A randomized clinical trial on zirconia versus titanium implants in maxillary single tooth replacement.

OBJECTIVES: This RCT aimed to compare zirconia and titanium dental implants in the maxillary premolar region. The comparison was based on marginal bone level (MBL) changes, clinical parameters, aesthetic outcomes, and patient related outcome measures (PROMs) 1 year after prosthetic loading. MATERIALS AND METHODS: Fifty patients were randomly assigned to receive either a zirconia (ZrO2, n = 25) implant or a titanium (Ti, n = 25) bone-level implant. Implants were provided with a lithium disilicate crown 3 months after placement. Follow-up was at 1 month and after 1 year. The primary outcome pertained to changes in MBL. Reported secondary outcomes consisted of implant survival, peri-implant tissue health, aesthetics, and PROMs. RESULTS: Mean MBL change after 1 year was 0.01 mm (SD = 0.45; min = 0.72, max = 0.86) for ZrO2 and -0.09 mm (SD = 0.34; min = 0.53, max = -1.06) for Ti (p = .439). Scores for the other clinical outcome parameters and PROMs were generally favorable, with no significant differences. However, significant differences were found for the aesthetic outcomes regarding two criteria: (a) level of facial mucosa (p = .022), in favor of Ti, and (b) root convexity/soft tissue color and texture (p = .005) in favor of ZrO2. CONCLUSION AND CLINICAL IMPLICATIONS: The ZrO2 and Ti implant types used in this study, replacing a single missing maxillary premolar, show a comparable outcome in terms of MBL change after 1 year. Clinical and aesthetic parameters, as well as PROMs, are favorable and similar between both implant types after 1 year of prosthetic loading. These short-term study results suggest that both are suitable for clinical use.

[A phd completed 10. Implant-supported removable partial -dentures in a Kennedy Class I-situation in the mandible]. / Hora est 10. Implantaat ondersteunde frame­prothesen in een Kennedy klasse I-situatie in de onderkaak.

Implant-supported removable partial dentures in the mandible often cause problems, which means that patients wear their dentures seldom if at all. A solution is to place implants that the dentures can be snapped onto. There is, however, no consensus about the best position of the implants in the mandible yet. In addition, it is worthwhile to balance the cost of treatment with its effectiveness. In a randomised cross-over clinical trial involving 30 patients with a shortened dental arch, the implant-supported removable partial denture in the mandible was evaluated based on the experience of the patient, mean time of wearing, chewing ability and the clinical and radiographic parameters in relation to 2 different implant positions: 2 in the pre-molar region or 2 in the molar region. The cost-effectiveness of both treatments was also evaluated. From the patient's point of view, the implant-supported removable partial dentures are best supported by implants placed in the molar region. The research also revealed, however, that significantly more bleeding occurred around implants placed in the molar region and from a clinical perspective placement in the pre-molar region would have preference. The cost-effectiveness of the treatment with an implant-supported removable partial denture depends on the choice of outcome measurement and monetary threshold.