Ceramic Implant Rehabilitation: Consensus Statements from Joint Congress for Ceramic Implantology.

The objectives of the study group focused on the following main topics related to the performance of one- and two-piece ceramic implants: defining bone-implant-contact percentages and its measurement methods, evaluating the pink esthetic score as an esthetic outcome parameter after immediate implantation, recognizing the different results of ceramic implant designs, as redefined by the German Association of Oral Implantology, incorporating the patient report outcome measure to include satisfaction and improvement in oral health-related quality of life, and conducting preclinical studies to address existing gaps in ceramic implants. During the Joint Congress for Ceramic Implantology (2022), the study group evaluated 17 clinical trials published between 2015 and 2021. After extensive discussions and multiple closed sessions, consensus statements and recommendations were developed, incorporating all approved modifications. A one-piece implant design features a coronal part that is fused to the implant body or interfaces with the post-abutment restoration platform, undergoing transmucosal healing. Long-term evaluations of this implant design have been supported by established favorable clinical evidence. Inaccuracies in the pink esthetic score and bone-implant-contact percentages were managed by establishing control groups for preclinical studies and randomizing clinical trials. The patient-reported outcome measures were adjusted to include an individual visual analog scale, collected from each clinical study, that quantified improved oral health and quality of life. Preclinical investigations should focus on examining the spread of ceramic debris and the impact of heat generation on tissue and cellular levels during drilling. Further technical advancements should prioritize wound management and developing safe drilling protocols.

Does placement of one-piece zirconia implants influence crestal bone loss? Retrospective evaluation 1 year after prosthetic loading.

PURPOSE: To evaluate the impact of immediate and delayed zirconia implant placement on crestal bone loss and the clinical outcomes achieved with this approach 1 year after prosthetic loading. Further objectives were to evaluate the influence of age, sex, smoking, implant dimensions, platelet-rich fibrin application and location of the implants in the jawbone on the crestal bone level. MATERIALS AND METHODS: Clinical and radiographic analysis were performed to evaluate the success rates for both groups. The data were analysed statistically through a linear regression analysis. RESULTS: No significant difference was found between immediate and delayed implant placement concerning the amount of crestal bone loss. Sex, age, bone augmentation, diabetes and prosthetic complications did not have a statistically significant influence; only smoking had a negative and statistically significant influence on crestal bone loss (P < 0.05). CONCLUSIONS: Immediate or delayed placement of one-piece zirconia implants may be a good alternative to the use of titanium implants concerning success and survival.

Interaction of Telomere Length and Inflammatory Biomarkers Following Zirconia Implant Placement: A Case Series.

Zirconia implants have gained popularity for their aesthetic appeal and biocompatibility, making them a preferred choice for anterior teeth replacement. This study explores the interaction between telomere length and inflammatory biomarkers in seven cases of zirconia implant placement to gain insights into postoperative cellular aging, inflammatory responses, and long-term outcomes. Zirconia implants offer advantages over titanium implants, as they do not corrode or release metal ions, leading to potential inflammation and implant failure. Monitoring immune and inflammatory biomarkers is essential to assess inflammation initiation, severity, and progression. C-reactive protein (CRP) and pro-inflammatory cytokines, like interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), play crucial roles in host immune responses, while anti-inflammatory cytokines, including interleukin-10 (IL-10), regulate and dampen immune responses. Achieving a delicate balance between pro- and anti-inflammatory cytokines is vital for maintaining a healthy immune response and preventing chronic inflammatory conditions. Telomeres, protective structures present at chromosome ends, influence cellular aging and mitochondrial function. Shorter telomeres are associated with impaired mitochondrial function, increased oxidative stress, and cellular senescence, while longer telomeres are linked to reduced inflammation and improved immune function. Understanding these mechanisms is essential for addressing age-related conditions and promoting overall well-being. In this case series, we investigated the interaction between telomere length and inflammatory biomarkers in patients who received zirconia dental implants. The study aims to improve our understanding of postoperative cellular aging, inflammatory responses, and the biocompatibility of zirconia implants, potentially leading to improved treatment protocols and patient outcomes. This innovative assessment of telomere length and inflammatory biomarkers in the context of zirconia implants provides novel insights into the field of dental implantology. By exploring the effects of zirconia implants on cellular health and inflammation, this study contributes to advancements in implant technology and patient care.

