SICwhite the individual approach Metal free. Cement free. Two parts. www.sic-invent.com

editorial A new year, new faces and new long-term data Janine Conzato research Dental implants and bone marrow defects Dr Johann Lechner Ceramic dental implants in clinical use Dr Jens Tartsch case report page 18 Ceramic implant placement in a medically compromised patient Dr Alexandr Bortsov Single-tooth replacement with ceramic implants Professors Curd Bollen & Paul Tipton Biological and osseointegration capabilities of a zirconia implant Dr Saurabh Gupta Rehabilitation of the maxilla with implant-supported zirconia bars Dr Witalij Kolbe page 28 interview Ceramic implants account for 50% of implants we use Prof. Michael Gahlert & Dr Stefan Röhling industry Patent™—the proven master of zirconia implants Zircon Medical Management Second-generation ceramic implant bredent medical page 34 events news manufacturer news news about the publisher imprint 03 06 12 14 18 24 28 30 34 36 46 42 48 50 | content Cover image courtesy of Zircon Medical Management AG www.zircon-medical.com issn 1868-3207 Sondernummer • Vol. 6 • Issue 1/2022 1/22 ceramic implants international magazine of ceramic implant technology research Dental implants and bone marrow defects case report Ceramic implant placement in a medically compromised patient industry Patent™—the proven master of zirconia implants 04 implants 1 2022

| research Dental implants and bone marrow defects Evaluation of bone quality by intra-oral ultrasonography Dr Johann Lechner, Germany Introduction In ceramic implants—international magazine of ceramic implant technology issue 2/2021, I discussed 1a 1b Inflammatory cytokines/acute TNF-α, IL-1β, IL-6, etc. Long-term increase in RANTES per implantation RANTES overexpressed Neuronal chemokine/ receptor expression Neurological symptoms Basal RANTES mirror in FDOJ Phase 1 3–30 days Phase 2 30–? days Implant placed in the FDOJ area Triggering of RANTES expression by TNF-α, IL-1β, IL-6, etc. Successful osseointegration 2 Figs. 1a & b: Radiograph of an implant. No sign of inflammation in the jawbone (a). Fatty degenerative osteolysis directly attached to the implant and thus not detectable by radiograph (b). Fig. 2: This figure shows schematically the sequence of cytokine expression after wound setting by insertion of an implant into a bone area that is already preloaded with chronic inflammation of fatty degenerative bone marrow. 06 implants 1 2022 the objective validation of bone quality before im- plant placement in light of establishing whether the level of mineralisation in the jawbone is sufficient to osseointegrate an implant without any issues and to keep it secure in a stable bone bed for a long time or whether the implant is connected to a bone marrow defect.1 In this current article, I would like to consider two questions relevant to the situation after implant insertion: – Was the implant inserted into poorly healed bone? – Is implant failure directly associated with incomplete wound healing of the implant site and a bone marrow defect around the implant? How to forecast the success of dental implants The measurement of the quantitative ultrasonic trans- mission velocity (UTV) has been established as an in- novative, objective, valid and reliable method for re- peated, non-invasive measurements of bone quality before dental implantation.5 The intra-individual correla- tion of the UTV values of the maxillary and mandibular lateral regions makes the data easy to interpret. The use of a small UTV device in this study enabled the record- ing of intra-oral UTV values in a large and heteroge- neous patient population. Assessment of alveolar ridge UTV could provide a method for identifying critical bone quality before implant insertion or for monitoring bone healing (mineralisation) after augmentation proce- dures.6 The main advantages of ultrasonic measurement are that it is non-ionising, non- invasive, tolerable and avail- able at relatively low costs. Furthermore, the examination is not a complicated process and can be easily per- formed by clinicians.7, 8 The new technology of trans- alveolar ultrasonic (TAU) measurement by CaviTAU can reliably identify regions of low mineralisation density in bone marrow cavities with signs of bone marrow defects and collateral chronic ischaemic inflammation.9, 10

| research 5c 5a 5b 5d Figs. 5a–d: Frontal and sagittal CBCT images of implant #16. No conspicuous signs of inflammation (a & b). CaviTAU image of the apical part of the implant in green (green = hard substance), surrounded by suspected osteolytic or osteo- necrotic areas in red (red = low bone density; c). CaviTAU image of the hard substance of the implant in white, surrounded by suspected osteolytic or osteo- necrotic areas in red (d). initiated by implant placement, which induces the release of acute cytokines through surgical trauma, provokes inflammatory cascades of TNF-, IL-6 and IL-1 expression. TNF- expression provokes in- creased secretion of RANTES in the bone surrounding the implant in the medium to long term (Fig. 2).13–16 The apparent clinical stability of the implant and the radio- graphic inconspicuousness of the implant lead to the misdiagnosis of an apparently inflammation-free osseointegration. 6a 6d 6b 6c Figs. 6a–d: Radiograph of the ceramic implant placed about nine months before. The radiograph did not give any indication of a possible cause of the atypical facial pain since insertion (a). CaviTAU image indicating a relatively high degree of bone loss around the implant in red (b). CaviTAU image of the implant in white and the surrounding diminished bone density in red (c). According to the CaviTAU measurement, the conspicuous areas with possible osteolysis indicated in red are towards the apical area of implant #16 with clear osteolysis (d). 08 implants 1 2022 CaviTAU detects focal inflammation areas around implants that cannot be identified by radiographs CaviTAU solves the problem by providing reliable ultra- sonic imaging of the circumscribed bone density. The measurement is divided into four vertical comparison steps, demonstrated here with reference to Figure 3: – Step 1: The bottom right measurement shows caudal visualisation of the lower cortical margin of the lower jaw, as well as the less dense areas of the infra- alveolar nerve canal in red and dark blue. – Step 2: The measurement shows the dense implant structure in green or light blue and white with a clearly straight delimitation of the distally located red or dark blue indicating reduced mineralisation density and suspected osteolysis. – Steps 3 & 4: In a cranial and vertical direction, the scan shows dense structures in green or white and areas of suspected minor osteolysis or peri-implantitis in light blue. Case reports on chronic inflammation around implants and their visualisation In the following case reports, the reduced bone den- sities shown by CaviTAU—where the practice proce- dures allowed—were confirmed with the postoperative findings of RANTES/CCL5 expression measured by the multiplex procedure and light microscopy. Generally speaking, panoramic radiographs do not show findings of reduced bone density and are not sufficient for diag- nosis of osteolysis.17 The focus of these case reports is the metrological evaluation of bone density with CaviTAU used from a diagnostic and a preventive perspective. Case 1 The 35-year-old female patient came to our practice with complaints of pressure in areas #24 and 25, into which two titanium implants had been placed. Pre- viously, after several root canal therapies and unsuccess- ful apicectomies, the teeth had finally been extracted and replaced with titanium implants. On the CBCT scan, the implanting dentist could not see any abnor- malities at implants #24 and 25 that could explain the pressure complaints and pulling pain in the implant area. As the patient did not wish to retain the two im- plants owing to this chronic feeling of pain, she came to our clinic with the request for a more detailed ultrasonic diagnosis of her bone situation in the region of implants #24 and 25. We performed a measurement of the bone density in the region of implants #24 and 25 with CaviTAU. The

