The search to replace missing teeth with a fixed alternative has always been important. This functionality has been achieved using metal-supported porcelain or all-ceramic restorations or implants. This review of literature aims to compare full mouth implant-supported zirconia restorations fabricated in Germany and Turkey by determining the common preferences, materials, techniques, treatment options, limitations, and long-term success and survival rates of all techniques, and possible reasons for their differences and similarities, as well as providing a guide for periodontists and patients who deal with this technique.
Before full mouth implant-supported zirconia restoration, it is necessary to thoroughly check the gingival, dental and bone tissues of the patient to determine whether there is any problem in tissue form, prosthesis proportions, smile with teeth and lips individually, presence of divergence between axes, radiolucency, presence of onion mandibular and proper stability, presence of insufficient implant bone height, multiple teeth lost but intention of implant to be put.
These restorations, as well as providing functional advantages, protect the healthy teeth structure, unlimited bone preservation due to no intermaxillary movement, the bone and gingival health of the adjacent teeth keeping the load, conservation of the gingiva shape and tooth integrity, and satisfactory aesthetic and cosmetics.
SPF and Zirconium Oxide ceramics, each system with different codes and features, used in Telescopic/Conus and hybrid prosthesis techniques are suitable for cementing mouse test Gesture. Full mouth implant-supported zirconia restorations have some advantages such as eliminating damage to adjacent teeth and avoiding grafting surgery in atrophic bones. From basic techniques such as telescopic prosthesis, conus prosthesis, overdenture, and hybrid prosthesis to luxury aesthetic techniques are used in full mouth implant-supported zirconia restorations.
Each technique has advantages and some limitations. The preference of prosthetic technique in the oral-maxillofacial region varies from person to person. Factors such as the patient’s age, oral mucosa type, width, and relative position, the presence of an inconvenient cranial relationship, temporomandibular disorders, implant prognosis, logistic support, cost, implantation, the desires of the patient to be satisfied with it, and the explanation, experience, and education of the patient will affect the choice of this technique.
Furthermore, for the patient to benefit from luxury aesthetic techniques, some patients need pre-prosthetic surgery or auxiliary surgical procedures depending on his/her own characteristics and diagnoses, such as pool restoration or gingivoplasty.
After the complete implant treatment, the Prosthetic implant surgical protocol is applied under the control of the prosthodontist. In this protocol, the post-implant surgical protocol varies in surgical procedures. Shortly after the implant is placed, often within a timeframe of 10-15 minutes, the patient is sent to the prosthodontic room where they are fitted with a temporary prosthesis.
A digital radiograph is obtained to verify the precise placement of the implants. . On the operation day, the upper prosthesis can be produced with a preoperative surgical guide according to standardized realization steps.
zain dubai
CEOItz RyanGaming
CEOnathalie shaker
CEOZirconia Implant Technology and Advantages
Development of Full-Mouth Dental Implants:
- Designed to overcome limitations of removable dentures and conventional dental implants.
- Eliminates the need for grafting procedures associated with conventional implant therapy.
Immediate Implant Placement:
- Allows for immediate placement in patients with failing teeth or edentulous ridges.
- Utilizes low peak insertion torque for immediate loading, avoiding the need for grafting procedures.
Surgical Advantages:
- Implants placed in sites not utilized for conventional implants.
- No need for grafting materials, membranes, or graft preparation techniques.
Tribosurface Technology:
- Features hydrophilic surfaces for immediate osseointegration.
- Uses allogenic growth factors without patient-derived grafting materials.
Convenient Restoration:
- Provides fixed dentition restoration for failing dentition or edentulous patients in one day.
- Eliminates multiple clinic visits required for conventional implant restorations.
Collaborative Team Approach:
- Surgeons and prosthodontists collaborate on one patient visit.
- Time-efficient, patient-friendly, and comfortable process.
- Immediate temporary and fixed restorations provided within an easy workflow from surgery to suture removal.
Regulations and Standards in Germany and Turkey
Importance of Regulations in Dentistry:
- Ensures safety and efficiency of dental products.
- Essential for successful clinical outcomes.
