Remaining Time

Gerhard Konrad Seeberger

  • Dentist in general practice 
  • Speaker of the General Assembly of the FDI World Dental Federation 
  • President-elect of the Academy of Dentistry International, ADI
  • Past-president of Italian Dental Association, AIO
  • Past-president of the ERO, European Regional Organization of FDI
  • Associate professor at University of Iaşi, Romania
  • Author, co-author, peer reviewer and lecturer nationally and internationally
  • Honorary member of many national and international societies. 
Aesthetic Treatment Options With Zirconia Implants
Rehabilitation of edentulous areas in the upper maxilla of shallow gingival type patients is best achieved with implant-abutments or implants in zirconia. However, “aesthetic" abutments do not avoid the disadvantages of two-piece implant systems. Today the micro-roughness of zirconia one-piece implants is similar to that of titanium implants allowing reasonable soft-tissue and bone healing times and immediate rehabilitation protocols. 
Materials and Method:
Threaded on-piece zirconia implants with an implant diameter of 4.1 mm and 3.3 mm and a micro-rough surface of 10 mm of length have been used in three different situations. In edentulous areas with immediate loading, in fresh alveolar sockets with immediate loading and in edentulous areas after bone splitting with immediate loading. Two different antibiosis protocols have been followed. Short therapy in edentulous sites and conventional antibiotic therapy, starting 36 hours before tooth extraction, have been followed. Implant bed preparation has been performed with drills, as well as chisels and bone-spreaders in edentulous sites, while a no-drill procedure combined with the use of bone-spreaders has been chosen to manage extraction sockets. The implant insertion torque has been measured with a torque controlled ratchet. All implants but one have reached more than 35 Ncm of insertion torque (< 30 Ncm upper left incisor). All implants have been loaded immediately with provisional crowns guaranteeing infra-occlusion. 
All implants have healed in without complications. Final restorations have been placed between 4 weeks and 10 weeks after implant insertion. 
Although longer healing times are indicated for zirconia implants to achieve osseointegration, it seems that immediate loading protocols do not differ significantly from protocols set for titanium implants. An insertion torque over 35 Ncm seems to be the standard for immediate loading also for zirconia implants. Further studies need to be performed to consolidate this statement.