RANTES (pg/ml) were altogether consistent with changes related to FDOJ (Figs. 8 & 9). 3,475.0 Conclusion | research 4.000,00 4.000,00 3.500,00 3.500,00 3.000,00 3.000,00 2.500,00 2.500,00 2.000,00 2.000,00 1.500,00 1.500,00 1.000,00 1.000,00 500,00 500,00 149.9 Norm jawbone (n=19) Norm jawbone (n=19) Our case studies demonstrate the immunological rela- tionship between implants and FDOJ. The extent to which increased expression of RANTES derived from FDOJ areas contributes to immune-mediated disease is difficult to determine. Our cases provide evidence for the possible interaction between implants, RANTES signal- ling and general health. A comprehensive understanding of the complex networks described in our cases requires further research. Removal of implants and surgical re- moval of surrounding FDOJ areas can reduce RANTES overexpressed signalling pathways, potentially reducing inflammatory input and associated symptoms. Owing to the insufficient imaging of the mineralisation levels in the bony implant environment in panoramic radiographs and the unavoidable hardening artefacts in CBCT scans, a considerable part of the bone marrow in the jaw cannot be correctly immunologically as- sessed. These assessment criteria in implantology can be measured by CaviTAU ultrasonography (Fig. 10). After extraction of implants and removal of surrounding FDOJ areas, the silent inflammation may remain in the jawbone in case of incomplete debridement and poor bone healing might occur. This situation is then also often responsible for failure of the subsequent implan- tation or even for immediate ceramic implantation. For future successful implant surgery, prior measurement of the bone density and thus a determination of the metabolic situation in the jawbone is therefore essential for overall immunological safety for the patient and the treatment success for the dentist. For unexplained pain as in our described case reports, the easy-to-use and radiation-free CaviTAU is available to detect radiograph- ically undetectable silent inflammation. Author details Literature 9a 9b 0,00 0,00 FDOJ implant area 16 FDOJ implant area 16 10a 10b Figs. 9a & b: Large areas of dissolved bone directly around the implant, as well as fatty parts (a). Local overexpression of RANTES by around 30-fold com- pared with the standard value of the multiplex analysis (b). Figs. 10a & b: The sender and receiver are in a fixed coplanar position (a bar connects the sender and receiver). There are semi-solid gel pads between the sender and the cheek on the outside of the mouth and between the receiver and the alveolar ridge in the intra-oral position. A trans-alveolar ultrasonic impulse is sent from the sender to the receiver (blue arrows; a). Positioning of the sender (outside) and receiver (intra-oral) in the lower jaw (b). The peri-implant tissue showed not only the typical FDOJ softening but also the overexpression of RANTES. This further validated the pathological imag- ing by CaviTAU. It appeared that further inflammatory signalling cascades—primarily based on RANTES mes- senger substances—had been provoked by the inser- tion of the implant and the directly associated wound healing (Fig. 6). Case 3 The 57-year-old female patient had suffered from mi- graines, but only on the right side, and atypical facial pain, in her upper right jaw only, since the implant placement (Fig. 7). Histology of a medullary tissue sample from region #16 found exclusively fatty marrow and necrobiotic changes and areas of mucinous degeneration as well as small oil cysts. It also found small areas of fibrosis. The findings contact Dr Johann Lechner Praxisklinik Ganzheitliche ZahnMedizin Grünwalder Straße 10 81547 München, Germany drlechner@aol.com www.dr-lechner.de 10 implants 1 2022

Ceramic dental implants in clinical use Evaluation of the ESCI scientific survey Dr Jens Tartsch, Switzerland Introduction Method In modern dental implantology, ceramic implants offer a supplement to the treatment spectrum with titanium implants. Increasing interest in ceramic implants owing to their biological advantages can be observed not only on the part of health-conscious patients but also in the dental profession. Promising short- and medium-term data on the successful use of ceramic implants is avail- able. Nevertheless, the topic of ceramic implants is still controversial in part because of the lack of long-term data. Even systematic reviews do not provide this, referring mainly to specific experiences with individual systems. Comprehensive findings on the general practical use of ceramic implants and experience from daily dental practice are still lacking. To this end, the European Society for Ceramic Implan- tology (ESCI) conducted a global survey aiming to gain deeper insight into the general daily handling of ceramic implants and to answer questions concerning ceramic implantology. This survey provides valuable information for the further development of ceramic implants and makes an important contribution to their reliable use— ultimately for the safety of our patients. The survey questionnaire was designed by the ESCI scientific advisory board in German and English and was addressed to users of ceramic implants, users of titanium implants and dental technicians. The results of the survey were evaluated by the ESCI. The survey was not conducted for commercial purposes, and no financial resources were provided by partners or other third parties. The question- naire was implemented in an online survey tool and sent as an online link via e-mail to the members of the ESCI, among others, published on the ESCI’s website, published via print media of the dental press and distributed via various other channels of the survey partners from April to November 2021. This included social media channels of and news- letters from collaborating professional societies and the ESCI’s company partners. The ESCI would like to thank all supporters for their efforts. These are the Austrian Society of Implantology (ÖGI), European Association of Dental Implantologists (BDIZ EDI), PEERS, the German Society for Environmental Dentistry (DEGUZ), the “Zahngipfel”, as well as the companies Institut Straumann AG, CAMLOG Biotechnologies GmbH, Nobel Biocare Services AG, Dentalpoint AG, Z-Systems GmbH, COHO Biomedical Technology Co., LTD., CeramTec GmbH, Zircon Medical Management AG and the Dental Campus Association, as well as numerous media partners. 12 implants 1 2022

