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ePaper created 2017-11-09, 09:28:26 | version 1.38.0
terior region than their titanium counterparts. In fact, im- plants made of titanium are more and more suspected to accelerate inflammatory processes in certain cases, or to even initiate inflammation. A few years ago and in a rather dramatic way, such cases were referred to as titanium al- lergy. Nowadays it is simply described as a hypersensitiv- ity or intolerance to titanium. However, today’s knowledge also include that fact that, due to abrasion and corrosion, small titanium particles can become detached from the implant surface and cause intolerances. Aspects of this phenomenon were extensively outlined by such speakers as Volker von Baer, Dr Daniel Olmedo and Dr Elisabeth Jacobi-Gresser in their respective lectures. Furthermore, Dr Jacobi-Gresser and colleagues strongly recommend a patient risk assessment prior to an implant therapy in or- der to filter out those patients who might develop an intol- erance due to titanium debris. “There is an individual and/ or genetic predisposition of certain patients to inflamma- tory reactions caused by titanium particles which could jeopardise an implant therapy’s long-term success,” said Dr. Jacobi-Gresser. For those identified as risk patients, treatment options with implants made of zirconium diox- ide are, according to expert opinions, particularly suitable. In addition to their immunological compatibility, osseo- integrative properties are a decisive aspect of the applica- tion of ceramic implants, highlighted Dr Richard J Miron in his speech. Thus, he pointed out that the osseous in- tegration of titanium implants was improved and acceler- ated by specific modifications in their surface (mainly by sandblasting and etching). Recently, similar procedures have become available for the manufacturers of ceramic implants, adding an improved osseo integration to their ad- vantageous effect on soft tissue regeneration. Moreover, Dr Jens Fischer described in his speech how the diameter of ceramic implants plays an important role in their appli- cation. According to Dr Fischer, a recently published study implies that implants made of zirconium dioxide should not feature a diameter smaller than 4.0 mm as this would dis- proportionately increase the risk of fracture. In his speech on the phenomenon of low-tempera- ture degradation (LTD) in the humid milieu, Dr Jerome Chevalier illustrated that we still need to do some home- work on ceramic implants. In certain zirconium dioxide implants, this milieu may lead to a loss of stiffness and stability due to the transition of the chemical phase from tetragonal to monocline. Dr Chevalier added that further efforts in materials research will be necessary in order to further evaluate this phenomenon. Dr Jaafar Mouhyi added another aspect in his speech on Saturday: Not only do the material features of the implant surface, the physical properties of the implant body and its design affect possible peri-implant complications, but implant positioning is another important factor. If a func- tional prosthetic restoration cannot be achieved due to a Fig. 1 Fig. 2 Fig. 1: From left: Dr Jens Tartsch, Prof. Dr Sami Sandhaus, Dr Sammy Noumbissi (IAOCI founder and President). Fig. 2: More than 100 participants attended the IAOCI congress in Miami. Photos: Henrik Schröder, OEMUS MEDIA AG disadvantageous implant position, this could be the start- ing point of peri-implant inflammations, states Dr Mouhyi. However, ceramic-implant manufacturers have recently found a way to prosthetically adjust incorrect implant po- sitioning to some extend: Dr Jens Tartsch and Dr Jochen Mellinghoff, M.Sc., discussed the prosthetic flexibility and advanced prosthetic applications of screwed two-piece zirconium dioxide implants. In conclusion, the congress makers behind the 6th IAOCI World Congress must be complemented for giv- ing the topic “ceramic implants” a rare but broad basis for discussion. However, further investigations and sym- posia of this calibre will be necessary in order to estab- lish zirconium dioxide as a fully adequate alternative to titanium implants. As predicted, there were even more ceramic implant manufacturers after the last International Dental Show in Cologne, Germany,—good prospects for patients who wish to be provided with a metal-free im- plant-based restoration. The 7th IAOCI World Congress will be held in California, USA, from 15 to 17 February 2018. For more information please visit: www.iaoci.com. implants 1 2017 53