Corrosion of titanium under simulated inflammation conditions: clinical context and in vitro investigations.

OBJECTIVES To analyse the soft tissue morphology under healthy and experimental mucositis conditions comparing zirconia and titanium implants. METHODS Forty-two patients with two adjacent missing teeth received one zirconia (Zr) and one titanium (Ti) implant, with the mesial and distal position randomized. At 3 months, half of the patients were instructed to continue (healthy; h) and the other half to omit (experimental mucositis; m) oral hygiene around the implants for 3 weeks. Clinical parameters were evaluated before and after the experimental phase, and a soft tissue biopsy was harvested. Mixed model analyses were performed to analyse the data. RESULTS The plaque control record increased significantly for the two mucositis groups, reaching 68.3 ± 31.9% (mean ± SD) for Zr-m and 75.0 ± 29.4% for Ti-m (p < .0001), being also significantly lower for Zr-m than for Ti-m. Bleeding on probing remained stable in group Zr-m and amounted to 21.7 ± 23.6%, but increased significantly in group Ti-m (p = .040), measuring 32.5 ± 27.8%. The number of inflammatory cells and the length of the junctional epithelium did not significantly differ between the groups. CONCLUSION Both implants rendered similar outcomes under healthy conditions. Lower plaque and bleeding scores were detected for zirconia implants under experimental mucositis conditions. Histologically, only minimal differences were observed.

Clinical and histological comparison of the soft tissue morphology between zirconia and titanium dental implants under healthy and experimental mucositis conditions—A randomized controlled clinical trial

Long-term studies of modern zirconia implants are still insufficient. This prospective 8-year follow-up study investigated one-piece zirconia implants.Patients who had received a one-piece zirconia dental implant (PURE ceramic implant, Institut Straumann GmbH, Basel, Switzerland) were included in this study. Next to the implant survival and success rates, the radiographic and clinical implant parameters were assessed.The overall survival rate of 67 zirconia implants in 39 patients was 100%. The overall success rate was 89.6%. Around the immediate zirconia implants, the success rate was 94.7%, and around the delayed implants, 87.5%. The immediate implants showed a significantly higher bone crest compared to the delayed implants (p = 0.0120). According to the pink esthetic score, the immediate implants revealed more favorable esthetic results compared to the delayed implants after an 8-year follow-up (p = 0.0002).After 8 years, the one-piece zirconia implants presented an 89.6% success rate. Regarding the timing of implantation, in individual cases, immediate implantation can have slight advantages over delayed implantation.Immediate implants can also be considered for zirconia implants and should not be excluded on principle. 

/pdf/evaluation-of-one-piece-zirconia-dental-implants-an-8-year-36eg2dtb.pdf

Evaluation of one-piece zirconia dental implants: An 8-year follow-up study

Background Shifts in microbial communities are common over time, but they may disturb the host-microbiome homeostasis and result in inflammation of the peri-implant issues if a dysbiotic biofilm is established. Purpose Considering that different oral substrate surfaces may have a relevant impact on the microbial adhesion and colonization, the aim of this study was to investigate the microbial communities of the biofilm formed on single-implant restorations using titanium or zirconia abutments and how they correlate with clinical parameters after 3-years of implant loading. Materials and methods MiSeq sequencing of 16S rRNA amplicons was used to characterize the oral biofilms of individuals (n = 20) who were sampled longitudinally during 3 years of masticatory loading. Bioinformatics analysis and multivariate statistical analysis were used to evaluate the microbial diversity and clinical outcomes. Results Microbiomes of both abutment materials presented high alpha-diversity indices during all the experimental period, irrespective of the time of sampling. Microbial communities of titanium and zirconia were quite different over time, differing about 30% after 3 years of functional loading. Similarity of microbiomes between tested abutments and contralateral teeth was also low, ranging between 45% and 50% after 3 years of investigation. Periodontal pathogens commonly associated with peri-implantitis were found in both groups. Furthermore, both abutment materials presented strong correlations of diversity indices and microbial taxa with clinical outcomes. Conclusions The type of abutment substrate significantly influenced diversity and clustering of communities during 3 years of functional loading. The time of sampling had no effect on the variables. Large correlations were found between microbial findings and clinical outcomes.

Microbial communities of titanium versus zirconia abutments on implant-supported restorations: Biodiversity composition and its impact on clinical parameters over a 3-year longitudinal prospective study.

Abstract Background The aim of this systematic review (SR) was to evaluate the clinical efficacy of different adjunctive methods/therapies to the non-surgical treatment (NST) of peri-implantitis. Materials and methods The protocol of the review was registered in PROSPERO database (CRD42022339709) and was designed according to PRISMA statement. Electronic and hand searches were performed to identify randomized clinical trials (RCTs) comparing non-surgical treatment of peri-implantitis alone versus NST plus any adjunctive method/treatment. The primary outcome was probing pocket depth (PPD) reduction. Results Sixteen RCTs were included. Only 2 out of 1189 implants were lost and follow-up ranged from 3 to 12 months. PPD reduction across the studies varied from 0.17 to 3.1 mm, while defect resolution from 5.3% to 57.1%. Systemic antimicrobials were associated to higher PPD reduction (1.56 mm; [95% CI 0.24 to 2.89]; p = 0.02) with high heterogeneity, and treatment success (OR = 3.23; [95% CI 1.17 to 8.94]; p = 0.02), compared to NST alone. No differences were found with adjunctive local antimicrobials and lasers for PPD and bleeding on probing (BoP) reduction. Conclusions Non-surgical treatment with or without adjunctive methods may reduce PPD and BoP even if complete resolution of the pocket is unpredictable. Among possible adjunctive methods, only systemic antibiotics seems to provide further benefits, but their usage should be considered with caution. 

Clinical efficacy of adjunctive methods for the non-surgical treatment of peri-implantitis: a systematic review and meta-analysis

Experimental peri-implant mucositis around titanium and zirconia implants in comparison to a natural tooth: part 2-clinical and microbiological parameters.

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Experimental peri-implant mucositis around titanium and zirconia implants in comparison to a natural tooth: part 2-clinical and microbiological parameters.