| case report Ceramic implant placement in a medically compromised patient Dr Alexandr Bortsov, Russia Introduction While dental implants are becoming a standard treat- ment for tooth loss, there is emerging but steadily growing patient demand for reliable, metal-free, natural- 1 3 5 7 2 4 6 8 Fig. 1: Initial situation. Fig. 2: coDiagnostiX planning in the molar region. Fig. 3: Guided surgery template. Fig. 4: Guided surgery template close up. Fig. 5: Checking precision fit of the guided surgery template. Fig. 6: Drill for the fixation pin preparation. Fig. 7: Fixation pin in place. The template was securely fixed. Fig. 8: Tissue punch, the pilot instrument. 14 implants 1 2022 looking ceramic implants. This demand is particularly pronounced not only in patients with metal sensitivity but also in those who would like to have highly aesthetic restorations. I personally have experienced that the latter group are patients who have had restorations before, done extensive research about the topic online and come to my practice specifically asking for ceramic implants. The challenge I face is that those patients would like to have a reliable ceramic implant and expect successful treatment outcomes irrespective of their age, lifestyle or medical history. The following clinical case report describes a three-unit bridge restoration on ceramic implants in a medically compromised patient who came to my practice seeking a natural-looking, metal-free restoration. Initial situation A 53-year-old diabetic patient who was a smoker and had good hygiene and no parafunctional habits pre- sented to the clinic for the replacement of the missing premolars and molars in the left mandible (Fig. 1). The patient had received metal–ceramic restorations in the past and was dissatisfied with the experience, com- plaining about a grey metal margin that became visible with time and had a non-aesthetic appearance. The pa- tient was well informed about the subject and wanted to have a natural-looking, metal-free restoration which would nevertheless be strong and reliable. He also was concerned about the surgery itself and had a strong preference for a minimally invasive surgical procedure. Further anamnesis and routine testing revealed ele- vated haemoglobin A1C at 9%. Treatment planning It was discussed with the patient and his endocrinolo- gist that Straumann PURE monotype ceramic implants (zirconia implants with the ZLA surface) restored with a full-ceramic three-unit bridge would provide a metal- free, aesthetic and mechanically strong restorative solution in this clinical case. It was also agreed to use a fully guided surgery approach to avoid incisions and minimise surgical trauma.

| case report 22 23 24 Fig. 22: Healed sites five days post-op. Fig. 23: Healed sites before cementation and after removal of the protective caps. Fig. 24: Final restoration. design. Thus, the surgical protocol for osteotomy preparation for PURE is the same as for the corre- sponding bone-level implant. For this case, the osteot- omy preparation guide was used according to the protocol established for bone-level implants provided by coDiagnostiX (Figs. 9–11). The basic implant bed preparation was done using pilot drills followed by twist drills: for the 3.3 mm diameter implant, the final drill was 2.8 mm in diameter; for the 4.1 mm diameter implant, the final drill was 3.5 mm in diameter. The fine implant bed preparation was done using the respective profile drilling and tapping for the 3.3 mm and 4.1 mm diameter implants. The PURE im- plant comes with a separate transfer piece that locks securely into place (Figs. 12 & 13). Three points on the driver line up with the flat surface of the implant abutment and indicate the distance to the shoulder (1, 2 & 3 mm; Fig. 14). This design greatly facil- itates implant placement and makes it very straight- forward. The implants were placed in the positions of the first premolar (diameter: 3.3 mm; narrow diameter; length: 12.0 mm; abutment height: 5.5 mm) and second molar (diameter: 4.1 mm; regular diameter: 12.0 mm; abutment height: 5.5 mm), respectively. The implants were placed precisely in the planned positions regard- ing the insertion depth and relative to the centre of the sleeve (Figs. 15 & 16). Prosthetic procedure Since good primary stability was achieved (about 45 Ncm), and there were no teeth in the maxilla, it was decided to take a closed-tray impression right after the surgery and fix the implant analogues in the clinic (Figs. 17 & 18). Appropriate protective caps were placed on the abutment portions of the implants (Fig. 19). The impressions were transferred to the laboratory, and within four working days, a one-piece anatomical bridge of zirconia was made (Figs. 20 & 21). mucosa appeared a healthy pink (Fig. 23). The abut- ment parts of the ceramic implants were cleaned and prepared for cementation. Excess cement was re- moved. A follow-up visit seven days after cementation was arranged. No further crown adjustments were re- quired, and the patient was very comfortable with the final restoration (Fig. 24). Treatment outcomes At the one-year follow-up, there were no biological or technical complications. The treatment option of ceramic implants and a zirconia restoration appears to be a valid alternative to titanium implants in patients requiring metal-free restoration, even in a diabetic patient. The soft tissue around the implant remained stable over time, indicating the excellent biocompatibility of the ceramic. The tissue-level design of the implant places the cementation line at or above the gingival margin to facilitate hygiene maintenance. The tooth-like colour of the body enables the achievement of high aesthetics. The patient was satisfied with the functional and aes- thetic outcomes. about the author Dr Alexandr Bortsov graduated with a DDS from South Ural State University in Chelyabinsk in Russia. As a surgeon, his focus areas are implantology and guided surgery, aesthetic dentistry and digital dentistry. Dr Bortsov is the director of the Dental Art clinic in Chelyabinsk and of the International Team for Implantology study club in Chelyabinsk. Author details contact After five days, the patient came to the clinic for fixation of the final restoration. At this appointment, plaque was seen on the protective caps (Fig. 22), but the healed Dr Alexandr Bortsov +7 905 839850 89058398504@mail.ru 16 implants 1 2022

