After a mean exposure time of 10.75 years, high survival rates for reconstructions supported by Sand-blasted Large-grit Acid-etched implants can be expected. Ceramic chipping was the most frequent complication and was increased in dentitions with attrition and in FDPs compared with SCs.

BackgroundThe aim of this study was to compare the 5-year survival and success rates of 3.3 mm dental implants either made from titanium-zirconium (TiZr) alloy or from Grade IV titanium (Ti Grade IV) in mandibular implant-based removable overdentures.MethodsThe core study had a follow-up period of 36 months and was designed as a randomized, controlled, double-blind, split-mouth multicenter clinical trial. Patients with edentulous mandibles received two Straumann Bone Level implants (diameter 3.3 mm, SLActive®), one of TiZr (test) and one of Ti Grade IV (control), in the interforaminal region. This follow-up study recruited patients from the core study and evaluated the plaque and sulcus bleeding indices, radiographic crestal bone level, as well as implant survival and success 60 months after implant placement.ResultsOf the 91 patients who initially received implants, 75 completed the 36 month follow-up and 49 were available for the 60 month examination. Two patients were excluded so that a total of 47 patients with an average age of 72 ± 8 years were analysed. The characteristics and 36-month performance of the present study cohort did not differ from the non-included initial participants (p > 0.05). In the period since the 36-month follow-up examination, no implant was lost. The cumulative implant survival rate was 98.9 % for the TiZr group and 97.8 % for the Ti Grade IV group. Crestal bone level changes at 60 months were not different in the test and control group (TiZr −0.60 ± 0.69 mm and Ti Grade IV −0.61 ± 0.83 mm; p = 0.96). The cumulative implant success rate after 60 months was 95.8 and 92.6 % for TiZr and Ti Grade IV, respectively.ConclusionsAfter 60 months, the positive outcomes of the 36 month results for TiZr and Ti Grade IV implants were confirmed, with no significant differences with regard to crestal bone level change, clinical parameters and survival or success rates. TiZr implants performed equally well compared to conventional Ti Grade IV 3.3 mm diameter-reduced implants for mandibular removable overdentures.Trial registrationRegistered on www.clinicaltrials.gov: NCT01878331

First-generation zirconia implants showed low overall survival and success rates. The evaluated clinical and radiographic parameters were consistent with healthy peri-implant tissues. Additionally, nonfractured failures were not associated with peri-implant infections.

Implant therapy has evolved into an important part of daily dental practice. Appropriate knowledge of diagnostic and therapeutic options with dental implant therapy is, therefore, mandatory for dental students. The present consensus paper describes the theoretical knowledge as a foundation to the teaching of implant dentistry at the undergraduate level. Students need a solid basic knowledge about biological prerequisites and clinical procedures leading to successful implant treatment and, in particular, an understanding of the importance of embedding implants into the overall treatment concept. Among others this includes aspects of bone and soft tissue integration of dental implants, as well as aspects of materials that are used in implant dentistry. The students should also be able to differentiate between low, medium and high‐risk situations, which assumes that they have knowledge about a proper clinical examination. Furthermore, the students need to be able to inform the patient about the different treatment options and their advantages and disadvantages. Frequently, a choice has to be made between an FDP anchored on teeth and an implant‐borne reconstruction. This is highly influenced by the long‐term prognosis of the different treatment options. In order to perform implant placement in uncomplicated cases and to give appropriate patient information, adequate knowledge of surgical procedure and surgical complications is mandatory. Furthermore, the dentist needs to be competent in evaluating clinical situations and in advising patients about the suitability of the different options, e.g. removable or fixed reconstructions. It is possible that peri‐implant tissue destruction may be a more common finding during long‐term service of implant‐borne reconstructions than was previously believed. The dentist needs knowledge about etiology and pathogenesis of peri‐implantitis and should know how to provide an effective maintenance care programme. In cases of peri‐implantitis the student should be knowledgeable regarding suitable interventions.

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