goal of the present review is to update the reader on the scientific background of zirconia ceramic implants. Clinical investigations using zirconia ceramic implants over the last couple of years have brought up some new developments and questions. Can we be confident in placing zirconia ceramic implants given the recently published data? Is there a difference in the application of one- and two-piece implants? Recent Findings Systematic reviews on preclinical investigations of zirconia implants revealed that one-piece zirconia implants (> 4 mm) are sufficiently stable for clinical use. The same is true for some clinically available two-piece implant systems. Osseointegration and soft tissue integration are, according to the reviews, similar between titanium and zirconia implants with similar surface topographies. Regarding the clinical outcome, a meta-review exists evaluating systematic reviews. The findings of the systematic reviews and the meta-review are that there are good short-term clinical results for one-piece zirconia implants. However, the data for two-piece implants is not robust. Summary In certain applications (single tooth restorations and small bridges), the results of zirconia implants are comparable with titanium implants in short-term studies. Some mid-term investigations support the short-term results. However, according to the current scientific data available, zirconia implants cannot yet be considered an alternative to titanium implants because there are many areas where there is a lack of clinical studies on zirconia implants. Currently, they are an addendum to the titanium implant armamentarium for situations where they are useful (patient request, known hypersensitivity to titanium, or questions of esthetics when titanium might appear inappropriate for a certain situation/condition), but long-term studies are needed. Without a doubt, there is a need for two-piece zirconia implants, but limited research exists to support their clinical use at the moment.

An Overview of Zirconia Dental Implants: Basic Properties and Clinical Application of Three Cases

2014 ◽  
Vol 40 (4) ◽  
pp. 485-494 ◽  
Author(s):  
Merve Bankoğlu Güngör ◽  
Cemal Aydın ◽  
Handan Yılmaz ◽  
Esma Başak Gül
Keyword(s):  
Dental Implants ◽  
Titanium Implants ◽  
Maxillary Incisor ◽  
Bone Implant ◽  
Basic Properties ◽  
Ceramic Implants ◽  
Zirconia Implants ◽  
Natural Tooth ◽  
Ceramic Implant

Due to the possible aesthetic problems of titanium implants, the developments in ceramic implant materials are increasing. Natural tooth colored ceramic implants may be an alternative to overcome aesthetic problems. The purpose of this article is to give information about the basic properties of dental zirconia implants and present 3 cases treated with two-piece zirconia implants. Two-piece zirconia dental implants, 4.0 mm diameter and 11.5 mm in length, were inserted into maxillary incisor region. They were left for 6 months to osseointegrate. Panoramic and periapical radiographs were obtained and examined for bone-implant osseointegration. During the follow-up period the patients were satisfied with their prosthesis and no complication was observed.

scholarly journals Single tooth restoration in the maxillary esthetic zone using a one-piece ceramic implant with 1 year of follow-up: case series

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Miren Vilor-Fernández ◽  
Ana-María García-De-La-Fuente ◽  
Xabier Marichalar-Mendia ◽  
Ruth Estefanía-Fresco ◽  
Luis-Antonio Aguirre-Zorzano
Keyword(s):  
Case Series ◽  
Biological Properties ◽  
Titanium Implants ◽  
Plaque Index ◽  
Marginal Bone Loss ◽  
Bleeding On Probing ◽  
Probing Depth ◽  
Zirconia Implants ◽  
Ceramic Implant

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 96.9%. 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 96.9%. For these reasons, we can say that zirconia implants could be an alternative to titanium implants in the esthetic zone.

scholarly journals Marginal Bone Loss and Aesthetics Around Zirconia and Titanium Dental Implants-A Metanalysis

2020 ◽  
Author(s):  
Pulijala Sathwika ◽  
Rampalli Viswa Chandra
Keyword(s):  
Bone Loss ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Titanium Implants ◽  
Controlled Trials ◽  
Marginal Bone Loss ◽  
Randomized Controlled ◽  
Cie Lab ◽  
Titanium Dental Implants ◽  
Zirconia Implants