| case report Single-tooth replacement with ceramic implants A case series Professors Curd Bollen & Paul Tipton, UK ties have been proved.1 Yet, this material is not exempt from complications. Firstly, these metallic implants show aesthetic limitations when used in the anterior region, especially in patients with a thin gingival biotype. Examples are the possible appearance of a metallic margin in case of gingival recession and a greyish discoloration due to translucency of the peri-implant mucosa.2, 3 Secondly, studies have reported immunological reactions to titanium particles, leading to biological complications.4 Others have demonstrated allergic reactions to titanium, reporting a prevalence of 0.6%.5 Thirdly, it must be taken into account that the number of patients demanding metal-free implants has been increasing during recent years. For these rea- sons, non-metallic alternatives to titanium have emerged. The first ceramic implants arrived on the market more than 40 years ago.6 They were made of alumina, a material prone to fracture when loaded unfavourably, and so they are no longer available on the market.7 More recently, yttrium tetragonal zirconia polycrystal (Y-TZP) became the material of choice for the manufacture of ceramic implants. It is characterised by a high resistance to fracture, a low modulus of elasticity, a low affinity to plaque and high bio- compatibility.8, 9 In this series of four cases, the CERALOG system (BioHorizons Camlog) was used. CERALOG implants are manufactured from Y-TZP.10 The CERALOG system provides all the necessary elements to permit retention of any type of prosthesis upon these implants, ranging from single crowns to a full-arch restoration. In this case series, the treatment indication was single-tooth implants. 1a 1c 1b 1d Figs. 1a–d: Pre-op situation in all four patients. Case 1 (a). Case 2 (b). Case 3 (c). Case 4 (d). Introduction Dental implants have helped to improve quality of life for our patients. The material of choice for implants remains Type IV titanium, whose mechanical and biological proper- Table 1: Patients’ data. Sex Male Male Male Male Case 1 Case 2 Case 3 Case 4 Age (years) Health status Smoking status Periodontal health Diastema location 52 43 57 61 ASA I ASA I ASA I ASA I No No No No Healthy Healthy Healthy Healthy #35 #25 & 26 #16 & 26 #26 18 implants 1 2022

| case report 5a 5b 5c 6a 6b Figs. 5a–c: Radiograph after five months (a) and healing abutments in place (b & c; Case 3). Figs. 6a & b: Radiograph after five months (a) and healing abutment in place (b; Case 4). Digital intra-oral scanning One week after the second-stage surgery, the intra-oral scanning was performed using a Medit i500 scanner (Medit) following the scanning protocol prescribed by the company (Fig. 7). After the removal of the healing abutments, CERALOG scan bodies (PEEK–titanium alloy screw) were inserted into the implants. After the scan- ning procedure, the original healing abutments were re inserted. Shade determination was digitally carried out with a Rayplicker (Borea). For the planning of the prosthetic restoration, polyphenylsulphone selection abutments were used. All the crowns were ordered digi- tally from the same dental laboratory. For all the crowns, a ceramic material was selected. Crown installation On average, two weeks after the scanning procedure, the crowns were available for placement. PEKK abutments were used. All the crowns were prepared as screw- retained superstructures. Since the four patients strictly 7a 7c 7b 7d Figs. 7a–d: Digital intra-oral scans after the second-stage surgery. Case 1 (a). Case 2 (b). Case 3 (c). Case 4 (d). 20 implants 1 2022

| case report 8a 8b 9a 9b 10a 10b 10c Figs. 8a & b: Final control radiograph of the implant position (a) and final intra-oral situation for Case 1 (b). Figs. 9a & b: Final control radiograph of the implant position (a) and final intra-oral situation for Case 2 (b). Figs. 10a–c: Final control radiograph of the implant position (a) and final intra-oral situation for Case 3 (b & c). wished for a bio-holistic approach, the six titanium abut- ment screws were replaced with six gold abutment screws (Holisticor screws). These gold screws were tight- ened to a maximum torque of 15 Ncm. When titanium abutment screws are used, a maximum toque of 25 Ncm should be applied. As recommended by the company, 11a 11b Figs. 11a & b: Final control radiograph of the implant position (a) and final intra-oral situation for Case 4 (b). with occluding paper). Oral hygiene instructions were given, focused on interdental cleaning with interdental brushes. A final control radiograph was taken. The PEKK abutment is not radiopaque, and therefore the distance between the implant and crown can easily be determined in the radiograph: the abutment is correctly positioned in the implant when the gap between the implant shoulder surface and the lower edge of the crown measures 0.55 mm in the radiograph (Figs. 8–11). Conclusion All the patients were happy with the results of the therapy: the functional and aesthetic outcome was satisfying. The only remark was the long duration of the complete therapy for the upper jaw cases. Owing to the extended osseointegration period of five months, the complete therapy took more than six months. From the practi- tioner’s point of view, there was no major difference in comparison with the use of titanium implants, besides the fol lowing of the strict guidelines from the manufacturer. CERALOG implants seem to be an adequate and stable alternative to titanium implants in the replacement of lateral teeth in the upper and lower jaws. all the screws were retightened to the corresponding torque (15 Ncm) after at least 5 minutes. The screws were protected with PTFE tape, and the remaining screw openings were filled with a composite material of the same colour as the zirconia crown. The occlusion was checked and adjusted where necessary (occlusal con- cepts included no guidance on the implant-retained res- torations and very light intercuspal contact as verified contact Prof. Curd M.L. Bollen +44 121 3459847 curdbollen@me.com Author details Literature 22 implants 1 2022

| case report Biological and osseointegration capabilities of a zirconia implant Dr Saurabh Gupta BDS MDS, India 1 2 Introduction Extraction of tooth is carried out for numerous reasons, including caries, fractures, periodontal problems, pros- thetic purposes, orthodontic, and widespread external or internal root resorption. Root resorption (pathological) has a multifactorial etiology, although many aspects re- main unclear, and can lead to loss of tooth structure. The use of dental implants is a reliable treatment option for replacing missing or hopeless teeth, and the satisfactory and predictable outcomes reported by several implant research studies have supported the huge development and standardisation of oral implantology. According to the available data, the current success rate of dental implants is around 94–95% in the maxillary area and 97–98% in the mandibular area after a ten-year follow up period.1 However, the rising demand for usage of dental implants is associated with a growing need for long term and predictable results, and despite having excellent success rates, complications/failures may occur because of biomechanical and biological complications. Peri-implantitis is a biological complication and is still a topic of concern. Peri-implantitis is a pathological condition that occurs in the tissues around dental implants and is characterised by inflammation of the peri-implant connective tissue and progressive loss of the supporting bone. In clinical situ- ation, peri-implantitis sites exhibit signs of inflammation and, in particular, increased probing depths and/or re- cession of the mucosal margin, bleeding on probing and/ or suppuration, and radiographic bone loss. According to Jan Derks, the prevalence of peri-implant mucositis 3 4 24 implants 1 2022

