Waltenberger Lukas, Bishti Shaza, Wolfart Stefan
Department of Prosthodontics and Biomaterials, Center for Implantology, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen, 52074, Germany.
Int J Implant Dent. 2025 Aug 13;11(1):53. doi: 10.1186/s40729-025-00641-7.
With increasing demand for aesthetic, metal-free restorations, all-ceramic materials have gained popularity in implant prosthodontics. However, questions regarding their long-term performance, material selection, and design features remain unresolved. This guideline, developed by the German Association of Oral Implantology (DGI) in collaboration with the German Society of Dentistry and Oral Medicine (DGZMK), aims to enhance treatment safety, guide clinical decision-making, and improve patient education concerning all-ceramic implant-supported restorations.
A systematic literature review was conducted to evaluate the clinical performance of all-ceramic restorations in three main indications: implant-supported single crowns, short-span fixed dental prostheses, and full-arch restorations. Recommendations were developed based on the quality of evidence or expert consensus.
For single crowns, lithium disilicate, silicate ceramics, and all generations of zirconia demonstrated favorable 3-year survival rates (~ 96-97%). In contrast, polymer-infiltrated ceramics showed inferior performance and were not recommended. For short-span FDPs and full-arch reconstructions, only 3Y-TZP zirconia is supported by clinical evidence. Micro-veneering and monolithic designs reduce chipping risks. Patient education is emphasized due to limited evidence for newer materials and full-arch restorations.
All-ceramic implant restorations can be successfully implemented with careful material selection, adherence to bonding protocols, and appropriate prosthetic design. However, clinical limitations persist, especially in full-arch indications. Interdisciplinary collaboration is essential to optimize outcomes and minimize complications.
随着对美观、无金属修复体的需求不断增加，全瓷材料在种植义齿修复中越来越受欢迎。然而，关于其长期性能、材料选择和设计特点的问题仍未得到解决。本指南由德国口腔种植学会（DGI）与德国牙科学与口腔医学学会（DGZMK）合作制定，旨在提高治疗安全性，指导临床决策，并加强患者对全瓷种植支持修复体的教育。
进行了一项系统的文献综述，以评估全瓷修复体在三个主要适应症中的临床性能：种植支持的单冠、短跨度固定义齿和全牙弓修复体。根据证据质量或专家共识制定了建议。
对于单冠，二硅酸锂、硅酸盐陶瓷和各代氧化锆的3年生存率均良好（约96%-97%）。相比之下，聚合物渗透陶瓷表现较差，不建议使用。对于短跨度固定义齿和全牙弓重建，只有3Y-TZP氧化锆有临床证据支持。微贴面和整体设计可降低崩瓷风险。由于新材料和全牙弓修复体的证据有限，因此强调了患者教育。
通过仔细的材料选择、遵守粘结方案和适当的修复设计，可以成功实施全瓷种植修复。然而，临床局限性仍然存在，尤其是在全牙弓适应症方面。跨学科合作对于优化治疗效果和减少并发症至关重要。
