Papilla‐Crown Height Dimensions around Zirconium Dioxide Implants in the Esthetic Area: A 3‐Year Follow‐Up Study

Kniha, Kim; Schlegel, Karl Andreas; Kniha, Heinz; Modabber, Ali; Neukam, Friedrich Wilhelm; Kniha, Kristian

doi:10.1111/jopr.12766

Cited by 10 publications

(7 citation statements)

References 23 publications

(48 reference statements)

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“…Titanium implants are considered the gold standard for dental implantology, due to sufficient long-term data [ 11 ]. Conversely, zirconia implants are considered an alternative implant material because of their comparable osseointegration potential and natural teeth color matching [ 12 , 13 , 14 ]. However, because of the novelty of zirconia, there is currently a lack of valuable long-term data in the literature.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Implant Geometry and Primary Stability in Different Bony Defects and Variant Bone Densities: An In Vitro Study

et al. 2020

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Aim: This in vitro study aimed to evaluate the effects of implant designs on primary stability in different bone densities and bony defects. Methods: Five implant types (tapered-tissue-level, tissue-level, zirconia-tissue-level, bone-level, and BLX implants) were used in this assessment. The implants were inserted into four different artificial bone blocks representing varying bone-density groups: D1, D2, D3, and D4. Aside from the control group, three different types of defects were prepared. Using resonance frequency analysis and torque-in and -out values, the primary stability of each implant was evaluated. Results: With an increased defect size, all implant types presented reduced implant stability values measured by the implant stability quotient (ISQ) values. Loss of stability was the most pronounced around circular defects. Zirconia and bone-level implants showed the highest ISQ values, whereas tissue level titanium implants presented the lowest stability parameters. The implant insertion without any thread cut led to a small improvement in primary implant stability in all bone densities. Conclusions: Compared with implants with no peri-implant defects, the three-wall and one-wall defect usually did not provide significant loss of primary stability. A significant loss of stability should be expected when inserting implants into circular defects. Implants with a more aggressive thread distance could increase primary stability.

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Section: Introductionmentioning

confidence: 99%

Relationship between Implant Geometry and Primary Stability in Different Bony Defects and Variant Bone Densities: An In Vitro Study

et al. 2020

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“…Four studies reported on the height of the papilla. Three studies measured soft tissue thickness (Bösch et al., 2018; Chang & Wennström, 2013; Chang et al., 1999) and one determined the phenotype (Kniha et al., 2019). The mean follow‐up time ranged between 18 months and 8.9 years.…”

Section: Resultsmentioning

confidence: 99%

The influence of thin as compared to thick peri‐implant soft tissues on aesthetic outcomes: A systematic review and meta‐analysis

Bienz

Pirc

Papageorgiou

et al. 2022

Clinical Oral Implants Res

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Objectives In systematically healthy patients with an implant‐supported fixed restoration (P), what is the influence of thin (E) as compared to thick (C) peri‐implant soft tissues on aesthetic outcomes (O)? Methods Following an a priori protocol, a literature search of six databases was conducted up to August 2020 to identify prospective/retrospective clinical studies on healthy patients with an implant‐supported fixed reconstruction. Measurement of the buccal soft tissue thickness and an aesthetic outcome was a prerequisite, and sites presenting with a buccal soft tissue thickness of <2 mm or shimmering of a periodontal probe were categorized as a thin phenotype. After study selection, data extraction, and risk of bias assessment, random‐effects meta‐analysis of Mean Differences (MD) or Odds Ratios (OR) with their corresponding 95% Confidence Intervals (CI) were conducted, followed by sensitivity analyses and assessment of the quality of evidence. Results Thirty‐four unique studies reporting on 1508 patients with 1606 sites were included (9 randomized controlled trials, one controlled trial, 10 prospective cohort studies, 8 cross‐sectional studies, and 6 retrospective cohort studies). The mean difference of the pink aesthetic score (PES) after the follow‐up was not significantly different between thin (<2.0 mm) or thick soft tissues (≥2.0 mm) or phenotypes (12 studies; MD = 0.15; [95% CI = −0.24, 0.53]; p = .46). PES changes during the follow‐up, however, were significantly in favour of thick soft tissues (≥2.0 mm) or phenotypes (p = .05). An increased mean mucosal thickness was associated with an increased papilla index (5 studies; MD = 0.5; [95% CI = 0.1, 0.3]; p = .002) and an increase in papilla presence (5 studies; OR = 1.6; [95% CI = 1.0, 2.3]; p = .03). Thin soft tissues were associated with more recession, −0.62 mm (4 studies; [95% CI = −1.06, −0.18]; p = .006). Patient‐reported outcome measures (patient satisfaction) were in favour of thick soft tissues −2.33 (6 studies; [95% CI = −4.70, 0.04]; p = .05). However, the quality of evidence was very low in all instances due to the inclusion of non‐randomized studies, high risk of bias and residual confounding. Conclusion Within the limitations of the present study (weak study designs and various soft tissue measurements or time‐points), it can be concluded that increased soft tissue thickness at implant sites was associated with more favourable aesthetic outcomes.

