Titanium vs ceramic single dental implants in the anterior maxilla: A 12‐month randomized clinical trial

Abstract

Objective The aim of this randomized clinical trial was to compare ceramic and titanium implants with respect to the esthetic and clinical parameters, and patient‐reported outcome measures (PROMs). Material and methods Thirty patients received thirty implants (8–12 mm in length, 3.3 mm diameter, and a tissue level design) to replace single teeth in the anterior maxilla. Patients were randomly allocated to receive a ceramic or a titanium implant. Esthetic, clinical parameters, and PROMs were evaluated 18 months after surgery. Results At 12 months post‐final loading, there were no significant differences between groups with respect to esthetics. Mean Index Crown Aesthetic score was 6.31 (95% C.I. 4.59–8.04) and 6.07 (95% C.I. 4.21–7.93) for ceramic and titanium implants, respectively. The pink esthetic score (PES) was 7.81 (95% C.I. 6.90–8.73) for ceramic implants and 7.86 (95% C.I. 7.11–8.60) for titanium implants, with no significant differences between groups. No statistically significant differences were found for any of the other clinical parameters and PROMs. Conclusions Monotype ceramic implants have proven to be a good treatment option in the upper anterior sector, showing favorable esthetic results, being comparable to titanium implants. This clinical trial has been registered in clinical trials with the identifier CI_RCT_US16 and registration number NCT04707677. A retrospective registration of the clinical trial was carried out since registration was not mandatory on the date the study began.

Clinical performance of zirconium implants compared to titanium implants: a systematic review and meta-analysis of randomized controlled trials

“…After initial screening by titles and abstracts, 3,107 records were excluded from the initial screening. We reviewed the full texts of the remaining 29 articles and finally included four RCTs with six records ( Bienz et al, 2021 ; Koller et al, 2020 ; Osman et al, 2014b ; Payer et al, 2015 ; Ruiz Henao et al, 2021 ; Siddiqi et al, 2015 ). A flow diagram of this study is presented in Fig.…”

“…(2) Success rate: Four articles provided survival data and were included in the meta-analysis ( Koller et al, 2020 ; Osman et al, 2014b ; Payer et al, 2015 ; Ruiz Henao et al, 2021 ). A statistically significant difference was found in the survival rate of different implant materials (RR = 0.87, CI [0.78–0.98], P = 0.030, I 2 = 0%) ( Fig.…”

“…(3) MBL: Three studies with four reports were included in the meta-analysis ( Koller et al, 2020 ; Osman et al, 2014b ; Payer et al, 2015 ; Ruiz Henao et al, 2021 ). One study reported pre- and post-changes in MBL, while others only reported MBL at the end of the follow-up period.…”

“…(4) PPD: Three articles provided survival data and were included in this meta-analysis ( Bienz et al, 2021 ; Ruiz Henao et al, 2021 ; Siddiqi et al, 2015 ). The two subgroups were divided according to mucosal conditions (normal versus experimental mucositis).…”

Ceramic Toughening Strategies for Biomedical Applications

“…Large amount of these devices are made of metal but their metal-color ( Bayne et al, 2019 ), high wear rates of bearing components and large amount of ion release ( Chevalier and Gremillard, 2009 ) greatly impede their clinical applications. Thus, benefited from its excellent mechanical, esthetic ( Bayne et al, 2019 ) and biocompatible properties ( Gao et al, 2014 ; Ruiz Henao et al, 2021 ), ceramic becomes potential candidate for biomedical applications, such as dental restorations ( Li et al, 2014 ; Spitznagel et al, 2018 ), dental implants ( Kohal et al, 2008 ; Saadaldin and Rizkalla, 2014 ), heads and cups of joint replacements ( Rahaman et al, 2007 ), as well as bone fillers and scaffolds ( Ma et al, 2018 ) for tissue engineering. Although ceramic materials show their huge potential and preponderance, high brittleness of ceramic restrains its biomedical applications, which might result in severe clinical complications, such as fracture ( Benaqqa et al, 2005 ; Koo et al, 2014 ; Morimoto et al, 2016 ; Kong et al, 2019 ).…”