Abstract:Objectives: To evaluate implant survival, peri-implant marginal bone loss, technical, and biological complications as well as aesthetic outcomes of zirconia implants in clinical studies. Material and Methods: Electronic (Medline, Embase) and hand searches were perinvestigating zirconia dental implants with a mean follow-up of at least 12 months. Primary outcomes were implant survival and peri-implant marginal bone loss. Secondary outcomes included technical and biological complications as well as aesthetic out… Show more
“…There was a moderate consensus towards a tendency to ceramic materials coexisting with the standard titanium. Although the data from Zirconia‐based implants are scarce (Cionca, Hashim, & Mombelli, ; Pieralli, Kohal, Jung, Vach, & Spies, ; Roehling, Schlegel, Woelfler, & Gahlert, ), the “green” tendencies among populations from European Countries provide reasonable expectations for higher demands on non‐metal solutions. Similarly, although data on oral biofilm adherence to different implant surfaces are scarce, it is expected that ceramics may provide more cleansable surfaces (Sanz‐Martin, Sanz‐Sanchez, Carrillo de Albornoz, Figuero, & Sanz, ; Sanz‐Sanchez, Sanz‐Martin, Carrillo de Albornoz, Figuero, & Sanz, ).…”
Section: Discussionmentioning
confidence: 99%
“…There was a moderate consensus towards a tendency to ceramic materials coexisting with the standard titanium. Although the data from Zirconia-based implants are scarce (Cionca, Hashim, & Mombelli, 2017;Pieralli, Kohal, Jung, Vach, & Spies, 2017;Roehling, Schlegel, Woelfler, & Gahlert, 2018)…”
Objectives
To assess the potential trends for the year 2030 in dental implant dentistry in Europe using the Delphi methodology.
Material and methods
A steering committee and a management team of experts in implant dentistry were created and validated a questionnaire including 60 questions, divided in eight topics. The survey was conducted in two rounds using an anonymous questionnaire, which provided the participants in the second round with the results of the first. Each question had three possible answers, and the results were expressed as percentages.
Results
A total of 138 experts were invited to participate in the survey. From all the invited experts, 52 answered in both the first and second rounds. Three different consensus categories were established based on the percentage of agreement: no consensus (<65%); moderate consensus (65%–85%); and high consensus (≥86%). Within the topic categories, a consensus was reached (mainly moderate consensus) for the majority of questions discussed among experts during a face to face consensus meeting. However, consensus was not reached for a small number of questions/topics.
Conclusions
About 82% of the questions reached consensus. The consensus points towards a lower number of implants to replace chewing units, with implants surfaces made of bioactive materials with reduced micro‐roughness using mainly customized abutments with polished surfaces and an internal implant–abutment connection (85%). CBCT‐3D technologies will be the main tool for pre‐surgical implant placement diagnosis together with direct digital restorative workflows. There will be an increase in the incidence of peri‐implantitis, although there will be more efficient interventions its treatment and prevention.
“…There was a moderate consensus towards a tendency to ceramic materials coexisting with the standard titanium. Although the data from Zirconia‐based implants are scarce (Cionca, Hashim, & Mombelli, ; Pieralli, Kohal, Jung, Vach, & Spies, ; Roehling, Schlegel, Woelfler, & Gahlert, ), the “green” tendencies among populations from European Countries provide reasonable expectations for higher demands on non‐metal solutions. Similarly, although data on oral biofilm adherence to different implant surfaces are scarce, it is expected that ceramics may provide more cleansable surfaces (Sanz‐Martin, Sanz‐Sanchez, Carrillo de Albornoz, Figuero, & Sanz, ; Sanz‐Sanchez, Sanz‐Martin, Carrillo de Albornoz, Figuero, & Sanz, ).…”
Section: Discussionmentioning
confidence: 99%
“…There was a moderate consensus towards a tendency to ceramic materials coexisting with the standard titanium. Although the data from Zirconia-based implants are scarce (Cionca, Hashim, & Mombelli, 2017;Pieralli, Kohal, Jung, Vach, & Spies, 2017;Roehling, Schlegel, Woelfler, & Gahlert, 2018)…”
Objectives
To assess the potential trends for the year 2030 in dental implant dentistry in Europe using the Delphi methodology.
Material and methods
A steering committee and a management team of experts in implant dentistry were created and validated a questionnaire including 60 questions, divided in eight topics. The survey was conducted in two rounds using an anonymous questionnaire, which provided the participants in the second round with the results of the first. Each question had three possible answers, and the results were expressed as percentages.
Results
A total of 138 experts were invited to participate in the survey. From all the invited experts, 52 answered in both the first and second rounds. Three different consensus categories were established based on the percentage of agreement: no consensus (<65%); moderate consensus (65%–85%); and high consensus (≥86%). Within the topic categories, a consensus was reached (mainly moderate consensus) for the majority of questions discussed among experts during a face to face consensus meeting. However, consensus was not reached for a small number of questions/topics.
Conclusions
About 82% of the questions reached consensus. The consensus points towards a lower number of implants to replace chewing units, with implants surfaces made of bioactive materials with reduced micro‐roughness using mainly customized abutments with polished surfaces and an internal implant–abutment connection (85%). CBCT‐3D technologies will be the main tool for pre‐surgical implant placement diagnosis together with direct digital restorative workflows. There will be an increase in the incidence of peri‐implantitis, although there will be more efficient interventions its treatment and prevention.
