One-piece ceramic implants in the maxillary anterior region - limitations and possibilities

1W762 ePOSTER CLINICAL RESEARCH – SURGERY

Background: Because of their tooth-like color, ceramic implants can show a decisive advantage over titanium implants in the esthetically relevant maxillary anterior region. The bone situation in this region, however, often requires angulation of the implant axis and the need for angled abutments. The aim of this investigation is to determine the basic possibility and the possibly additionally necessary augmentative measures in comparison to two-part titanium implants

Aim/Hypothesis: So far, there are only limited data available with regard to the indication restrictions for one-piece implants. Hypothesis: One-piece ceramic implants are an equivalent alternative to two-piece implants in the maxillary anterior region.

Materials and Methods: By simulating the implant position in a 3-D implant planning program (SMOP, Swissmeda, Zurich, CH), the possibilities of inserting one-piece implants are examined. Based on 72 patient cases in which titanium implants had been planned and 3D-guided, a rescheduling was carried out into one-piece implants. Three groups with a differently complex indication were selected: 24 patients with single tooth gaps (I.). 24 patients with three missing teeth in the maxillary anterior tooth region (II.) and 24 patients with more than 3 missing teeth (III.). During the investigation, it was determined whether there was a basic availability. If this was the case, it was recorded whether the need for augmentation had increased or whether the implant position had to be rescheduled. The implant planning was carried out according to the prosthetic criteria specified by the set-up. The computer simulation was carried out independently by two dentists (CE and AK).

Results: For indication class I, the possibility of supplying one-piece implants 98% or 100% was determined. If three missing teeth were restored, implant-prosthetic restoration with one-piece implants could have taken place in 90-100% of the cases. The need for augmentative measures increased by about 15%. In complex cases with more than three missing teeth (III.), one-piece implants were treated in 70-80% of the cases. If the augmentation requirement and / or the number of implants were to increase, the feasibility would be 95-100% Overall.

Conclusions and Clinical Implications: According to these results, one-piece ceramic implants represent an alternative to titanium implants. However, the use of one-piece implants requires a consequent planning effort. Modifications in the implementation compared to two-part titanium implants are sometimes necessary. One-piece implants should be inserted using navigated procedures. The increasing desire of patients for metal-free or aesthetically tooth shade materials can be fulfilled with a critical assessment of the indication.

Keywords: dental implant, one-piece implant, ceramic implant