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Case presentation : Zirconia implants and peek restorations for the replacement of upper molars [2]

Case presentation : Zirconia implants and peek restorations for the replacement of upper molars [2]

author: Jos Mara Parmigiani-Izquierdo, Mara Eugenia Cabaa-Muoz, Jos Joaqun Merino, Arturo Snchez-Prez | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

Fifteen days after surgery, the appearance of the soft tissue was excellent, with no signs of inflammation in the mucosa. The patient mentioned the absence of bleeding and pain during the post-operation period. At the same time, we made a clinical and radiological evaluation. Three months after surgery, the stumps of the implants were carved to improve their parallelism with a special diamond drill (Kit Bredent®). Finally, we took impressions for the final restoration with polyether (Impregum, 3 M ESPE) without using retraction threads.

The final restorations were produced using CAD/CAM System Juvora® for the PEEK structure with composite coating (Anaxdent®). For cementation ionomer glass cement reinforced with resin was used (GC FujiCEM, GC Europe N.V.) (Figs. 3 and 4).

A clinical and radiographic review carried out a year after the initial surgery showed the complete success of the procedure according to Albrektsson’s criteria and the natural aspect of the soft tissue around the restorations (Fig. 5).

Intraoral conditions (saliva pH, acidic drinks, bacterial plaque, etc.) interact with metals, increasing corrosion, a phenomenon that also affects titanium implants [4, 5]. Amongst other reasons, this is whereby patients increasingly request the use of materials free of metallic alloys. In response to this growing demand, zirconia implants are considered an alternative, due to their low reactivity [6].

In recent years, several implant manufacturers have investigated the behaviour of zirconia implants on hard and soft tissues. The characteristics of their biocompatibility, together with good osseointegration, make them clear candidates for clinical use in dentistry [7, 8]. One of the advantages of these implants is the absence of cracks (gap) between pillar and implant since they are made in a single block. (Bredent®, Straumman®) [9, 10]. However, this feature implies the need to carve the pillars to achieve proper parallelisation.

Several studies have shown that zirconia implants present a similar healing pattern to titanium implants, both as regards the healing time and marginal bone stability [11–13]. However, there is a controversy over the long-term stability of the bone-implant interface, which depends on several factors such as surface, composition and design of the implant. Other important factors to consider are the implant-stump-crown connection, as well as the composition of the restorative material and the occlusal load transmitted by the antagonist tooth.

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