Metal-Free Custom-Made Zirconia Implants-A Prospective 5-Year Follow-Up Single-Arm Clinical Trial

Area of Science:

• Dental Implantology
• Biomaterials Science
• Prosthodontics

Background:

• Zirconia (ZrO2) dental implants offer potential advantages over titanium due to biocompatibility and aesthetics.
• However, limited long-term clinical data exists to support the success of zirconia implants.
• This study investigates the clinical performance of custom-made two-piece zirconia implants.

Purpose of the Study:

• To evaluate the 5-year survival and success rates of custom-made zirconia implants in the maxillary premolar region.
• To identify factors influencing implant performance, including handling and occlusal scheme.
• To assess the performance of the implant-supported lithium disilicate crowns.

Main Methods:

• A prospective 5-year follow-up clinical trial involving 30 custom-made zirconia implants in 31 patients.
• Assessment of clinical performance, marginal bone-level changes, and patient-reported outcome measures (PROMs).
• Kaplan-Meier survival analysis, stratified by implant handling and occlusal scheme.

Main Results:

• The 5-year survival and success rates for the custom-made ZV3 implants were 75.8% and 71.0%, respectively.
• No significant differences in survival rates were observed based on implant handling or occlusal scheme.
• Patient satisfaction was high (91.7%) for implants in function, with no crown failures reported.

Conclusions:

• The observed survival rate of these ZV3 zirconia implants was lower than anticipated and not clinically acceptable.
• The study does not recommend ZV3 implant placement as applied in this context for clinical practice.
• Further research into mechanical failures of zirconia implants is crucial before larger trials.