de Beus, J.H.W. (2021) Metal free implants made of zirconia – a prospective 5-year follow-up single arm clinical trial. thesis, Dentistry.
Full text available on request.Abstract
Background - Dental implants made of zirconia, have been applied in dentistry due to its biocompatibility, good mechanical properties and excellent aesthetic results. Therefore, zirconia could meet the demands of an alternative implant material to titanium. However, solid long-term scientific data to prove clinical success of zirconia implants is scarce. The aim of this study was to describe and examine the clinical performance of zirconia dental implants and its implant-supported fixed dental prosthesis and identify possible influencing factors. This helps the clinician to find a clear indication for the clinical use of Y-TZP as a material for dental implants. This follow-up study collected and examined the 5-year data in order to answer the main question: What are the survival and the success of ZV3 zirconia implants and the implant-supported prostheses in the maxillary, premolar region after 5 years? Method – Of 31 included patients in this prospective 5-year follow-up single arm clinical trial study at the ‘Centrum voor Tandheelkunde en Mondzorgkunde’, 30 were implanted with an ZV3 implant at the place of a missing single maxillary premolar, which was provided with a lithium disilicate prosthesis. Parameters regarding clinical performance, peri-implant bone level alteration and patient satisfaction were assessed pre-operative, at baseline and one and five years after crown-placement. Chances of survival and success of the ZV3 implant and the implant-supported prostheses were displayed using Kaplan-Meier. Kaplan-Meier survival analysis was also performed with stratification by means of occlusal guidance and manipulation of the implant and compared using Log-Rank tests. Bone level moderation was compared using a paired samples t-test. Patient’s expectation and satisfaction after 5 years were compared using a Wilcoxon signed-rank test. Results Survival and success probability after 5 years of 75.8% (95% CI [60.0%;91.0%]) and 71.0% (95% CI [54.0%;88.0%]) for the ZV3 implant and 100% and 64.9% (95% CI [43.0%;87.0%]) for the implant-supported prosthesis were found. No significant differences in survival rate were found after stratification by means of occlusal guidance and manipulation of the implant. Mean bone level alteration baseline and first follow-up was +0.06 mm (95% CI [-0.23 mm;0.12 mm]; SD=0.42 mm) and between baseline and second follow-up was +0.04 mm (95% CI [-0.35 mm;0.26 mm]; SD=0.54 mm). Patients’ satisfaction after 5 years was 91.7% (IQR = [90.5%-97.3%]). Pooled satisfaction after five years was significantly higher than patients had expected on average before treatment. Discussion and conclusion - Survival rate of the ZV3 implants is lower than expected. The indication for ZV3 implants as applied in this study cannot be recommended for the clinical practice. A trend was identified for possible influences of the kind of occlusal guidance of the dentition. Hence, occlusal guidance might also play a role in the mechanical overload of the implant and therefore survival. Mechanical load should be included to further investigate a possible effect on survival. A larger prospective randomized clinical trial should be conducted to evaluate treatment with zirconia dental implants.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Schepke, Dr. U. |
| Faculty: | Medical Sciences |
| Date Deposited: | 19 May 2023 11:44 |
| Last Modified: | 19 May 2023 11:44 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3526 |
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