Kohal Ralf-Joachim, Komine Futoshi, Lith Agneta, Spies Benedikt C, Burkhardt Felix, Vach Kirstin
Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany.
Department of Fixed Prosthodontics Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-Ku, Tokyo 101-8310, Japan.
J Dent. 2025 Sep;160:105911. doi: 10.1016/j.jdent.2025.105911. Epub 2025 Jun 13.
This prospective case series aimed to evaluate the long-term clinical and radiographic outcomes of one-piece zirconia implants used to support three-unit fixed dental prostheses after a decade of functional loading. The primary endpoint was implant survival.
A total of 54 implants were placed in 27 patients using a one-stage surgical approach with immediate provisionalization. Peri-implant bone loss was assessed using standardized radiographs; soft-tissue parameters were also evaluated. Statistical analysis was conducted using linear mixed regression models and Wilcoxon Signed Rank tests to compare differences over time and between variable groups (p < 0.05).
One patient was lost to follow-up after one year, and another declined participation in the 10-year evaluation. Over the 10-year period, 21 implants failed, leading to a cumulative survival rate of 59.26 %. The mean marginal bone loss of the remaining implants was measured at 1.61 mm. Probing depth, clinical attachment loss, bleeding on probing and plaque index showed an increase from the initial prosthesis placement to the 10-year follow-up.
The studied one-piece zirconia implants demonstrated lower survival rates compared to previously reported survival rates of zirconia and titanium implants. Implant failures were mainly due to peri‑implantitis, necessitating their removal. This specific implant is not commercially available.
Despite favorable initial outcomes, the one-piece zirconia implants studied showed a low 10-year survival rate, primarily due to peri‑implantitis. These findings highlight the importance of long-term monitoring and material selection when using zirconia implants to support multi-unit restorations. Clinicians should exercise caution with similar implant designs.
本前瞻性病例系列旨在评估用于支持三单位固定义齿的一体式氧化锆种植体在功能加载十年后的长期临床和影像学结果。主要终点是种植体存留率。
采用一期手术方法并即刻临时修复，为27例患者共植入54枚种植体。使用标准化X线片评估种植体周围骨吸收；还评估软组织参数。采用线性混合回归模型和Wilcoxon符号秩检验进行统计分析，以比较不同时间和不同变量组之间的差异（p<0.05）。
1例患者在1年后失访，另1例拒绝参与10年评估。在10年期间，21枚种植体失败，累积存留率为59.26%。其余种植体的平均边缘骨吸收为1.61mm。探诊深度、临床附着丧失、探诊出血和菌斑指数从最初义齿修复到10年随访时均有所增加。
与先前报道的氧化锆和钛种植体的存留率相比，本研究中的一体式氧化锆种植体显示出较低的存留率。种植体失败主要归因于种植体周围炎，需要将其取出。这种特定的种植体尚无商业产品。
尽管初始结果良好，但本研究的一体式氧化锆种植体显示出较低的10年存留率，主要原因是种植体周围炎。这些发现凸显了使用氧化锆种植体支持多单位修复时长期监测和材料选择的重要性。临床医生对类似的种植体设计应谨慎使用。
