Molar tooth restoration with Zeramex XT – case report by Dr. Marcel Podhorec

The following case report shows the molar tooth restoration with the Zeramex 2-piece ceramic implant that uses a carbon fiber-reinforced Vicarbo Screw to offer a true metal-free solution in the posterior region.

A female patient, 56 years old, was referred to the VitaDent Slovakia. She lost her molar tooth 36. The first consultation took place in December 2022. Treatment options were discussed with the patient. The patient decided to have a metal-free rehabilitation due to the better aesthetic and biological properties of Zeramex ceramic implants.

Surgical phase

The implantation was performed in February 2023. The site was prepared according to the surgical Zeramex XT protocol. To prevent excessive implant insertion torque, Zeradrill taps (S10, R10 and W10) were used. A 2-piece Zeramex XT made of alumina-toughened zirconia (ATZ) with a diameter of 5.5 mm (WB) and a length of 10 mm was placed under local anesthesia 0.6 mm supracrestally. The implant was then closed with a healing cap and the tissue was sutured.

Prosthetic phase

After the healing phase of about 3 months, the radiograph control was performed. The soft tissue showed no signs of inflammation and demonstrated excellent biocompatibility with the implant. A standard restorative process of using open-tray impression post was planned and performed. A Zeramex standard abutment (2 mm height) made of ATZ was fixed in the implant with a Vicarbo screw. In June 2023, the final crown was tried in, cemented, and screwed on the zirconia abutment. The final radiograph showed a stable bone and soft tissue level.

Conclusion

Through the treatment, the patient received a natural aesthetic and biocompatible denture with minimal surgical and prosthetic procedures. The demand for aesthetic and metal-free materials has been increased in the recent years. Comparable osseointegration, better soft-tissue healing, better blood circulation, low bacterial adhesion, and a naturally white color made zirconia implants a better choice for aesthetics- and health-conscious patients.

"Overall, we love the Zeramex XT system, its simplicity, the platforms (SB / RB / WB) with different lengths, and the clean zirconia material. Patients are always surprised by the white color of zirconia implants and the nonmetal gingiva aspect. I think, zirconia implants are the future of dental implantology." Dr. Marcel Podhorec, owner of VitaDent Slovakia, says.

About the author

Dr. Marcel Podhorec is a graduate of the Comenius University in Bratislava University. Since 1999, he has been running VitaDent, a private practice in Trenčín, Slovakia. Dr. Podhorec is a specialist in ceramic implantology.

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Further reading

Cionca N, Mombelli A et al.: Pro-inflammatory cytokines at zirconia implants and teeth. A cross-sectional assessment. Clin Oral Investig (2016).

Janner S, Gahlert M, Bosshardt D, Roehling S, Milz S, Higginbottom F, Buser D, Cochran DL: Bone response to functionally loaded, two-piece zirconia implants: A preclinical histometric study. Clin Oral Implants Res 29 (3), 277-289 (2018).

Kajiwara Net al.: Soft tissue biological response to zirconia and metal implant abutments. Implant Dentistry 24 (1), (2015).

Roehling, S.; Schlegel, K.A.; Woelfler, H.; Gahlert, M. Performance and outcome of zirconia dental implants in clinical studies: A meta-analysis. Clin Oral Implants Res 2018, 29 Suppl 16, 135-153.

Roehling S et al.: In vitro biofilm formation on titanium and zirconia implant surfaces. | Periodontol 88 (3), 298-307 (2016).

Roehling S, Gahlert M, Janner S, Bo Meng, Woelfler H, Cochran DL: Ligature-induced peri-implant bone loss around loaded zirconia and titanium implants. International Journal of Oral & Maxillofacial Implants, Review process (2018).

Scarano A, Piattelli M, Caputi S, Favero GA, Piattelli A: Bacterial adhesion on commercially pure titanium and zirconium oxide disks: An in vivo human study. J Periodontol 75, 292-296 (2004).

Spies C, Vach K, Kohal RJ, Hämmerle CHF, Jung RE: Three-year analysis of zirconia implants for single-tooth replacement and three-unit fixed dental prostheses. Clin Oral Implants Res 29 (3), 290-299 (2018).

Tartsch J: Keramikimplantate - Exoten oder sinnvolle Erweiterung des Behandlungsspektrums. ZMK 34-11 (2018).

Tartsch J: Komplexe Restauration mit Keramikimplantaten: zweiteilig, metallfrei und verschraubt. Dentale Implatologie und Parodontologie
(2021).

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