Clinical and radiographic evaluation of narrow-diameter titanium-zirconium implants in unilateral atrophic mandibular distal extensions: a 1-year pilot study

Clinical performance of monolithic zirconia crowns on titanium-zirconium reduced-diameter implants in the molar area: Interim data at three years of a randomized controlled trial

AIM

The aim of the present study was (i) to evaluate the clinical performance of reduced-diameter implants placed in the molar area and (ii) to test whether monolithic zirconia implant-supported crowns lead to similar clinical outcomes compared to porcelain-fused-to-metal crowns.

MATERIALS AND METHODS

A total of 76 patients needing a single implant crown in the posterior region were recruited. All patients received a titanium-zirconium reduced-diameter implant (Straumann Roxolid, Tissue Level, Standard Plus, diameter 3.3 mm, regular neck) randomly allocated to receive either a (1) monolithic zirconia crown (test) or (2) porcelain-fused-to-metal crown (control). Implant survival, prosthetic outcomes, and patient-reported outcomes were assessed at crown delivery and after 3 years of follow-up. Marginal bone levels (MBL) as well as clinical parameters including probing depth (PD), bleeding on probing (BOP), and plaque levels (PCR) were also recorded.

RESULTS

A total of 59 patients were available at the 3-year follow-up; 32 patients with a monolithic zirconia crown (TEST) and 27 patients with a porcelain-fused-to-metal crown (CONTROL). 14 implants (11 implant fractures/3 aseptic losses) were lost leading to an estimated implant survival rate of 80% ± 5.1% (95% CI 70.8%-90.8%). Prosthetic complications were limited to the control group and involved minor chippings.

CONCLUSIONS

This type of reduced-diameter implant to support single implant molar crowns in the molar area cannot be recommended. Monolithic zirconia crowns appear to be a viable option in the posterior region showing similar prosthetic outcomes to porcelain-fused-to-metal crowns.

Short-term and long-term success and survival rates of implants supporting single-unit and multiunit fixed prostheses: A systematic review and meta-analysis

STATEMENT OF PROBLEM

Whether placing implants to replace each missing tooth or using implant-supported fixed partial dentures provides better outcomes is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to assess the success and survival rates of implants supporting single-unit and multiunit fixed prostheses by using conventional protocols for placement and loading in short- and long-term follow-ups.

MATERIAL AND METHODS

An electronic search was conducted in PubMed, Scopus, and Web of Science for studies published up to March 17, 2022. Comparative studies that reported the success or survival rates of both single-unit and splinted multiunit prostheses were considered for qualitative and quantitative analyses.

RESULTS

A total of 68 publications comprising 11 271 implants were included. Compared with the single prostheses, the splinted multiunit group showed no significant differences in implant success rates in the short-term (risk difference=-0.004; 95% confidence interval (CI)=-0.033 to 0.025; P=.780) and long-term (risk difference=0.003; 95% confidence interval (CI)=-0.029 to 0.034; P=.874) follow-ups. Significant statistical differences were also not found in terms of the survival rates of the 2 groups (short-term risk difference=-0.004; 95% CI=-0.031 to 0.023; P=.779, long-term risk difference=-0.002; 95% CI=-0.029 to 0.025; P=.887).

CONCLUSIONS

Implants supporting single-unit or splinted multiunit prostheses seem to be a predictable treatment in terms of survival and success over short and long periods. Nonetheless, it seems that cantilever and nonsplinted multiunit prostheses should be used with more caution.

Clinical Performance of Narrow-Diameter Titanium-Zirconium Implants: A Systematic Review

PURPOSE

Implant-supported prosthetic rehabilitations are in constant augmentation in everyday dental practice. This is largely due to increasing demand from patients for fixed or implant-stabilized prosthesis, although they are frequently reticent to complex preimplant bone augmentation surgeries, whenever bone volume is lacking. Narrow-diameter implants (NDI; ≤3.5 mm) have been developed to offer relatively simple implant solutions in challenging bone-deficient sites. However, concerns regarding their mechanical properties have been raised. Special titanium-zirconium material (Ti-Zr), with superior mechanical resistance, compared with pure titanium alloys has been introduced into the market. The purpose of this systematic review was to determine the available data on clinical performance of Ti-Zr NDI.

MATERIALS AND METHODS

A literature search of all available clinical articles dealing with Ti-Zr NDI has been carried out. After including only prospective clinical trials, 14 papers were retrieved for thorough reviewing.

CONCLUSION

Short-term results from preliminary clinical reports are quite promising, although the number of published studies and the follow-up periods are still insufficient to determine the real benefit of this hybrid material compared with titanium, especially when using NDI.