Jonas Lorenz1, Nino Giulini2, Werner Hölscher2, Andreas Schwiertz3, Frank Schwarz4, Robert Sader1. 1. Department of Oral, Maxillofacial and Plastic Facial Surgery, Johann-Wolfgang Goethe University, Frankfurt/Main, Germany. 2. Private Dental Practice, Frankfurt/Main, Germany. 3. Institute for Microecology, Herborn, Germany. 4. Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.
Abstract
BACKGROUND: Dental implants made of zirconia ceramics experienced a renaissance in the past years. However, there is still a lack in reliable long-term clinical data. PURPOSE: Aim of the present prospective clinical study was to analyze the dental implants made from zirconia, regarding their clinical performance compared to natural teeth (control). MATERIALS AND METHODS: Eighty-three zirconia implants in 28 adults were analyzed after 7.8 years of integration. Approximal plaque index (API), sulcus bleeding index (SBI), probing pocket depth (PPD), probing attachment level (PAL), and creeping or recession (CR/REC) of the mucosa/gingiva were analyzed. Changes in the marginal bone level (MBL) have been determined by comparing radiographs recorded immediately after implant placement and at the follow-up investigation. Furthermore, the pink esthetic score (PES), Periotest values (PTV), microbial colonization of the implant/dental sulcus fluid, and patient satisfaction were assessed. RESULTS: The survival rate of zirconia implants was 100%, however one implant presented a profound peri-implantitis, resistant to therapies. No statistical significance was observed between implants and teeth regarding SBI and PAL. Statistical significance was detected regarding API and CR/REC with significantly less plaque accumulation and recession in the study group. Significantly higher values for PPD were obvious in the zirconia implant group. PES of 9 ± 2.7 indicate a rather average esthetic result. Analysis of MBL revealed a mean peri-implant bone resorption of 1.2 mm. Microbial analysis revealed a nonstatistically significant higher colonization of bacteria in the study group, whereas single bacteria species were detected in statistically significant higher amounts. CONCLUSION: The investigated one-piece zirconia dental implants presented favorable long-term clinical results, comparable to natural teeth (SBI and PAL), and, regarding adhesion of plaque and creeping attachment (CR/REC), even superior. The microbial investigation revealed a shift in peri-implant colonization around zirconia implants over years, mainly without clinical effect on peri-implantitis.
BACKGROUND: Dental implants made of zirconia ceramics experienced a renaissance in the past years. However, there is still a lack in reliable long-term clinical data. PURPOSE: Aim of the present prospective clinical study was to analyze the dental implants made from zirconia, regarding their clinical performance compared to natural teeth (control). MATERIALS AND METHODS: Eighty-three zirconia implants in 28 adults were analyzed after 7.8 years of integration. Approximal plaque index (API), sulcus bleeding index (SBI), probing pocket depth (PPD), probing attachment level (PAL), and creeping or recession (CR/REC) of the mucosa/gingiva were analyzed. Changes in the marginal bone level (MBL) have been determined by comparing radiographs recorded immediately after implant placement and at the follow-up investigation. Furthermore, the pink esthetic score (PES), Periotest values (PTV), microbial colonization of the implant/dental sulcus fluid, and patient satisfaction were assessed. RESULTS: The survival rate of zirconia implants was 100%, however one implant presented a profound peri-implantitis, resistant to therapies. No statistical significance was observed between implants and teeth regarding SBI and PAL. Statistical significance was detected regarding API and CR/REC with significantly less plaque accumulation and recession in the study group. Significantly higher values for PPD were obvious in the zirconia implant group. PES of 9 ± 2.7 indicate a rather average esthetic result. Analysis of MBL revealed a mean peri-implant bone resorption of 1.2 mm. Microbial analysis revealed a nonstatistically significant higher colonization of bacteria in the study group, whereas single bacteria species were detected in statistically significant higher amounts. CONCLUSION: The investigated one-piece zirconia dental implants presented favorable long-term clinical results, comparable to natural teeth (SBI and PAL), and, regarding adhesion of plaque and creeping attachment (CR/REC), even superior. The microbial investigation revealed a shift in peri-implant colonization around zirconia implants over years, mainly without clinical effect on peri-implantitis.
Authors: Frank Akito Spitznagel; Marc Balmer; Daniel B Wiedemeier; Ronald Ernst Jung; Petra Christine Gierthmuehlen Journal: Clin Oral Implants Res Date: 2021-11-05 Impact factor: 5.021
Authors: Marc Balmer; Carolin Fischer; Miha Pirc; Christoph H F Hämmerle; Ronald E Jung Journal: Materials (Basel) Date: 2022-08-15 Impact factor: 3.748