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14 IMPLANT NEWS Implant Tribune United Kingdom Edition | 2/2017 implants. “Various treatment mo- dalities are applicable with ce- ramic implants: immediate place- ment, immediate temporization, full arch and full mouth rehabili- tation can be performed with ex- cellent and predictable outcomes. I, however, believe that adopting ceramic implants should be ac- companied by training or shad- owing from an experienced clini- cian, even if one has experience with titanium implants.” Only a few implant manufacturers focus on ceramics Interestingly, most of the major implant manufacturers do not have a ceramic implant on the market, let alone in development. The most notable exception is Straumann. Headquartered in Basel, Switzerland, Straumann is an international leader in implant and restorative dentistry, with its products and services available in more than 100 countries. Strau- AD mann currently offers Pure, a completely zirconia-based im- plant that is ivory- coloured, simi- lar to a natural tooth. The com- pany recently announced that it has entered into a partnership with maxon motor, which will allow it to develop dental implant components through ceramic injection moulding rather than conventional cutting techniques. The move demonstrates the com- pany’s recognition of the grow- ing market for aesthetically pleas- ing, metal-free implants. Given that one of the main barriers to zirconia implants is their compara- tively high price, Straumann aims to make it a more widely available and affordable option. In addition, TAV Dental is one of the few companies that offer both one-piece and two-piece ceramic implants. Their primary focus is to create state-of-the-art zirconia dental products through an innovative approach to tech- nology, fostered by their parent company, TAV Medical. TAV Den- tal offers a variety of one-piece and two-piece zirconia implants that are entirely white, a distinct aesthetic improvement from the metallic colour of a titanium im- plant that is often visible. Further- more, the inert nature of TAV Den- tal’s zirconia implants make them less likely to fracture and highly resistant to foreign compounds as well as the application of heat, fur- ther beneitting patients. Another company manufactur- ing ceramic implants, CeraRoot, in- troduced its zirconia implant sys- tem to the European market in 2005 and the US market in 2011. Located in Barcelona, Spain, the company utilised improvements in ceramic materials to design a one-piece ceramic implant. Whereas titani- um-based implants have two sepa- rate parts—the ixture and the abutment— CeraRoot’s product in- corporates both elements into one implant. This ensures that there is no prosthetic connection where bacteria can grow, theoretically leading to better periodontal health. International Magazines implants international magazine of oral implantology www. dental-tribune.com issn 1868-3207 Vol. 17 • Issue 2/2016 implants international magazine of oral implantology 2 2016 EUR 44 per year (4 issues per year; incl. shipping and VAT for customers in Germany) and EUR 46 per year (4 issues per year; incl. shipping for customers outside Germany). Your subscription will be renewed automatically every year until a written cancellation is sent to Dental Tribune International GmbH, Holbeinstr. 29, 04229 Leipzig, Germany, six weeks prior to the renewal date. Shipping Address Name Address Zip Code, City Country E-mail Date, Signature research Morbidity after harvesting of autologous pelvic bone case report Bimaxillary implant restoration by all-ceramic bridges interview A nuanced perspective on periimplantitis PayPal Credit Card Credit Card Number Expiration Date Security Code SUBSCRIBE NOW! F +49 341 48474 173 subscriptions@dental-tribune.com One of the primary players in ceramic implantology is Dental- point with their metal-free Zeramex system. Established in 2005, the company spent four years researching and developing a two-part implant made of zirco- nia, presenting it to the world in 2009. Zeramex offers a revolu- tionary approach to ceramic im- plantology through their metal- free, screw-in implant, allowing for a lexible restoration with a high level of biocompatibility. Combining this with a higher re- sistance to corrosion results in a product that rivals titanium im- plants in performance. Zsystems is a Switzerland- based company that, through their Zirkolith range of products, offers extensive ceramic implant options. Similar to TAV Dental, they offer both one-piece and two- piece implants and their osseoin- tegration rate is similar to leading titanium implants. Another com- pany, VITA Zahnfabrik, has en- tered the ceramic implant market with its own one-piece cylindro- conical ceramic implant. In opera- tion since 1924, and with a focus on innovation, VITA claims their ceramic implant offers faster, safer healing than titanium-based implants. With a compatibility rate of 98 per cent for more recent models, zirconia-based ceramic implants are increasingly match- ing the standards set by titanium implants and have thereby be- come a more viable option. As Noumbissi concludes, “The future of ceramic implants is re- ally bright for many reasons. Pa- tients increasingly ask for safer, less invasive solutions, as well as metal-free alternatives for teeth repair or replacement. Dental atti- tudes and understanding of zirco- nia and bioceramics are slowly but steadily evolving, with a deinite shift toward biological and inert materials. There has also been a shift in the health care industry towards wellness and wellbeing, and providing therapies that have little to no side effects.” Since some of the larger play- ers in the implant industry are incorporating, or have already adopted ceramic implants in their product lines, either by develop- ment or by corporate acquisi- tions, implantologists could even- tually look at ceramic implants as a viable alternative to titanium. Treatment plan should be adapted for smokers By DTI XI’mN, China: A Chinese study com- paring implant stability and peri-implant tissue response in heavy smokers and non-smokers has found that smoking did not af- fect the overall success of implant surgery, as all implants achieved osseointegration without compli- cations at least by the end of the 12th week after placement. How- ever, smoking did cause the bone around the implants to heal more slowly; thus, implants began to osseointegrate considerably later than in the non-smoking group. Research has demonstrated that smoking can negatively af- fect implant and bone integration. In order to improve treatment outcomes and avoid implant fail- ure, surgeons need to have a pre- cise understanding of how the habit will affect the healing pro- cess. In the current study, 45 ITI (Straumann) implants were placed in the partially edentulous posterior mandibles of 32 male patients, of whom 16 were heavy smokers and 16 did not smoke at all. Implant stability and peri-im- plant tissue response were as- sessed at three, four, six, eight and 12 weeks post-surgery. Although implants in both groups achieved osseointegration by the end of the 12th week, the healing process differed signii- cantly between non-smokers and heavy smokers. In non-smokers, stability improved and implants began to better integrate into the bone after the second week. In the smoking group, however, im- plants only began to osseointe- grate and become more stable after the third week. Despite successful short-term outcomes in both groups, smokers experienced more problems, in- cluding greater bone loss around the implants and deeper soft- tissue pockets. However, smoking had no signiicant effect on plaque build-up or sulcular bleeding in the study group. In light of the indings, the re- searchers suggested that surgeons might need to change their stand- ard implant loading schedule for patients who smoke heavily. In ad- dition, smokers should be aware that their habit promotes the loss of marginal bone and the further development of dental pockets and could thereby lead to compli- cations even after osseointegra- tion, they concluded.