| case report 9 11 10 12 and the socket was debrided using diode laser therapy. After 12 weeks, a one-piece zirconia implant (ZiBone, COHO Biomedical Technology) was inserted following the company’s protocol (Figs. 4–7). A zirconia implant was chosen for better biological integration. Further- more, the patient had requested a metal-free option, since there was a possibility of a metal allergy. The fixture was loaded with a metal-free zirconia crown after 16 weeks (Figs. 8 & 9). During the follow-up period, the patient did not report any symptoms of peri-implantitis or other problems, and the clinical and radiographic examination showed the success of the metal-free im- plant prosthetic restoration. In particular, the peri-implant tissue appeared healthy (Figs. 10 & 11), and the radio- graph confirmed the absence of marginal bone loss around the implant and no sign of bone resorption (Fig. 12). Discussion latter releases corrosion products around the implant site. The characteristics of their enhanced biocompatibility, along with good osseointegration and success rates, make zirconia implants clear candidates for use in clinical implant dentistry. However, further investigations on tita- nium release and its connections with peri-implantitis, hypersensitivity and bone resorption are recommended. about the author Dr Saurabh Gupta graduated from Manipal College of Dental Sciences in India with a BDS and holds a master’s degree in oral and maxillofacial surgery from Rajiv Gandhi University of Health Sciences in Bangalore in India. He is an international and national lecturer and a board member and Education Director of the International Academy of Ceramic Implantology. He is a member of the Zirconia Implant Research Group, which aims to orient and lead research in the field of metal-free implantology. He founded and directs WhiteZ Dental in Bangalore. In the above case, the zirconia dental implant seemed to have integrated well without any signs of marginal bone loss and established excellent soft tissue healing. A ceramic dental implant has some benefits over titanium: although the survival and success rates of zirconia and titanium dental implants are quite comparable, some re- search studies have stated that a zirconia dental implant is more biocompatible compared with titanium, as the contact Dr Saurabh Gupta BDS MDS Oral & Maxillofacial Surgeon Bangalore, India +91 9916 203455 whitezdental.com Author details Literature 26 implants 1 2022

| case report Rehabilitation of the maxilla with implant-supported zirconia bars Dr Witalij Kolbe, Germany 1 2 Fig. 1: Pre-op radiograph revealing severely pronounced atrophy in the maxilla. Fig. 2: Six zirconia implants were placed in the patient’s maxilla. The use of zirconia as a material for dental implants and prostheses, in conjunction with newly developed materi- als and CAD/CAM technology, undoubtedly represents a fascinating opportunity to restore the teeth of our pa- tients. As with any new technology, increasingly precise manufacturing techniques are bringing about a change in indications. Today, it is possible to realise custom- fabricated CAD/CAM zirconia bars on zirconia implants. The use of the material zirconia for abutments, implants and bars is certainly recommended from a biological stance. Based on the vast number of past successful clinical res- torations, one can be confident in choosing restoration with bar-supported hybrid prostheses. In the recent past, the employment of zirconia as a material for implants, abutments and bars in the context of surgery and hybrid prostheses has proved to be both a successful combina- tion method and a successful stand-alone approach in clinical practice. In the following, a clinical case report is described which illustrates how even the smallest details matter when it comes to determining the optimal use of zirconia implants, abutments and bars in clinical practice. Clinical case Owing to severely advanced atrophy in the maxilla, not only missing tooth structure but also missing jawbone and soft tissue had to be replaced in the patient (Fig. 1). Six zirconia implants (AWI, WITAR) were placed in the patient’s maxilla (Fig. 2). A complete denture was fabricated for the healing phase and the base lined with a soft lining material. Six months later, after the surgical phase had been completed, the prosthetic restoration was carried out. The therapeutic decision was made in favour of a removable palate-free combination restoration. In order to meet the aesthetic demands, it is imperative to perform an overall wax try-in before designing the bar so that the bar can be designed according to the tooth 3a 3b Figs. 3a & b: The implant shoulders and zirconia abutments were positioned transgingivally. 28 implants 1 2022

| interview Ceramic implants account for 50% of implants we use An interview with Prof. Michael Gahlert & Dr Stefan Röhling, Germany Dr Stefan Röhling (left) and Prof. Michael Gahlert are experts in two-piece ceramic implants. Experts in the field of two-piece ceramic implants, Prof. Michael Gahlert and Dr Stefan Röhling together run an oral surgery practice in Munich. In this interview with ceramic implants, they discuss the advantages of ceramic implants and provide a scientific update on the topic. In addition, the implantologists, being pioneers in the field of modern ceramic implants, share their experience of zirconia im- plants and consider the significance for clinicians of the statement by the European Society for Ceramic Implantol- ogy on the clinical application of two-piece zirconia im- plants and what the future holds for ceramic implantology. loaded zirconia and titanium implants”. What exactly did you investigate in that research? Dr Röhling: In this experimental study, we investigated for the very first time the occurrence and onset of ligature-induced peri-implantitis around ceramic implants in direct comparison with titanium implants. In the joint project with Prof. David Cochran of the University of Texas Health Science Center at San Antonio School of Dentistry in the US, we were able to show that during ac- tive and spontaneous progression of inflammation there was significantly less bone loss around ceramic implants than around titanium implants. Dr Röhling, together with Prof. Gahlert and other colleagues, you received the 2020 André Schroeder Prize for Preclinical Research for your study titled “Ligature-induced peri-implant bone loss around There is clinical evidence that ceramic implants offer superior biocompatibility. Does this have an impact on the lower tendency to develop peri-implantitis? 30 implants 1 2022

