Clinical Longevity of Zirconia Implants with the Focus on Biomechanical and Biological Outcome PDF Download

Author: Ralf-Joachim Kohal
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Book Description
Abstract: Purpose of Review The goal of the present review is to update the reader on the scientific background of zirconia ceramic implants. Clinical investigations using zirconia ceramic implants over the last couple of years have brought up some new developments and questions. Can we be confident in placing zirconia ceramic implants given the recently published data? Is there a difference in the application of one- and two-piece implants? Recent Findings Systematic reviews on preclinical investigations of zirconia implants revealed that one-piece zirconia implants (> 4 mm) are sufficiently stable for clinical use. The same is true for some clinically available two-piece implant systems. Osseointegration and soft tissue integration are, according to the reviews, similar between titanium and zirconia implants with similar surface topographies. Regarding the clinical outcome, a meta-review exists evaluating systematic reviews. The findings of the systematic reviews and the meta-review are that there are good short-term clinical results for one-piece zirconia implants. However, the data for two-piece implants is not robust. Summary In certain applications (single tooth restorations and small bridges), the results of zirconia implants are comparable with titanium implants in short-term studies. Some mid-term investigations support the short-term results. However, according to the current scientific data available, zirconia implants cannot yet be considered an alternative to titanium implants because there are many areas where there is a lack of clinical studies on zirconia implants. Currently, they are an addendum to the titanium implant armamentarium for situations where they are useful (patient request, known hypersensitivity to titanium, or questions of esthetics when titanium might appear inappropriate for a certain situation/condition), but long-term studies are needed. Without a doubt, there is a need for two-piece zirconia implants, but limited research exists to support their clinical use at the moment

Author: Georgios E. Romanos
Publisher: John Wiley & Sons
ISBN: 1119807034
Category : Medical
Languages : en
Pages : 596

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Book Description
Comprehensive, multidisciplinary approach to all aspects of dental implant maintenance, based on treatment outcomes Saving Dental Implants offers a complete reference to all factors in long-term success in dental implants. Taking an interdisciplinary approach, each chapter is written by leading experts in the field. The book examines treatment outcomes, provides advice on how to manage implants for long-term success, and supports clinicians in avoiding and managing peri-implant complications. The text presents global treatment approaches and concepts—established philosophies in practice for the last 20 years—and also looks to possible future management strategies. Designed to help clinicians apply the concepts in practice, the text also covers the pros and cons of implant therapy and the specifics of pre-implant diagnostics, treatment methodology, prosthetic concepts, and further maintenance visits. Featuring hundreds of high-quality color photographs to support the text, Saving Dental Implants covers topics such as: The anatomic features of peri-implant tissues, including clinical and histological information, and an evaluation of the studies using different implant systems and prosthetic concepts Diagnostic tools and procedures to make the proper diagnosis of peri-implant conditions, and microbiota of the peri-implant tissues and diagnostic opportunities for bacterial diagnosis Nanoparticles found in the peri-implant tissues from the implant placement, their loading, and their impact on peri-implant diseases The significance, applications, and limitations of bone grafting techniques to optimize the shape of the alveolar ridge New technologies for better treatment of peri-implant complications Examining the most current information and research on diagnosing, preventing, and managing peri-implant complications, Saving Dental Implants is a must-have practical reference for dental practitioners, specialists, and students who wish to help patients reach the best functional and esthetic outcomes.

Author: Nishihara Hironobu
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Background (500)Despite biocompatibility and excellent clinical outcome of titanium implants, a growing interest for an alternative implant material is noticeable. This is mostly due to patient-specific requests for metal-free treatment and concerns about adverse reactions titanium particle corrosion. Therefore, manufacturers are increasingly introducing zirconia implants with different features and designs. While most systems offer one-piece implant design, little is known about the applicability and features of two-piece implants.Aim of the study (300)This review aimed to summarize the preclinical knowledge about two-piece zirconia implant systems. Focus was given on design features, mechanical resistance of the implants and of the implant-restoration complex as well as peri-implant tissue response.Material and Methods (1000)An electronic search of the literature until March 2017 was performed to identify all articles related to preclinical research on two-piece zirconia implant systems. The search was conducted using MEDLINE (National Library of Medicine), Pubmed without restrictions concerning the date of publication. The search terminology included: zirconia implant, two-piece, mechanical properties, fracture resistance, strength, osseointegration, bone-to-implant contact, soft tissue, histology, histomorphometry (connecting different keywords with AND, OR). Hand-searching of the bibliographies of all full-text articles and related reviews, selected from the electronic search, was also performed. The literature search was limited to only English language articles. References appraised in related systematic reviews were also considered.Results (1000)Of the initially-identified 1026 titles, 58 papers were selected for full-text evaluation. After exclusion 53 articles, a total of 6 article were finally selected and analysed. The mechanical resistance was evaluated in 4 studies, where a clinical situation of implants placed in the anterior region was simulated. Interestingly, most studies used titanium abutment screws for evaluation. Irrespective of connection type (screw- or cement-retained), implant fractures were mostly reported in the implant-abutment connection, with the weakest component to be abutment screw, abutment and implant, respectively. In general, two-piece zirconia implant systems showed higher failure rates and lower resistance than one-piece zirconia implants as well as titanium implants.Peri-implant tissues were evaluated in 2 studies. Regardless of implant type (one- or two-piece), a significant marginal bone loss was recorded 6months after placement (0.19-1.11mm). The height of buccal peri-implant mucosa and bone-to-implant contact ranged, respectively, between 2.64-3.03mm and 78.6-87.9% with no statistically significant differences at follow-up evaluations.Conclusion and Clinical implications (500)Irrespective of connection type and the design, two-piece zirconia implants show sufficient strength to withstand normal forces applied in the anterior region. Hard and soft tissue response around two-piece zirconia implants seem to be similar to one-piece implants as well as titanium implants. Although they have the potential for clinical application, the limited knowledge about two-piece zirconia implants does not support their clinical application yet.