AIM: To evaluate and compare the marginal bone loss and aesthetic outcomes of zirconia implants with titanium implants in randomized controlled trials (RCTs). MATERIAL AND METHODS: Electronic [PubMed] and hand searches were performed to identify randomized controlled trials that were published between January 2008 to April 2020 which investigated and compared various outcomes between zirconia and titanium dental implants. Outcomes included assessment of marginal bone loss and aesthetics using spectrophotometric measurements. Meta-analysis was performed to estimate the above parameters among various studies. RESULTS: A total of 58 articles were screened for titles and abstracts. Subsequently 8 articles were selected for data extraction and evaluation. Zirconia implants were investigated and compared to titanium implants for marginal bone loss [MBL]. Customized zirconia and titanium abutments seated over implants were analyzed for aesthetic outcomes using spectrophotometric method using CIE-Lab measurements. Meta-analysis estimated that zirconia implants exhibited marginal bone loss reduction of 0.179mm (95% CI, 0.02 to 0.33) and -0.242mm (95% CI, -4.026 to 3.542) in aesthetic measurements than titanium implants. CONCLUSIONS: No heterogeneity was observed among studies analyzed for marginal bone loss and significant differences were noticed between two groups. Noticeable heterogeneity was observed among studies assessing aesthetics using spectrophotometry and CIE-Lab measurements and results revealed no many significant differences between the two groups.

scholarly journals Surface Modifications of Dental Ceramic Implants with Different Glass Solder Matrices:In VitroAnalyses with Human Primary Osteoblasts and Epithelial Cells

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Jana Markhoff ◽  
Enrico Mick ◽  
Aurica Mitrovic ◽  
Juliane Pasold ◽  
Katharina Wegner ◽  
...  
Keyword(s):  
Solder Matrix ◽  
Tetragonal Zirconia ◽  
Ceramic Materials ◽  
Bone Cell ◽  
Titanium Implants ◽  
Type I ◽  
Dental Surgery ◽  
Procollagen Type ◽  
Procollagen Type I ◽  
Ceramic Implants

Ceramic materials show excellent esthetic behavior, along with an absence of hypersensitivity, making them a possible alternative implant material in dental surgery. However, their surface properties enable only limited osseointegration compared to titanium implants. Within this study, a novel surface coating technique for enhanced osseointegration was investigated biologically and mechanically. Specimens of tetragonal zirconia polycrystal (TZP) and aluminum toughened zirconia (ATZ) were modified with glass solder matrices in two configurations which mainly consisted of SiO2, Al2O3, K2O, and Na2O. The influence on human osteoblastic and epithelial cell viability was examined by means of a WST-1 assay as well as live/dead staining. A C1CP-ELISA was carried out to verify procollagen type I production. Uncoated/sandblasted ceramic specimens and sandblasted titanium surfaces were investigated as a reference. Furthermore, mechanical investigations of bilaterally coated pellets were conducted with respect to surface roughness and adhesive strength of the different coatings. These tests could demonstrate a mechanically stable implant coating with glass solder matrices. The coated ceramic specimens show enhanced osteoblastic and partly epithelial viability and matrix production compared to the titanium control. Hence, the new glass solder matrix coating could improve bone cell growth as a prerequisite for enhanced osseointegration of ceramic implants.

Ceramic implants (Y-TZP): are they a viable alternative to titanium implants for the support of overdentures? A randomized clinical trial

2013 ◽  
Vol 25 (12) ◽  
pp. 1366-1377 ◽  
Author(s):  
Reham B. Osman ◽  
Michael V. Swain ◽  
Momen Atieh ◽  
Sunyoung Ma ◽  
Warwick Duncan
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Titanium Implants ◽  
Viable Alternative ◽  
Ceramic Implants

The Biologic Tissue Responses to Uncoated and Coated Implanted Biomaterials

1999 ◽  
Vol 13 (1) ◽  
pp. 27-33 ◽  
Author(s):  
D.E. Steflik ◽  
R.S. Corpe ◽  
T.R. Young ◽  
A.L. Sisk ◽  
G.R. Parr
Keyword(s):  
Collagen Fiber ◽  
Bone Matrix ◽  
Titanium Implants ◽  
Osteoblastic Activity ◽  
Osseointegrated Implants ◽  
Tissue Responses ◽  
Ceramic Implants ◽  
Fiber Matrix ◽  
Morphology And Morphometry ◽  
Uncoated Titanium

