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.
Highlights
Since the 1980s and the introduction of dental implant therapy by Per-Ingvar Brånemark, the replacement of missing teeth using implant-supported restorations is a daily and globally-accepted clinical approach [1]
Safioti et al reported the presence of dissolved titanium at higher quantities in the submucosal biofilm taken from implants with peri-implantitis, versus biofilm taken from healthy implants [5]
Zirconia ceramic implants made with yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) have been widely investigated
Summary
Since the 1980s and the introduction of dental implant therapy by Per-Ingvar Brånemark, the replacement of missing teeth using implant-supported restorations is a daily and globally-accepted clinical approach [1]. Titanium and its alloys are commonly used in implant dentistry and various clinical studies have demonstrated their high survival rates [2]. Several concerns have been expressed with regard to the titanium particles and its implications in inflammatory reactions in peri-implant tissues [3,4]. Safioti et al reported the presence of dissolved titanium at higher quantities in the submucosal biofilm taken from implants with peri-implantitis, versus biofilm taken from healthy implants [5]. The local concentration of titanium particles, mainly distancedependent, may result in damage to the intraepithelial hemostasis, bone resorption through a stimulation of osteoclast differentiation, and implant detachment [6]. Zirconia ceramic implants made with yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) have been widely investigated
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