Multiple restoration with two-piece zirconia implants

In issue 1-2021 of the magazine ceramic implants, Dr. Gernot Obermair is featured with a technical article on the topic of “Multiple restoration with two-piece zirconia implants”:

In the early days of implant dentistry there was a strong focus on osseointegration to make sure that the implants stayed in the bone for a long time. In recent years, the focus has shifted to soft-tissue integration and different prosthetic components to realise long-term aesthetic results with healthy gingiva and stable tissue levels. However, the increased complexity of the solutions and the phenomenon of peri-implantitis has created a lot of challenges for current systems, jeopardising their long-term success. The implant system inserted in following clinical case (Patent™ Dental Implant System, Zircon Medical) has a patented surface and is significantly rougher than other systems. Also, it’s integrated abutment eliminates a micro-gap and the high-tech glass fibre post offers effective retention and load distribution for the superstructure. In addition, the implant system’s success is backed by clinical long-term follow-up.1 Studies indicate that the survival rates of ceramic implants are on par with titanium implants, and that stable marginal bone levels as well as soft-tissue integration are superior to titanium implants.2, 3 These properties lead to complete biointegration of the implant system.

Initial situation

A 59-year-old male patient with partial edentulism asked for dental implants. Teeth had been extracted more than one year prior to implant placement due to periodontitis. Implants were planned in regions 15, 24, 25, 26 and 36. Bone quality was D3 in region 24–26 and D2/D3 in region 15 and 36. The implant selection is presented in Table 1. Pretreatment Teeth were extracted and socket preservations with PRGF (plasma rich in-growth factors) were carried out. No further bone augmentation procedures were performed. Gentle periodontal treatment was performed successfully on the remaining teeth. A titanium stimulation test was done, which revealed significant inflammatory values with regard to titanium particles. As a result, a metal-free solution (Patent™, Zircon Medical) was selected for the patient. A treatment plan was then developed  and surgical guides were fabricated to allow precise flapless surgery.

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The full article is featured in the magazine ceramic implants.

Teaser photo: Dr. Gernot Obermair

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