Ultrastructural examination of the morphology and morphometry of the bone supporting uncoated titanium and ceramic implants was assessed in an experimental animal model involving 120 implants placed into the mandibles of 30 adult mongrel dogs. Further, preliminary morphologic and morphometric observations of the bone supporting uncoated and hydroxylapatite-coated endosteal titanium implants was evaluated in a second investigation involving 72 implants placed into the mandibles and maxillae of 6 additional dogs. A densely mineralized collagen fiber matrix was observed directly interfacing with uncoated implants. The only material interposed between the implant and bone matrix was a 20- to 50-nm electron-dense material suggestive of a proteoglycan. Also seen in these same osseointegrated implants were narrow unmineralized zones interposed between the implant and bone matrix. In these zones of remodeling bone, numerous osteoblasts were observed interacting with the collagen fiber matrix. It was shown that a normal homeostasis of anabolic osteoblastic activity and catabolic osteoclastic activity resulted in bone remodeling and the resultant osseointegration of the implants. Hydroxylapatite-coated implants intimately interfaced with healthy bone. The mineralized matrix extended into the microporosity of the HA coating. This matrix contained viable osteocytes.

scholarly journals One-Piece Zirconia Ceramic versus Titanium Implants in the Jaw and Femur of a Sheep Model: A Pilot Study

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
A. Siddiqi ◽  
W. J. Duncan ◽  
R. K. De Silva ◽  
S. Zafar
Keyword(s):  
Animal Studies ◽  
Surface Characteristics ◽  
Titanium Implants ◽  
Zirconia Ceramic ◽  
Domestic Sheep ◽  
Sheep Model ◽  
Mixed Breed ◽  
Alternative Materials ◽  
The One ◽  
Zirconia Implants

Reports have documented titanium (Ti) hypersensitivity after dental implant treatment. Alternative materials have been suggested including zirconia (Zr) ceramics, which have shown predictable osseointegration in animal studies and appear free of immune responses. The aim of the research was to investigate the bone-to-implant contact (BIC) of one-piece Zr, compared with one-piece Ti implants, placed in the jaws and femurs of domestic sheep. Ten New Zealand mixed breed sheep were used. A One-piece prototype Ti (control) and one Zr (test) implant were placed in the mandible, and one of each implant (Ti and Zr) was placed into the femoral epicondyle of each animal. The femur implants were submerged and unloaded; the mandibular implants were placed using a one-stage transgingival protocol and were nonsubmerged. After a healing period of 12 weeks, %BIC was measured. The overall survival rate for mandibular and femur implants combined was 87.5%. %BIC was higher for Zr implants versus Ti implants in the femur (85.5%, versus 78.9%) (p=0.002). Zirconia implants in the mandible showed comparable %BIC to titanium implants (72.2%, versus 60.3%) (p=0.087). High failure rate of both Zr and Ti one-piece implants in the jaw could be attributed to the one-piece design and surface characteristics of the implant that could have influenced osseointegration. Further clinical trials are recommended to evaluate the performance of zirconia implants under loading conditions.

scholarly journals Will Zirconia Implants Replace Titanium Implants?

2021 ◽  
Vol 11 (15) ◽  
pp. 6776
Author(s):  
Liana Preto Webber ◽  
Hsun-Liang Chan ◽  
Hom-Lay Wang
Keyword(s):  
Soft Tissue ◽  
Clinical Results ◽  
Titanium Implants ◽  
Tissue Response ◽  
Advantages And Disadvantages ◽  
New Material ◽  
Soft Tissue Response ◽  
Zirconia Implants

This review aims to discuss the advantages and disadvantages of zirconia implants compared with titanium implants. Moreover, it intends to review the relevant available long-term literature of these two materials regarding osteointegration, soft-tissue, microbiota, and peri-implantitis, focusing on clinical results. Briefly, titanium implants are a reliable alternative for missing teeth; however, they are not incapable of failure. In an attempt to provide an alternative implant material, implants made from ceramic-derivate products were developed. Owing to its optimal osseointegration competence, biocompatibility, and esthetic proprieties, zirconium dioxide (ZrO2), also known as zirconia, has gained popularity among researchers and clinicians, being a metal-free alternative for titanium implants with its main use in the anterior esthetic zones. This type of implant may present similar osseointegration as those noted on titanium implants with a greater soft-tissue response. Furthermore, this material does not show corrosion as its titanium analog, and it is less susceptible to bacterial adhesion. Lastly, even presenting a similar inflammatory response to titanium, zirconia implants offer less biofilm formation, suggesting less susceptibility to peri-implantitis. However, it is a relatively new material that has been commercially available for a decade; consequently, the literature still lacks studies with long follow-up periods.

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