Success and patient satisfaction of immediately loaded zirconia implants with fixed restorations one year after loading.

BACKGROUND: There is limited evidence for the use of zirconium dioxide implants in immediate implant placement as well as for related immediate loading protocols. The aim of this retrospective study was to investigate the survival rate, success and patient satisfaction of immediately placed zirconia implants compared to delayed placed implants. METHODS: The study included 58 partially edentulous patients who were treated between 2013 and 2015 with immediate and delayed transgingival healing zirconium dioxide implants (SDS, Kreuzlingen/ Switzerland). In addition to survival and success rate, marginal bone loss was assessed using radiographs and soft tissue was evaluated using Pink Esthetic Score. Oral health-related quality of life was investigated prospectively using a modified OHIP questionnaire. RESULTS: The cumulative survival rate of all implants included was 92% with 88% classified as full success. No significant difference was found between the bone levels of immediately and delayed placed and immediately and delayed loaded implants. The mean Pink Esthetic Score after final prosthetic rehabilitation was 12.2/14 points indicating excellent esthetic clinical results. Analysis of the OHIP questionnaire showed a mean value of 0.54/100 points reflecting a high patient satisfaction. CONCLUSIONS: Immediate and delayed placed as well as loaded zirconium dioxide implants showed excellent results regarding implant success and survival in this study. Zirconium dioxide implants may ensure excellent esthetic results and high patient satisfaction.

Implantes cerâmicos - evidências científicas para o seu uso / Ceramic implants - scientific evidence for its use

A cerâmica de zircônia (ZrO) vem sendo objeto de muitas pesquisas biomédicas pela excelente biocompatibilidade e estabilidade química. Nos últimos anos tem sido utilizada como uma opção aos implantes dentários metálicos, principalmente pelas qualidades estéticas e periointegração. O propósito desta revisão bibliográfica é destacar as características das cerâmicas Y-TZP (zircônia tetragonal policristalina estabilizada com ítria) e ATZ (zircônia tenacificada por alumina), citando algumas limitações do uso como materiais alternativos na Implantodontia, baseadas em evidências científicas. Muitas pesquisas in vitro e in vivo demonstraram que as cerâmicas Y-TZP apresentam vantagens estéticas e biológicas sobre outros biomateriais. Os valores de resistência à fratura são clinicamente aceitáveis, sendo mais elevados nos compósitos ATZ. Alguns testes de carga cíclica com implantes dentários ATZ mostraram resistência igual ou superior aos de titânio (Ti). Novos tratamentos de superfície na cerâmica estão abreviando o tempo de cura, possibilitando carga imediata. Os experimentos com animais confirmaram o bom potencial de osseointegração das cerâmicas, com quantidade de BIC equiparável ao Ti e com menor acúmulo de biofilme. Estudos de até 5 anos com implantes dentários Y-TZP de peça única em humanos apresentaram índices de sucesso de 84,4 a 100%, enquanto que a taxa de sobrevida em 7 anos com ATZ foi de 99%. Apesar dos bons resultados com implantes dentários Y-TZP e ATZ, os autores sugerem cautela nas indicações e mais estudos prospectivos de longo prazo.

Ceramic zirconia (Zr02) has been the subject of many biomedical researches due to its excellent biocompatibility and chemical stability. In recent years it has been used as an alternative to metallic dental implants, and mainly for its aesthetic periointegration qualities. The purpose of this literature review was to evaluate some of the characteristics of ceramic Y-TZP (tetragonal zirconia polycrystalline yttria stabilized) and ATZ (zirconia toughened alumina), pointing its limitations of use as alternative materials in Implantology. Many in vitro and in vivo studies have demonstrated that the ceramics Y-TZP exhibit aesthetic and biological advantages over other biomaterials. The values of fracture toughness are clinically acceptable, being higher in ATZ composites. Some cyclic loading tests with ATZ dental implants showed resistance equal or superior to titanium (Ti). New surface treatments for ceramics have shortened the cure time, allowing immediate loading. Animal experiments have confirmed the good potential for osseointegration of ceramic, with the amount of BIC comparable to Ti and less accumulation of biofilm. Studies up to 5 years with dental implants Y-TZP one-piece in humans have success rates between 84.4 and 100%, whereas the survival rate in 7 years with ATZ implants was 99%. Despite the good results with the ceramic Y-TZP and ATZ, the authors suggest caution in their indications and further long-term prospective studies are required.