Author: Yusuke Hamada
Publisher:
ISBN:
Category :
Languages : en
Pages : 82

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Book Description
Currently titanium implant fixtures are considered as a gold standard because of their biocompatibility and their clinical success rates have been well documented. The esthetic outcome of restorations supported by titanium implants may be compromised if the dark gray color of the implant shows through a thin peri-implant mucosa or if the implant fixture becomes visible following soft tissue recession. Also titanium might cause allergic reactions. For these reasons, zirconia implants have been considered as alternative materials because of their white color, high material properties and biocompatibilities. Still, further investigations are necessary to confirm the in-vivo performance of these implants. Purpose: The purpose of this study is to determine the histomorphometric and biomechanical properties of zirconia implants manufactured by Shofu Inc. with a sand-blasted and acid-etched surface treatment, compared to that of the titanium implants from the same manufacturer with a sand-blasted and acid-etched surface treatment in a canine model. Material and Methods: Six beagle dogs (1-2 years old) will be used in this split mouth trial. After 8 weeks following extraction of the second to fourth mandibular premolars, zirconia implants (experimental group) and titanium implants (control group) were placed on the each side of mandible. At 8 weeks and 12 weeks after implant placement, the animals were sacrificed, and implants were removed in block sections, and histological and histomorphometric analyses were measured. Specifically, the bone-implant contact (BIC), bone area (BA), removal torque (RTQ), mineral apposition rate (MAR), bone forming area (BFA), and Periotest value (PTV) of the two groups were studied and compared. Results: At 12 weeks post operatively, one Shofu thread type Ti implant were not integrated. Over all failure implant was 0/12 in zirconia group, and 1/12 in titanium group. In 8 weeks samples, only statistical differences were higher BA (p=0.02) in macro threads area and BFA (p=0.02) in zirconia implants group than titanium implants group. In 12 weeks group, zirconia implant group showed higher MAR at 9-10 and 10-11weeks time frame (p=0.02, and 0.04 restectively), and PVT value (p=0.01) than titanium implants group. Removal torque value increased in both titanium and zirconia group with time. Average of removal torque value showed higher in titanium implants than zirconia implants, but the differences were not statistically significant in both 8 weeks (Ti; 64.16±16.93 N-cm, ZrO2: 42.5±6.01 N-cm : p=0.247) and 12 weeks (Ti; 82.5±9.41 N-cm, ZrO2: 51.3±19.38 N-cm: p=0.16). In the removal torque analysis, it is observed that the bone-implant interface seems to be of more rigid and brittle in nature as indicated by the lower averaged onset angle, peak angle, area under curve and RTQ. Conclusion: Zirconia implants group showed higher value of BA with macro thread and BFA in 8weeks and MAR at 9-10, 10-11 weeks period, and PVT in 12 weeks post operatively. Within the limited number of samples tested in this study, there is no difference between the BIC and RTQ of zirconia and titanium implants after 8 and 12 weeks of implantation.