“…However, only data from preclinical studies are included in the present review. The evaluation of the clinical data has been reported in a separate manuscript (Roehling, Schlegel, Woelfler & Gahlert, ). For the MEDLINE search, the following combinations of terms were applied:“Dental implants” [MeSH] OR “dental implantation” [MeSH] AND “zirconium oxide” [MeSH] OR “yttria‐stabilized tetragonal zirconia” [MeSH] OR “zirconia” OR “zirconia implant*” OR “ceramic implant*” AND “osseointegration” [MeSH] or “bone‐implant‐interface” [MeSH] or “survival rate” [MeSH] or “success rate” or “marginal bone loss” or “soft tissue.”…”
Section: Methodsmentioning
confidence: 99%
“…ROEHLING Et aL. in a separate manuscript (Roehling, Schlegel, Woelfler & Gahlert, 2018). For the MEDLINE search, the following combinations of terms were applied: "Dental implants" [MeSH] OR "dental implantation"…”
Objectives
To evaluate whether zirconia implants demonstrate differences in hard and soft tissue integration compared to titanium implants in preclinical studies.
Material and Methods
In March 2017, electronic (MEDLINE, EMBASE) and hand search was performed to identify preclinical studies comparing zirconia and titanium implants. Primary outcomes were bone‐to‐implant contact (BIC) and removal torque out (RTQ), respectively, push‐in (PI) measurements. Secondary outcomes included biologic width (BW) dimensions.
Results
A total of 37 studies were included for data extraction after screening of 91 from 1,231 selected titles. Thirty‐seven experimental studies using six different species were identified. The follow‐up periods ranged between 0.4 and 56 weeks. For titanium, mean values of 59.1% (95% CI: 53.3 – 64.8), 102.6 Ncm (95% CI: 81.5 – 123.6), and 25.1 N (95% CI: 20.2 – 30.0) for BIC, RTQ, and PI were estimated, respectively. The mean values for zirconia were 55.9% (95% CI: 51.6 – 60.1), 71.5 Ncm (95% CI: 51.1 – 91.9), and 22.0 N (95% CI: 13.2 – 30.7) for corresponding parameters. Confounding factors such as animal species, implant material, loading protocol, and study or loading duration significantly influenced the outcomes. Similar qualitative soft tissue integration was reported for zirconia and titanium implants. However, faster maturation processes of epithelial and connective tissues around zirconia implants were assumed. Quantitatively, similar BW dimensions were evaluated for titanium (3.5 mm; 95% CI: 2.9 – 4.2) and zirconia (3.2 mm; 95% CI: 2.7 – 3.7), whereas the loading protocol significantly influenced the outcomes.
Conclusions
Zirconia and titanium implants demonstrate a similar soft and hard tissue integration capacity. However, titanium tended to show a faster initial osseointegration process compared to zirconia. Importantly, not only material characteristics but predominantly animal species and study protocols can significantly influence the outcomes.
“…Zirconia implants may well be advantageous in these situations thanks to their tooth‐like color (Elnayef et al, ; Ioannidis et al, ), and they offer the additional benefit of reduced bacterial and plaque adhesion (Cionca, Hashim, & Mombelli, ; Roehling et al, ). Anyway, their clinical use has rapidly increased in recent years due to the aforementioned growing demand for metal‐free alternatives to titanium implants, and numerous clinical and experimental studies have demonstrated excellent biocompatibility as well as promising short‐ and medium‐term outcomes (Haro Adanez, Nishihara, & Att, ; Piconi & Maccauro, ; Roehling, Schlegel, Woelfler, & Gahlert, ).…”
Objectives
To prospectively evaluate, as part of an ongoing randomized pilot trial, the clinical outcomes of two‐piece zirconia implants in comparison with titanium implants 80 months after delivery of all‐ceramic (lithium disilicate) single‐tooth restorations.
Material and methods
The original sample included 31 (16 zirconia and 15 titanium) implants in 22 healthy patients. In addition to evaluating implant survival and success, a number of clinical or radiographic parameters were statistically analyzed: plaque index (PI), bleeding on probing (BOP), pink esthetic score (PES), and marginal bone loss (MBL). Both implant groups were compared using a Mann–Whitney U test.
Results
Three implants (2 zirconia and 1 titanium) had been lost, so that 28 implants (14 zirconia and 14 titanium) in 21 patients could be evaluated after a mean of 80.9 (SD: 5.5) months. All surviving implants had remained stable, in the absence of any fixture or abutment fractures and without any chipping, fracture, or debonding of crowns. The zirconia implants were associated with PI values of 11.07% (SD: 8.11) and the titanium implants with 15.20% (SD: 15.58), the respective figures for the other parameters being 16.43% (SD: 6.16) or 12.60% (SD: 7.66) for BOP; 11.11 (SD: 1.27) or 11.56 (SD: 1.01) for PES; and 1.38 mm (SD: 0.81) or 1.17 mm (SD: 0.73) for MBL.
Conclusions
No significant differences were found between the clinical outcomes of two‐piece zirconia and titanium implants based on the aforementioned parameters after 80 months of clinical service. Our results should be interpreted with the limited sample size in mind.
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