| interview Dr Röhling: The development of peri-implantitis de- pends on multiple factors. However, the accumulation of bacteria on the implant surface in the form of biofilm can clearly be observed to be one of the main causes of the development of peri-implant inflammation. This formation of biofilm depends not only on the physical (surface roughness) and chemical (surface energy and surface tension) properties of the surface but also on the type of biomaterial used (titanium versus ceramic). Scientific studies have shown that less biofilm accumulates on ceramic than on titanium for implants with similar surface “There is now sufficient scientific data to support reliable clinical use of ceramic implants of zirconia.” topography. The results of our experimental study are even more concrete. Based on the currently available data, it can certainly be assumed that the biocompatibil- ity has an impact on the development of peri-implantitis. However, whether ceramic implants truly have a lower tendency to develop peri-implant infections over the long term is very difficult to say based on the current data. The research data obtained to date is very promising nonetheless. Prof. Gahlert, you are currently working on a retrospec- tive follow-up study of Zeramex two-piece ceramic implants. Do you already have initial results to share? Prof. Gahlert: We conducted a retrospective follow-up examination of 21 patients with one of our doctoral students and the University of Basel. This involved re-examination of 36 two-piece ceramic implants of the type Zeramex XT. In addition to measuring clinical parameters, the study considered abutment–implant connection by means of a carbon screw, which did not lead to complaints in any of the cases we re-examined. The average loading phase of the ceramic implants was 2.1 years, and the survival and success rates were the same as for comparable and established titanium implants. Of the implants placed in your practice, what per- centage are ceramic implants? Prof. Gahlert: Looking back at the last ten years, the pro- portion of ceramic implants placed at our practice has risen continuously alongside the use of titanium implants. Today, especially at our practice, I would put the share of ordinary ceramic implants at 50%. There are hardly any one-piece titanium implants. What role do one-piece ceramic implants play in clinical practice? Dr Röhling: One-piece ceramic implants are definitely a niche product that is only routinely used by a few prac- titioners. Many clinicians are sceptical about the surgical and prosthetic handling as well as the fact that the super- structures can only be cemented. The two-piece ceramic implant designs are closer to what the majority of dental surgeons would like to use, since the clinical handling is comparable with that of titanium implants. At our prac- tice, however, one-piece ceramic implants are an import- ant factor in everyday clinical work because excellent results can be achieved with regard to the red–white aesthetics, especially in the aesthetically critical area of the anterior teeth. In which cases do you prefer two-piece, screw- retained ceramic implants? Prof. Gahlert: For larger prosthetic restorations, the two- piece implants offer greater prosthetic flexibility. Plus, as implantologists, we prefer it when the implants heal sub- gingivally or epigingivally because this poses a lower risk of early or improper loading caused by projecting implant stumps. This problem remains with one-piece implants, especially if patients wear removable temporary dentures during the healing phase. The current trend in titanium implants is bone- level design. Does this also apply to ceramic im- plants? Dr Röhling: Looking at the international market for titanium implants, we see more bone-level designs in use than tissue-level designs. This development can definitely be attributed to increased prosthetic flexibility. To further establish ceramic implants on the market and make them of interest to more clinicians, it is absolutely essential for reversible, screw-retained, two-piece bone- level ceramic implant designs to be available to permit the creation of individual abutments. The discussion surrounding bone-level versus tissue-level designs, however, should not be limited to the factor of prosthetic flexibility. The underlying biological principles should be considered as well. This makes it clear that there certainly still are justifications for a tissue-level design in regular clinical practice today. Is the interest in ceramic implants reflected in your patients? Prof. Gahlert: We are repeatedly amazed at the range of information which new patients looking for implant restoration have when they arrive at our practice. The Internet has a wealth of information to offer on this topic. Many patients also come because ceramic implants have now opened up new options for them that would not be achievable with titanium from the patient’s per- spective. 32 implants 1 2022

| industry Patent™—the proven master of zirconia implants Supported by fi rst ever long-term studies Zircon Medical Management, Switzerland The fi rst ever nine-year study on ceramic implants The prospective nine-year study presented at the recent AO annual meeting investigated patients with average health profi les who had received two-piece Patent™ Implants in single-tooth posterior restorations at Heinrich Heine University Düsseldorf between 2011 and 2012.1 Extremely high survival rates for the implants (95.8%) were documented after nine years of wear—rates com- parable to those of titanium implants. Also, stable bone and soft-tissue levels with mucosal recession of less than 1 mm were documented in all the implants after the nine- year period. Furthermore, the researchers observed no bleeding on probing in more than half of the implants after this period. In light of the convincing results, lead researcher Prof. Jürgen Becker emphasised that pre- dictable, safe and long-term reliable restorations can be achieved in average implant patients with the two-piece Patent™ Implants. Revolutionary prosthetic concept The excellent long-term performance of the two-piece Patent™ Dental Implant System documented in the pro- spective study can be attributed to a number of special design factors implemented with the aim of eliminating the drawbacks of conventional ceramic implants once and for all. Unlike some other ceramic implants, the Patent™ implant design was not merely copied from titanium implants, but was purposefully engineered with the specifi c material properties of zirconia in mind. While other systems rely on metal screws for the inter- nal connection or employ an unfavourable ceramic– ceramic screw connection, the Patent™ Dental Implant System has developed a revolutionary prosthetic con- cept: the prosthetic connection is realised via a high- tech glass fi bre post, which has dentine-like properties and, being fl exible, dampens the masticatory forces transferred from the defi nitive restoration to the implant. The result is a metal-free and extremely stable con- struction without a bacteria-prone micro-gap at the sub gingival level. Fig. 1: At the 2022 Academy of Osseointegration annual meeting in February, the fi rst ever nine-year prospective study on two-piece ceramic implants was presented. In response to the desire for a broader range of indica- tions and greater prosthetic fl exibility, two-piece ceramic implant systems are increasingly fi nding their way on to the market. In the past, however, numerous two-piece ceramic implant systems have come to the market that presented major drawbacks regarding failing osseointegration or high fracture rates. With the Patent™ Dental Implant System, Zircon Medical Management has adopted a revolutionary, 20-year-old technology that promises to eliminate these drawbacks of conventional ceramic implant systems. Making good on this ambitious claim, a team of research- ers at Heinrich Heine University Düsseldorf in Germany has now presented the fi rst reliable long-term data of its kind on the clinical success of two-piece ceramic im- plants at the recent 2022 Academy of Osseo integration (AO) annual meeting in San Diego in the US, heralding a paradigm shift in the scientifi c debate surrounding dental implants. The fact that long-term successful treatments can be realised with the two-piece Patent™ Dental Implant System has now been scientifi cally proved. 34 implants 1 2022