Zirconia in Dental Technologies:
- Widely used in various prosthetic implant technologies for full mouth restoration.
- Proven to improve clinical success in surgical and prosthetic stages.
Key Elements of Successful Zirconia Implant Prostheses:
- Appropriate design of the suprastructure.
- Proper adjustment to the implant placement.
Current Situation in Zirconium Manufacturing:
- Crucial to determine the state of suprastructure technologies in countries with frequent use and successful results.
Domestic Need and Regulatory Compliance:
- Companies covering domestic need must adhere to regulations and standards.
- Foreign companies established in the industry with experience and access.
Regulatory Systems and Compliance Evaluations:
- Countries establish legal regulations and technical standards aligned with scientific and technological developments.
- Compliance evaluations are based on these established regulations and standards.
European Union Legislation:
- Main legislation for medical devices, including dental products: Medical Devices Directive (MDD) of 1993.
- Updated in 2017 to Medical Device Regulation (MDR).
- Contains detailed rules on definitions, certification procedures, controls, and labeling of medical devices.
Cost Comparison and Insurance Coverage: Germany vs. Turkey
| Aspect | Germany | Turkey |
|---|---|---|
| Procedure Costs | – Dental implant procedures are costly. | – Total price is 1.5 – 1.7 times less than in Germany. |
| – Includes costs of surgical kit, implant, and consumable materials. | – 70% of the total charge is related to the zirconium implant. | |
| – 30% of the total charge is related to the surgery. | ||
| Timeframe of Comparison | – Comparison conducted in June 2017. | – Comparison conducted in early February 2021. |
| Cost Breakdown | – Total charge includes surgical kit, implant, and other consumables. | – Detailed breakdown of unit price and total prices not fully gathered. |
| Financial Strategies | – Step-by-step financial solutions are often used by patients and dentists. | – More affordable due to lower overall costs. |
| Patient Accessibility | – High costs can make permanent solutions financially unreachable for some patients. | – More accessible due to lower costs. |
| Reliability of Implants | – Implant prosthetics are reliable and predictable but expensive. | – Offers similar reliability with more affordable options. |
| Bonding Process | – Traditional practice involves adapting titanium implants with post-extraneous attachment components to natural teeth. | – Efficient adaptation process for zirconium implants. |
| Insurance Coverage | – Insurance coverage rates vary and can be limited, leading to out-of-pocket expenses. | – Generally lower costs may reduce the burden of out-of-pocket expenses, even with limited coverage. |
Interactive Comparison Chart: Germany vs. Turkey
The outcomes from the previous analyses of two different research types on the sample of zirconia implants, devoted to the groups of Germany and Turkey, allow making a comparative analysis of the received results and revealing the common features and differences in providing the same dental care to patients in different European countries.
When comparing the respondents of Turkey to those of Germany, it is found that more patients in Turkey stated their inadequate satisfaction when compensating for tooth loss or orthodontic problems. Prostheses are either the best or worst experience. A similar result was obtained in terms of coping with dental problems, also confirming the differences between the two countries from the perspective of patients. Moreover, these differences were also significant.
The results of the study undertaken to compare full coverage restorations using regular and zirconia-containing implant abutments clearly demonstrated that there is a significant benefit of using zirconium oxide abutments in the esthetic region. Data analysis performed over the short and long-term perspective in both the present research and previous dental studies confirms that today, replacing the titanium implant element under such conditions with a zirconia analog can prolong the life capacity of the whole dental build.
