title: Zirconia Dental Implants: Investigation of Clinical Parameters, Patient Satisfaction, and Microbial Contamination.
abstract: OBJECTIVE
  In recent years, dental implants made from zirconia have been further developed and are considered a reliable treatment method for replacing missing teeth. The aim of this study was to analyze dental implants made from zirconia regarding their clinical performance compared with natural teeth (control).
  
  
  METHODS
  One hundred six zirconia implants in 38 adults were analyzed in a clinical study after 1 year of loading. The plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), probing attachment level (PAL), and creeping or recession (CR/REC) of the gingiva were detected and compared with natural control teeth (CT). Furthermore, the papilla index (PAP), Periotest values (PTV), microbial colonization of the implant/dental sulcus fluid, and patient satisfaction were assessed.
  
  
  RESULTS
  The survival rate was 100%. No statistical significance was observed between implants and teeth regarding BOP, PPD, and PAL. A statistical significance was detected regarding PI and CR/REC with significantly less plaque accumulation and recession in the study group. Mean PAP was 1.76 ± 0.55, whereas the mean PTV was -1.31 ± 2.24 (range from -5 to +6). A non-statistically significant higher colonization of periodontitis/peri-implantitis bacteria was observed in the implant group. The questionnaire showed that the majority of the patients were satisfied with the overall treatment.
  
  
  CONCLUSIONS
  One-piece zirconia dental implants exhibited similar clinical results (BOP, PPD, and PAL) compared with natural teeth in regard to adhesion of plaque (PI) and creeping attachment (CR/REC); zirconia implants performed even better. The favorable results for PAL and CR/REC reflect the comparable low affinity of zirconia for plaque adhesion. Patient satisfaction indicated a high level of acceptance for zirconia implants. However, a long-term follow-up is needed to support these findings.
authors.forename: Jens
authors.initials: J
authors.lastname: Holländer
authors.forename: Jonas
authors.initials: J
authors.lastname: Lorenz
authors.forename: Stefan
authors.initials: S
authors.lastname: Stübinger
authors.forename: Werner
authors.initials: W
authors.lastname: Hölscher
authors.forename: Detlef
authors.initials: D
authors.lastname: Heidemann
authors.forename: Shahram
authors.initials: S
authors.lastname: Ghanaati
authors.forename: Robert
authors.initials: R
authors.lastname: Sader
mesh_terms: D000328:Adult; D000368:Aged; D015921:Dental Implants / Q000009:adverse effects / Q000382:microbiology; D003764:Dental Materials; D003774:Dental Plaque Index; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D005260:Female; D005889:Gingival Recession / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D057873:Peri-Implantitis; D017622:Periodontal Attachment Loss / Q000473:pathology; D010514:Periodontal Pocket / Q000473:pathology; D010518:Periodontitis; D015040:Zirconium
chemical_list: D015921:Dental Implants; D003764:Dental Materials; D015040:Zirconium; C028541:zirconium oxide