Author: Anina Zu00fcrcher
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Background: Implant-overdentures (IODs) supported by titanium bars improve stability and comfort in edentulous patients being unsatisfied with their complete dentures. Todayu2019s computer-assisted design/computer-assisted manufacture (CAD/CAM) technology allows for fabrication of bars made from titanium but also from zirconium dioxide (ZrO). However, ZrO bars have not been in clinical use on a standard basis. Thus, scientific data with focus on ZrO bar reliability and peri-implant bone resorption are missing.Aim/Hypothesis: To report on the clinical short-term outcomes of CAD/CAM ZrO bars and respective mandibular IODs, and on the radiographical crestal bone level changes after 12-months. The null-hypothesis was that the bar fracture rate would be 5% and no significant crestal bone resorption would occur.Materials and Methods: Fifteen edentulous patients (53% men) with a mean age of 62 years were treated with a total of 30 implants, i.e. two interforaminal standard diameter implants (NobelReplace Select RP) per patient. After a healing time of six weeks, all patients received a mandibular IOD supported by a CAD/CAM ZrO bar milled from one homogenous block. All bars had a rigid design (Dolder) with bilateral 7mm extensions and were retained with 35Ncm directly on the implant, using a specific screw, and without titanium base at the interface. Female parts in the IOD were prefabricated gold attachments. The maxilla was rehabilitated with a complete denture and a lingualised occlusion concept was applied. Panoramic radiographs were taken at delivery and at the one year appointment. Prosthetic complications such as bar fractures and the need for maintenance service of the anchorage system, as well as biological outcomes including implant survival and crestal peri-implant bone level changes were recorded.Resultats: All the 30 implants osseointegrated without complications and were successfully in use at the 12-months recalls. One patient showed generalised hyperplasia of the mucosa around the bar. Radiographic measurements of the crestal bone resorption at mesial and distal implant sites revealed bone level changes of -2.9mm to +1.4mm (mean +0.2mm) after 12 months. While 10% percent of the sites showed bone levels with an increase of 1mm and 62% between 0 and 1mm, 27% had a loss of maximally 1mm and one site was measured -2.9mm without clinical signs of inflammation. All the 15 ZrO bars and corresponding IODs were successfully in use without fracture or any technical complications. No special maintaining service was recorded other than removal of superficial bar discoloration at lingual sites.Conclusions and Clinical Implications: None of the 15 ZrO bars and IODs showed a fracture or a prosthetic complication after 12 months. Survival and success rate of the 30 implants were 100% with stable crestal bone levels. These short-term results of this prospective study showed that the use of ZrO bar with its unique biocompatibility and, due to its white colour, easiness to perform and control good cleansability for elder patients is possible with a high predictability and without technical or biological complications.

Author: Sangwon Park
Publisher: Mdpi AG
ISBN: 9783036578156
Category : Science
Languages : en
Pages : 0

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Book Description
This reprint provides a comprehensive overview and critically explores the recent trends in the zirconia additive manufacturing process or 3D printing and various surface treatments and their characterization for application in the dental and biomedical fields. It will be a valuable resource for the researchers to design or fabricate the implants according to clinical demands.

Author: Ralf-Joachim Kohal
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Abstract: Mid-term data on zirconia oral implants is very rare. Therefore, the aim of this prospective clinical investigation was to evaluate the survival rate and the marginal bone loss of a one-piece zirconia implant after five years. Patient-reported outcomes were also recorded. Zirconia implants to support single crowns (SC) or a 3-unit fixed dental prosthesis (FDP) were placed and subsequently restored. After the insertion of the implants, at prosthetic delivery, and after five years, standardized radiographs were taken to evaluate marginal bone loss (MBL). For bone tissue evaluation, linear mixed models with random intercepts were fitted. Twenty-seven patients received one implant for an SC and 13 patients received two implants for a 3-unit FDP. Three patients each lost one implant for an SC before prosthetic delivery. Thirty-five patients were seen after five years, and no further implant was lost. The cumulative five-year implant survival rate was 94.3%. The MBL from implant installation up to five years was 0.81 mm. The MBL from implant installation to prosthetic delivery was statistically significant (p

Author: Lynne C. Jones
Publisher: Springer
ISBN: 9781461490005
Category : Technology & Engineering
Languages : en
Pages : 200

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Book Description
This book addresses the background and significance of the factors potentially influencing the clinical and biological outcomes of metal-on-metal hip implants. Metal-on-metal bearings were introduced and evaluated as an alternative to other bearing couples, particularly metal-on-polyethylene, due to their enhanced wear resistance as determined in laboratory testing. Initially, reports of short-term clinical outcomes were favorable and an increasing number of metal-on-metal prostheses were implanted. Subsequently, isolated case findings describing adverse tissue responses around the articulation became the harbinger of an increasing number of reports describing pseudotumors and other significant lymphocytic-based responses associated with metal-on-metal prostheses. Questions have been raised as to whether this is an implant, design, or patient-specific response. The reasons why some patients have a negative biological response and pathology while others do not remain to be determined, but tens of thousands of patients in the US, the UK, and around the world are considered to be at risk. Leading researchers and clinicians describe the issues related to the nature of the biological and pathological responses and the protocols that should be followed to determine if an adverse response is occurring. This book is essential reading for researchers, engineers, and orthopaedic surgeons who are involved in the design, evaluation, and implantation of metal-on-metal prostheses.

Author: Manfred Rühle
Publisher:
ISBN:
Category : Ceramics
Languages : en
Pages : 866

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Author: Costas Sikalidis
Publisher: BoD – Books on Demand
ISBN: 9533073500
Category : Science
Languages : en
Pages : 566

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Book Description
The current book consists of twenty-four chapters divided into three sections. Section I includes fourteen chapters in electric and magnetic ceramics which deal with modern specific research on dielectrics and their applications, on nanodielectrics, on piezoceramics, on glass ceramics with para-, anti- or ferro-electric active phases, of varistors ceramics and magnetic ceramics. Section II includes seven chapters in bioceramics which include review information and research results/data on biocompatibility, on medical applications of alumina, zirconia, silicon nitride, ZrO2, bioglass, apatite-wollastonite glass ceramic and b-tri-calcium phosphate. Section III includes three chapters in applications of ceramics in environmental improvement and protection, in water cleaning, in metal bearing wastes stabilization and in utilization of wastes from ceramic industry in concrete and concrete products.