| industry Second-generation ceramic implant Successional whiteSKY zirconia implant from bredent medical bredent medical, Germany 1 2 Fig. 1: The zirconia used for whiteSKY implants has a tetragonal structure. This structure only occurs in nature at temperatures between 1,173 °C and 2,370 °C. Yttria is added to stabilise the structure at room temperature.7 Fig. 2: Unground zirconia has a strength triple that of titanium and double that of alumina. Industrial grinding increases its strength even further, meaning that a strength of approximately 2,000 N can be achieved in implants. The contemporary zirconia implant is truly com­ parable to titanium and has no treatment limitations. This makes it a reliable alternative for patients with metal allergies, those wishing to lead a metal­free lifestyle and those needing implants in the aesthetic zone to ensure that dark shading does not affect the aesthetic out­ come of the restoration. Zirconia is perfectly suited for implants, since its strength is three times higher than that of titanium and it exhibits ideal elasticity and long­ “Zirconia is perfectly suited for implants, since its strength is three times higher than that of titanium and it exhibits ideal elasticity and long-term resistance to fracture.” term resistance to fracture. Scientific studies have shown that zirconia features the same characteristics as comparable titanium surfaces regarding osseo­ integration.1, 2 The whiteSKY zirconia implant system developed by bredent medical has been proved to be safe and dura­ ble, demonstrating excellent long­term results since its introduction in 2006.1, 2 The company has now built on this success with the launch of a second generation of the system. The new whiteSKY Tissue Line and Alveo Line ceramic implants incorporate all the features of the classic whiteSKY implant in an improved, con­ temporary design and new shape which has been scientifically and clinically proved. For the first generation of whiteSKY implants, clinical and scientific evaluations have been carried out from the very beginning, and histological investigations have confirmed the implant’s excellent osseointegration and verified its long­term clinical outcomes. Research shows that its survival rate is on par with that of titanium implants and that bone levels remain stable in the long term, and the red–white aesthetics have been shown 36 implants 1 2022

| industry 5 6 whiteSKY Alveo Line with its wide platform for the closure of the alveolus is ideal for customisation according to the anatomical situation of the patient to achieve maximum in aesthetics in any case—then it is used in the analogue and digital workflow like a natural tooth. whiteSKY Alveo Line and Tissue Line have the reduced abutment height with a 15° bevel at the tip which facilitates the resto­ ration of tilted implants in the maxillary ante­ rior region. The horizontal groove ensures easy insertion of temporary restorations and facilitate temporary and permanent cementation. The one­piece whiteSKY Tissue Line and Alveo Line are versatile and suitable for a wide range of indications, from single resto­ rations in the aesthetic zone as well as the posterior zone to short­span bridges in the premolar–molar region and even in free­end situations. Depending on the competence of the dental team, the new generation whiteSKY can be used also for very chal­ lenging cases of full arch restorations. There is also no limitation in terms of im­ plant placement timing—all options are possible from immediate implant placement to late implant placement for both systems. In all cases, the manufacturer recommends the imme­ diate restoration of the whiteSKY implants because of the proven improved osseointegration and patients’ wish for speedy but safe restoration. This year, bredent medical celebrates 15 years of the whiteSKY implant system in various European cities. At various international events you can find out more about the new whiteSKY implant system. Literature bredent Fig. 5: Placed whiteSKY Tissue Line implant. Fig. 6: Placed whiteSKY Alveo Line. Ideal for immediate implantation. process involving hot isostatic pressed zirconia; the surface treatment; the one­piece design, which ensures micro­gaps do not occur and therefore guarantees the long­term survival of the implant; and the opti­ mised design and bone­oriented surgical protocol, which have been shown to achieve excellent primary stability. This is a prerequisite for immediate resto­ ration, which is highly recommended, as clinical re­ search indicates that it can increase bone–implant contact by 50%.3 The tooth­coloured whiteSKY zirconia implant meets patients’ high aesthetic de­ mands—no dark shades will affect the beauty of the restoration. The implant can be used in cases of low gingival height. Its one­piece design makes it ideal for immediate loading. It has the same requirements as for an imme­ diately loaded titanium implant, such as sufficient bone volume, adequate primary stability and connection to adjacent teeth or to other whiteSKY implants. Two designs one goal—aesthetics The second generation of whiteSKY is available in two designs for the different user philosophies. whiteSKY Tissue Line with the slim and scalloped sulcus design offers the maximum space for the soft tissue and limits the need for customisation—therefore, it is ideal for the standardised analogue and digital workflows. contact bredent medical Germany +49 7309 872-600 www.bredent-medical.com 38 implants 1 2022