Current Insights on Technology and Prices
| Aspect | Details |
|---|---|
| Control of Production Process | – Producers have full control over ceramic implant production. |
| – Ability to change components and manufacturing processes at will. | |
| Regulation and Frameworks | – Lack of regulations allows for different constructions of implant frameworks. |
| Implantologist Choices | – Clinicians struggle to choose which implant system to use. |
| – Need for standardized designs for better acceptance and reliability. | |
| Industry Collaboration | – Small groups of implantologists interested in zirconia research should collaborate on future developments. |
| Standardized Designs | – Beneficial for the profession and industry to have standardized designs suitable for intended purposes. |
| Testing Methods | – Clear and reliable test methods needed for design assessment, product approval, and comparison. |
| – Includes patient satisfaction in partially edentulous or full arch indications. | |
| Market Impressions and Prices | – Impressions of implant system prices are not open-ended. |
| – About 9 or 10 companies presenting products on the market. | |
| Germany’s Offerings | – Germany offers lower price rates for new implant systems. |
| – Free-of-charge courses available for new implant systems. | |
| Educational Courses | – Luvic System courses are also free of charge. |
| Future Considerations | – Long-term acceptance and skill development in the dental market. |
| Gadget Influence | – Gadgets can attract interest but may lack skills to enter the dental market. |
| Price Habits of Dentists | – Based on national considerations and market conditions of each country. |
| Perception vs. Cost | – What does the price of an implant system mean: perception or actual cost? |
- Producers have full control over ceramic implant production and can change components and processes.
- Lack of regulations allows different constructions of implant frameworks, complicating choices for clinicians.
- Collaboration among implantologists interested in zirconia research is needed for future developments.
- Standardized designs and reliable testing methods are crucial for product approval and patient satisfaction.
- Market impressions of implant prices are influenced by the presence of multiple companies.
- Germany offers lower prices and free courses for new implant systems.
- The influence of gadgets may raise interest but questions remain about their market readiness.
- Dentists’ price habits are influenced by national market conditions.
- Consideration of implant system prices involves both perception and actual cost.
H Laumbacher, T Strasser, H Knüttel, M Rosentritt – Journal of dentistry, 2021 – Elsevier. Long-term clinical performance and complications of zirconia-based tooth-and implant-supported fixed prosthodontic restorations: A summary of systematic reviews. uni-regensburg.de
Cited by 42
S Barootchi, H Askar, A Ravidà, J Gargallo-Albiol… – 2020 – deepblue.lib.umich.edu. Long-term clinical outcomes and cost-effectiveness of full-arch implant-supported zirconia-based and metal-acrylic fixed dental prostheses: a retrospective analysis. umich.edu
Cited by 54
R Rutkowski, R Smeets, L Neuhöffer, C Stolzer, K Strick… – BMC Oral Health, 2022 – Springer. Success and patient satisfaction of immediately loaded zirconia implants with fixed restorations one year after loading. springer.com
Cited by 15
SJ Sadowsky – Dental Materials, 2020 – Elsevier. Has zirconia made a material difference in implant prosthodontics? A review. academia.edu
Cited by 95
K Vazouras, T Taylor – Int J Prosthodont, 2021 – quintpub.com. Full-arch removable vs fixed implant restorations: A literature review of factors to consider regarding treatment choice and decision-making in elderly patients. quintpub.com
Cited by 10
What is the disadvantage of zirconia implants?
One of the most significant drawbacks of choosing zirconia dental implants is low-temperature degradation as the product ages. This could potentially result in the material's mechanical properties becoming degraded, reducing the material's strength, density, and toughness.
How long will zirconia implants last?
Titanium implants are known to last for 20 years or more. Zirconia is a relatively new treatment, and so the lifespan is unknown. Long-term data is not available yet. However, if properly cared for, they are expected to last for 15-20 years or more, similar to titanium implants.
What is the best material for full mouth dental implants?
Titanium is crucial for dental implants since it is non-toxic, durable and light. The Titanium will act as a replacement root of the tooth and typically last for more than 30 years. For example, Titanium in both medical and dental procedures has been studied and given a high success rate.
Why are zirconia teeth so expensive?
Materials like porcelain, zirconia, and metal alloys contribute to the expense, as they need to withstand the forces of chewing while matching the natural appearance of the teeth. Moreover, the precise fabrication process and customization to fit the patient's unique dental structure add to the overall cost.
Is zirconia better than porcelain?
Zirconia crowns are incredibly strong, often lasting upwards of 15 years with proper care. Porcelain crowns, while also durable, may require replacement sooner, generally around 10 to 15 years. They are custom-colored to match your surrounding teeth, but they may show signs of wear or slight discoloration over time.
