Immediate provisional restoration of single-piece zirconia implants: a prospective case series - results after 24 months of clinical function

Aim of this prospective case series was to evaluate the outcome of immediately provisionalized single-piece zirconia implants.

A total of 20 zirconia implants were inserted in single-tooth gaps in the maxilla (11) and mandible (9) of 20 patients. Implants were restored with all-ceramic CAD/CAM provisionals without occlusal contacts immediately after placement. Permanent all-ceramic restoration was performed 4 months after surgery. Plaque index (PI), bleeding on probing (BOP), Periotest(®) (PV), pink aesthetic score (PES), mean radiographic marginal bone levels (MBL), implant survival and success were evaluated up to 24 months.

Assessment of PI at baseline and follow-ups after 6, 12, 18 and 24 months revealed 27% (±5.3), 24% (±6), 23% (±6.1), 23% (±5.3) and 22% (±6.4), respectively. Evaluation of BOP revealed 25% (±5.6), 21% (±6), 21% (±7.2), 18% (±5.9) and 15% (±5.5), respectively. Implants presented stable at follow-ups (PV). PES improved, but not statistically significant from 8.13 (±1.5) at baseline to 10 (±2) 24 months after implantation. Measurements of MBL showed a significant bone loss of 1.01 mm within the first year after placement (P < 0.001) and 1.29 mm 24 months post-implant insertion, not reaching further statistically significant levels (P > 0.05). One implant was lost 4 months after placement, resulting in a survival and success rate of 95%.

Clinical and radiographic parameters demonstrated a 95% integration of immediately loaded zirconia single-piece implants. A long-term randomized-controlled clinical trial was initiated to confirm evidence of this protocol.