Abstract
Background: To analyze the fracture resistance of zirconia implants within the anterior region and evaluate whether zirconia–zirconia implants can be a viable alternative to titanium implants. Methods: Four online databases (Cochrane Library, Ovid, PubMed, and Scopus) were searched for the period of January 2011 to July 2021. All studies that analyzed the in vivo clinical outcome of two-piece implants in the anterior region in English language were included. Results: The search strategy identified 242 studies. Of these studies, three studies were included for qualitative synthesis based on the pre-determined eligibility criteria. The results showed that there is significant difference in biological results, fractal behavior and other complications between one-piece and two-piece zirconia implants. Two-piece zirconia implants demonstrated favorable longevity and success rates within anterior maxillary in short-term trials. Conclusions: Although factors involved in fractures have been identified—sandblasting, implant diameter, occlusal load, age and implant coating—there is limited quantitative assessment to gauge the fracture resistance of two-piece zirconia implants. Hence, further research with long-term clinical evidence is required.
Highlights
Dental implants are increasingly being considered and established as a reliable option for the replacement of missing teeth, and titanium is widely accepted as the gold-standard material used in implant-borne reconstructions [1,2,3]
This systematic review aimed to address the following focused research question in PICOS format “What are the mechanical factors influencing fracture resistance in two-piece (Intervention) versus one-piece zirconia implants in humans (Population) within the anterior region?” and secondary questions included “What is the fractal behavior of anterior zirconia implants?” and “How does the longevity of two-piece zirconia implants compare to one-piece designs?”
Studies were included if they fulfilled these criteria: all original research articles and case series, and all study designs including prospective, retrospective and randomized controlled clinical trials on patients treated with one- or two-piece zirconia implants within the anterior region of the oral cavity that qualitatively addressed the incidence and factors implicated in the fracture of zirconia implants within the anterior region
Summary
Dental implants are increasingly being considered and established as a reliable option for the replacement of missing teeth, and titanium is widely accepted as the gold-standard material used in implant-borne reconstructions [1,2,3]. Titanium implants can pose significant aesthetic concerns in the presence of thin gingival biotypes in the anterior maxillary region, as greyish discoloration of the peri-implant tissue may become clinically noticeable due to the underlying metallic hue of titanium [2]. Periimplant bone loss may result from inflammatory reactions triggered by hypersensitivity to titanium, allergic reactions and titanium implant corrosion, leading to osseointegration failure of the dental implant [4]. To analyze the fracture resistance of zirconia implants within the anterior region and evaluate whether zirconia–zirconia implants can be a viable alternative to titanium implants. All studies that analyzed the in vivo clinical outcome of two-piece implants in the anterior region in English language were included. Two-piece zirconia implants demonstrated favorable longevity and success rates within anterior maxillary in short-term trials. Further research with long-term clinical evidence is required
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