27 May 2024

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Zirconium implants: evaluation of the long-term success of different implant designs

Lara Figini

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Zirconium dental implants have survival and success rates (acceptable and comparable to titanium implants) that reach 95% after the first year, then decreasing by 0.05% annually in the following 5 years. Currently, several zirconium implant design alternatives are available: one-piece implants (OPI) and two-piece implants (TPI) with varying diameters, lengths, and surface roughness.

In general, the OPI design consists of the endosseous screw and abutment, which form a single piece, while the TPI design has the abutment separated from the implant screw, with different implant-abutment connections that can be cemented, screwed or the combination of both . However, over time, these connections can present marginal infiltrations, plaque accumulation and mechanical complications in the joint interface, which can be avoided by using OPIs. The OPI design reduces the risk of issues associated with the contact area within the interface between the fixture and the abutment, therefore, zirconium OPIs are currently more commonly used and recommended for this very reason with promising results. Because zirconium dental implants represent a relatively new treatment alternative to equivalent Ti implants, there is insufficient evidence as to which zirconium dental implant model has the best clinical outcome. Therefore, it is essential to evaluate the clinical outcomes of each type of zirconium dental implant to determine which design offers the best predictability of treatment.

Materials and methods

In a systematic review, published soon in the Journal of Dentistry, the authors evaluated the clinical outcome of different zirconium dental implant designs. This systematic review adhered to the PRISMA checklist and followed the PICO protocol. The search was conducted in March 2023 across four databases (PubMed, Web of Science, Cochrane Library and Google Scholar) using a pre-established search strategy. Three authors screened titles and abstracts and selected relevant studies. From a total of 2728 titles, 71 full-text studies were selected of which 27 studies were considered, the risk of bias was assessed (ROBINS-I tool) and data extraction was performed. After quality assessment, four studies were included and the remaining 23 excluded studies were described narratively.

Results

The included prospective studies with moderate risk of bias reported success and survival rates of one-piece zirconia implants ranging between 95 and 98.4% with no statistically significant difference between different lengths and diameters. The acidified rough surface showed higher clinical results than other types of surface roughness.

Conclusions

From the data of this review, which must be confirmed in other similar studies and reviews, it can be concluded that there are promising clinical results at 5 years for monobloc zirconium implants without differences between different diameters and lengths. Regarding surface roughness, better results were found using the acidified implant surface.

For info: Zirconia dental implants; the relationship between design and clinical outcome: A systematic review. Abdulaziz Gul, Evaggelia Papia, Aron Naimi-Akbar, Amund Ruud, Per Vult von Steyern

Source: https://doi.org/10.1016/j.jdent.2024.104903