Prof. Dr. Dr. Eik Schiegnitz: "Ceramic implants are an exciting and certainly promising treatment option"

Where do we stand in terms of ceramic implants? What solutions are there for edentulous patients? What is the future of implant dentistry? We discussed these and other questions with Prof. Dr. Dr. Eik Schiegnitz, Head of the Implantology & Augmentation Surgery Section, specialist in oral and maxillofacial surgery and specialist in oral surgery at the University Medical Centre of Johannes Gutenberg University Mainz.

Good afternoon, Prof. Schiegnitz. First of all, let us congratulate you on being awarded the title of professor. We welcome the fact that the Department of Oral and Maxillofacial Surgery at the University of Mainz is taking a scientific approach to the topic of ceramic implantology. Why are you interested in zirconia implants and what added value do you think you can offer your patients?

Ceramic implants are an exciting and certainly promising treatment option for our patients. As the scientific data on modern ceramic implants is becoming increasingly well-founded and we are also seeing an increased demand for ceramic implants from patients, it is our aim to serve this at the highest level both clinically and scientifically.

Together with Prof. Dr. Dr. Bilal Al-Nawas and Priv.-Doz. Dr Keyvan Sagheb, you are currently conducting a case series on Zeramex XT implants and Docklocs® abutments, which are used to secure a prosthesis in edentulous patients. What is the subject of your investigation and can you already tell us anything about it?

To date, there have been very few clinical studies on ceramic implants in edentulous patients, so the scientific data is insufficient. We are therefore evaluating the clinical outcome of four ceramic implants in the restoration of the edentulous mandible in order to close this scientific gap. Another exciting aspect is that we are using locator connections (Docklocs® abutments) for the prosthetic restoration. This makes it possible to provide patients with a very cost-effective prosthetic restoration. The results to date show that this concept works reliably and predictably in the short-term follow-up and that patients report an enormous increase in their oral health-related quality of life.

You have also personally placed Zeramex XT implants. How do you rate the protocol, the surgical procedures and the handling of the system?

The Zeramex XT system is characterised by high primary stability with a very clear and comprehensible drilling protocol and handling. This system can therefore also be used for demanding indications such as immediate concepts or implantation in soft bone.

Zeramex XT is a tissue-level implant. Where do you see the advantages of tissue-level implants?

The scientific data indicates that tissue-level implants show reduced peri-implantitis rates due to the "biological width in the vertical". For us, the tissue-level design is therefore the implant design of choice when it comes to restorations in the posterior region or in the edentulous jaw.

Many colleagues are convinced and have experienced that the two-part design offers more prosthetic flexibility and at the same time undisturbed healing. What is your opinion of the two-piece concept in relation to ceramic implants?

The two-part design offers clear advantages in terms of the flexibility of the prosthetic restoration and allows more room for manoeuvre when positioning the implant. Two-piece systems considerably extend the range of indications for ceramic implants.

Bacteria and biofilm on implant surfaces, if not removed regularly, can lead to plaque formation and peri-implant infections, which in turn can result in implant failure. There is evidence of reduced bacterial accumulation and better biological compatibility between zirconia ceramic and peri-implant soft tissue. Is this clinically relevant in your experience?

The published in-vitro data on this topic are very promising and exciting. However, there is no clinical evidence to date that there are fewer biological complications such as peri-implantitis on ceramic implants compared to titanium implants. Further clinical data needs to be generated in the future.

Many colleagues use two-piece ceramic implants in aesthetically demanding indications and in difficult mucosal conditions. But does this also apply to the molar region? Based on your experience with Docklocs®, can you say that dentures on ceramic implants are another indication?

Our own experience with the restoration of edentulous patients in the mandible is currently very good, with no implant losses. However, we must emphasize that there is a lack of long-term data in the literature. There are also clinical studies with medium-term follow-up on molar restorations with two-part systems.

How do you see the future of implantology in terms of implant material and implant design?

The topic of conical ceramic implants is certainly one of the major topics in implantology of the future. We look forward to accompanying this path both clinically and scientifically.

Thank you very much for the interview, Prof. Schiegnitz.

About the person

Prof. Dr. Dr. Eik Schiegnitz is Senior Physician, Head of the Implantology & Augmentation Surgery Section, Specialist in Oral and Maxillofacial Surgery, Specialist in Oral Surgery at the University Medical Center of Johannes Gutenberg University Mainz. He is also Education Delegate Elect of the International Team of Implantology (ITI) Section Germany, Chief Editor International of the renowned specialist journal "Journal of Implant Dentistry" (IJID) as well as international speaker, researcher, and author of numerous scientific publications in the fields of implantology and augmentation surgery, tumour biology and tumour prevention, oral mucosal diseases, biomaterials and tissue engineering.

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