title: Clinical and Patient-reported Outcomes of a Zirconia Oral Implant: Three-year Results of a Prospective Cohort Investigation.
abstract: The objective of this study was to determine the clinical, radiographic, and patient-reported outcomes of a 1-piece alumina-toughened zirconia implant restored with single crowns (SCs) or 3-unit fixed dental prostheses (FDPs) after 3 y of observation. Forty patients received 53 implants, placed in a 1-stage operation with immediate temporization. Finally, 50 implants were restored with 24 SCs and 13 FDPs. To evaluate peri-implant bone loss, standardized radiographs were taken at implant insertion, at final restoration delivery, and after 1 and 3 y. Additionally, several soft tissue parameters and patient-reported outcome measures were evaluated. Linear mixed models with random intercept for each patient and patients as clusters were used to compare subgroups. Three patients did not receive a SC due to early implant loss, and 1 patient died. As a result, 36 patients with 49 implants were followed-up for 3 y, giving a cumulative survival rate of 94.2%. The average marginal bone loss amounted to 0.79 mm (SCs, 0.47 mm; FDPs, 1.07 mm; P < 0.001). After the delivery of the final prosthetic restoration, further bone loss was not statistically significant (0.09 mm; P = 0.700). Probing depth, clinical attachment level, and modified bleeding index increased significantly at the implant sites, whereas gingival recession decreased significantly. Compared with the pretreatment questionnaires, the patient-reported outcome measures showed a permanently improved perception of function, aesthetics, sense, speech and self-esteem. The survival rate of the investigated ceramic implant system seems to be comparable to reported survival rates of titanium implants when immediately restored. The recorded parameters suggest its potential for clinical utilization.
authors.affiliation: Medical Center-University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany benedikt.spies@uniklinik-freiburg.de.
authors.forename: B C
authors.initials: BC
authors.lastname: Spies
authors.affiliation: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Balmer
authors.affiliation: Medical Center-University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany.
authors.forename: S B M
authors.initials: SB
authors.lastname: Patzelt
authors.affiliation: Medical Center-University of Freiburg, Center for Medical Biometry and Medical Informatics, Institute for Medical Biometry and Statistics, Freiburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Vach
authors.affiliation: Medical Center-University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany.
authors.forename: R J
authors.initials: RJ
authors.lastname: Kohal
mesh_terms: D003442:Crowns / Q000592:standards; D015921:Dental Implants; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome; D015019:Yttrium / Q000627:therapeutic use*; D015040:Zirconium / Q000627:therapeutic use*
chemical_list: D015921:Dental Implants; C499362:yttria stabilized tetragonal zirconia; D015019:Yttrium; D015040:Zirconium
keywords: bone resorption; ceramics; clinical trial; dental implants; patient-centered outcomes research; prospective studies