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“…[10][11][12][13] Long-term studies on novel zirconium dioxide implants are scarce, although the initial clinical results were promising. 14 Materials with low affinity values for bacteria could minimize the risk of implant bed inflammation, jaw necrosis, or faulty osseointegration in patients with antiresorptive medications. Clever et al showed that the soft tissue around titanium implants clinically developed a stronger inflammatory response to experimental plaque accumulation compared with that around zirconia implants.…”

Section: Introductionmentioning

confidence: 99%

“…Titanium implants are the gold standard with a high amount of long‐term data, whereas zirconia has recently become an alternative implant material 10–13 . Long‐term studies on novel zirconium dioxide implants are scarce, although the initial clinical results were promising 14 …”

Section: Introductionmentioning

confidence: 99%

Microstructural volumetric analysis of the jaw following dental implantation under systemic bisphosphonate delivery: An in vivo and ex vivo rat study

Kniha

Peters

Magnuska

et al. 2020

Journal of Periodontology

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Background: Because of bisphosphonate medication, dental implantation with a subsequent infection poses a relevant risk factor to suffer from medicationrelated osteonecrosis of the jaw. This rat study evaluated different implant materials under systemic bisphosphonate delivery using micro-computed tomography (μCT) images. Methods: Fifty-four rats were randomly allocated into a control group 1, test group 2 with intravenous drug application of zoledronic acid and test group 3 with a subcutaneous application of alendronic acid. After 4 weeks of drug delivery, the first molar on each side of the upper jaw was extracted, and either a zirconia or a titanium implant was immediately inserted. Radiological examinations at four timepoints before the operation, 1 week later, 6 weeks later and after 12 weeks of follow up included μCT measurements of the in vivo peri-implant bone loss. μCT measurements of the ex vivo peri-implant bony structure after 12 weeks follow-up covered the bone mineral density, -volume, -trabecular thickness and -separation. Results: Both test groups showed a significant increase in bone loss over time (P < 0.05). The clinical observations of exposed bone revealed that most cases occurred under alendronic acid delivery. Exposed bone was recorded only in the test groups around both titanium and zirconia implants. Regarding the periimplant bony structure, no significant differences were found between both materials. Conclusions: Systemic bisphosphonate delivery led to increased peri-implant bone loss over time after immediate implant insertion. In terms of bone resorption and bone quality parameters, no implant material was superior to the other.

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Papilla‐Crown Height Dimensions around Zirconium Dioxide Implants in the Esthetic Area: A 3‐Year Follow‐Up Study

Abstract: An ideal papilla-crown proportion of 40% around single implants was observed after 3 years. A thin or thick gingival biotype showed a very weak correlation with soft tissue alterations.

Cited by 10 publications

References 23 publications

Relationship between Implant Geometry and Primary Stability in Different Bony Defects and Variant Bone Densities: An In Vitro Study

Relationship between Implant Geometry and Primary Stability in Different Bony Defects and Variant Bone Densities: An In Vitro Study

The influence of thin as compared to thick peri‐implant soft tissues on aesthetic outcomes: A systematic review and meta‐analysis

Microstructural volumetric analysis of the jaw following dental implantation under systemic bisphosphonate delivery: An in vivo and ex vivo rat study

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