Two‐piece zirconia implants in the posterior mandible and maxilla: A cohort study with a follow‐up period of 9 years

Abstract

Objectives: Long-term follow-up observations of zirconia implants are rare. This study aimed at evaluating the clinical performance of two-piece zirconia implants in the posterior jaws over 9 years. Materials and Methods:Sixty partially edentulous patients were treated with twopiece zirconia implants. In eight no primary stability could be achieved. Fifty-two patients received the final restoration (i.e., cemented fibreglass abutments and allceramic crowns). After 2 years, 2 implants failed and 4 dropouts were recorded. The remaining 46 patients with one target implant each were recalled at 9 years. Besides implant survival, clinical parameters at the implant level (plaque index-PI, bleeding on probing-BOP, probing depth-PD, mucosal recession-MR) were recorded and compared with previously collected data. Mechanical and technical complications were assessed.Results: Thirty patients responded. The mean observation period was of 111.1 ± 2.2 months. One implant was lost. Data recorded from the remaining 29 implants were analysed. PI values increased overtime. Mean BOP and PD remained unchanged during follow-up. No additional cases of peri-implantitis were recorded over the 10 diagnosed during the first 2 years of follow-up. No significant changes in mean MR values were detected over time, with 65% of the all included implants exhibiting no recession at 9 years and all the others, but one, a maximum MR of 1 mm. Three technical and 6 mechanical complications occurred in 7 patients between 2-and 9years (6.9% and 20.7%, respectively, at patient level). Conclusion:Within the limitations of the present study, a high survival rate was registered. Albeit frequent mechanical and technical complications, two-piece zirconia implants could represent a valid solution for the replacement of single teeth in the posterior jaws.

Clinical and radiographic outcomes of zirconia dental implants—A systematic review and meta‐analysis

“…After appropriate treatment, these infections could be successfully treated and no further cases of peri‐implantitis could be observed until the last follow‐up. However, at the 9‐year follow‐up, signs of inflammation (bleeding on probing) were observed around 13 implants (Brunello et al, 2022). In another study, peri‐implantitis was diagnosed around 1 out of 71 initially placed 1‐piece zirconia implants after 5 years of investigation, whereas the implant was included in a cumulative therapy, starting with non‐surgical procedures (Balmer et al, 2020).…”

“…After implant placement and unloaded healing of 10–12 weeks, fiberglass abutments as well as single crowns were cemented. After a mean follow‐up period of 111.1 months (±2.2), 32 implants were evaluated, and the authors reported a survival rate of 93.8% (Brunello et al, 2022).…”

“…Considering technical complications, only 1 study provided information regarding 2‐piece zirconia implants with cement‐retained abutments and SCs and 1 investigation reported on technical complications of SCs cemented on 1‐piece zirconia implants (Brunello et al, 2022). In addition, Spies and coworkers investigated the same patient population as Balmer and coworkers and reported data on technical complications regarding the prosthetic suprastructures after a mean follow‐up period of 61 (±1.4) months.…”

“…After appropriate treatment, these infections could be successfully treated and no further cases of periimplantitis could be observed until the last follow-up. However, at the 9-year follow-up, signs of inflammation (bleeding on probing) were observed around 13 implants (Brunello et al, 2022). In another study, peri-implantitis was diagnosed around 1 out of 71…”

“…TA B L E 1 Characteristics of clinical studies investigating implant survival. One study did not provide any information regarding MBL (Brunello et al, 2022), 5 studies used periapical radiographs to determine MBL between implant placement and the last follow-up investigation (Balmer et al, 2020;Borgonovo et al, 2021;Gahlert et al, 2022;Grassi et al, 2015;Kohal et al, 2020).…”