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| manufacturer news bredent medical Zirconia implant as alternative to titanium The whiteSKY Tissue Line and Alveo Line ceramic implants incor- porate all the features of the “classic” whiteSKY implant in an improved, contemporary design and new shape which has been scientifi cally and clinically proven. The zirconia implant is truly comparable to titanium and has no treatment limitations. This makes it a reliable alternative for patients with metal allergies, those who want to lead a metal-free lifestyle and those needing implants in the aesthetic-zone to ensure that dark shading does not affect the aesthetic outcome of the restoration. Zirconia is also perfectly suited for implants since its strength is comparable to that of titanium and exhibits ideal elasticity and long-term re- sistance to fracture. Dr Claude Gallizia from France stated titanium equates to bio tolerance whilst zirconia offers total bio compatibility. “In prac tical terms, I am pleased to say that with whiteSKY, we get minimal post-operative pain, achieve beautiful osseointegration and get a phenomenal reaction from bone and gingival tissues.” 1 2 Fig. 1: Clinical case with the whiteSKY Tissue Line by Dr Gallizia, France. Fig. 2: The new whiteSKY Tissue Line zirconia implant-reshaping scientifi c success. bredent medical GmbH & Co. KG · Germany +49 7309 87222 · info@bredent.com SIC invent Innovative dentistry, one hundred per cent metal-free Ceramics is an alternative to titanium for specifi c indications. The two-part, metal-free SICwhite implant lets the attending dentist, working closely with the patient, decide which treatment philosophy and which technology is the right one for a given indication. In Dentalpoint AG –Zeramex, we have found the ideal partner for technological joint ventures in ceramics. With more than 15 years of experience, they are one of the innovation leaders in ceramic implants. Dr Pascal Marquardt, a specialist in prosthodontics and oral implantology and a dedicated member of the Schilli Implantology Circle explains: “In 2016 I discovered this new option of the VICARBO® screw. The combination of high- strength PEEK thermoplastic polymer and specially aligned car- bon fi bres in the abutment screw and the most stable ceramic material on the market in the implant itself—fi nally success - fully rivalled the common components of titanium implants in terms of strength and long-term clinical success.” Compared to titanium implants, so the experienced implantologist, the low plaque adhesion and the lower peri-implantitis rates that have emerged in recent reports make ceramic implants a particularly t d r a u q r r a M l a c s a P Dr interesting option in patients with periodontal disease or who have issues with proper oral hygiene. The favourable soft- tissue reaction makes for uncomplicated handling in the aesthetic zone. Dr Marquardt also emphasises the complex manufacturing process of the SICwhite, in which both the implant and the abutment are milled from particularly strong, fully sintered ATZ ceramics providing maximum safety in terms of the fracture strength of these ceramic implants. It is true that not all cases are suitable for ceramic implants today. But given the developments over the last few years, we have good reason to expect that a growing range of indications and an increasing variety of implant types will eliminate many of today’s restrictions in the future. SIC invent AG · Birmannsgasse 3 · 4055 Basel · Switzerland · www.sic-invent.com 42 implants 1 2022

| manufacturer news ZiBone A wide range of zirconia products Zirconia is a well-known highly biocompatible material. Given more than 30 years of manufacture and research experience, COHO has produced orthopaedic, dental implants and surgical instruments for many years. Furthermore, COHO has cooperated with several world-famous dental experts and research units from National Taiwan University for launching various zirconia products, expanding application of zirconia, and last but not the least, the advancing surface treatment research to reduce the evitable risks during surgery and implantation by using metal materials in order to reach our terminal goal of enhancing the safety and convenience during surgical procedure. Currently Zibone has a series of zirconia products in the market, such as: zirconia implant drill, pilot drill, tissue punch, tissue trimmer, scalpel, ele- vator, etc. Now, COHO and doctors are working closely and hope- fully not far from the future to introduce Zircasso, IZI and tissue level implant system in the market. Therefore, we are so pleased to see doctors’ trust and allow us to manufacture the tools as needed and lead to the ideal working environment as you wish. Straumann COHO Biomedical Technology Co., LTD. · Taiwan +886 3 3112203 · www.zibone.com Changing lives by giving smiles back: SmileAward 2022 Submission requirements The required documentation includes all relevant diagnostics and step-by-step illustrations. It is also required to submit a 4-minute video that combines high-defi nition clinical images with the testimo- nial of the patient. All cases fulfi lling the criteria will go through to a public vote. A jury composed of key opinion leaders in dentistry will select the fi nal winners, who will be announced at EuroPerio10. Timeline – Submission of cases: by 20 July – Public voting: 1 Aug–29 Aug – Selection of winners by jury: 1 Sept–14 Sept – Announcement of winners: EAO Congress, Geneva (29 Sept–1 Oct) Great prizes All fi nalists in both categories will be awarded a prize so that they can continue changing lives together with Straumann. The top three winners in both contest categories will be #GivingSmilesBack with the materials needed to complete one or more pro bono cases, and our top winner in each category will also get their patient video story edited professionally, and it will be seen with worldwide visibility across Straumann channels and platforms. Our winners can also opt for a #ChangingLives prize, a dona- tion to a philanthropic organisation in their honour—or for a #BoostingYourPractice prize in which the top winner in each category will take home a TRIOS intra-oral scanner. Institut Straumann AG · Peter-Merian-Weg 12 · 4052 Basel Switzerland · www.straumann.com/smileaward Every day, around the globe, we know dental professionals rely on Straumann to give patients the confi dence to smile again, to laugh, to show off their smiles, to eat the foods they love. Thousands of dental professionals use our products and solutions to rebuild the quality of life for patients and to unlock the potential of people’s lives. While Immediacy Protocols stood in the focus in 2021, the SmileAward 2022, welcomed dental professionals to show us how they are changing the lives of their patients through full-arch rehabilitation or clear aligner therapy. They are invited to submit their best patient stories and share with the world the many ways that dentistry can restore confi dence and improve our well-being. The 2022 SmileAward aspires to be the most inspiring, most uplifting clinical case competition. 44 implants 1 2022

| events EuroPerio10 Congress programme with over 130 top speakers 30 countries in the main programme. The scientifi c programme features a wide variety of innovative formats, including live muco- gingival and bone-regeneration surgeries, in- teractive sessions, so-called nightmare ses- sions (worst-case scenarios), video sessions, debates, interviews, symposia, and more. Considerable attention will be also given to the EFP’s S3-level clinical guidelines on the treat- ment of periodontitis—the newest guideline, on stage IV periodontitis, will be presented at the congress. “The scientifi c programme addresses the interests of every member of the dental com- munity and provides them with an updated snapshot of what perio is today,” explains David Herrera, scientifi c chair of EuroPerio10. “We have a great faculty, complete and diverse, addressing the main challenges of our profes- sion with the most engaging session formats. So, we are proud to have prepared an exciting congress up to the task of bringing dental pro- fessionals up to date in terms of knowledge, skills, trends and solutions, but also in terms of personal interaction and networking with colleagues,” says Phoebus Madianos, chair of EuroPerio10. Registration for EuroPerio10 is possible at the EFP website and has been open to all professionals since August last year. EuroPerio10 · www.efp.org/europerio · europerio@mondial-congress.com David Herrera and Phoebus Madianos are looking forward to the EuroPerio10 taking place in June. The tenth edition of EuroPerio returns in 2022 after having been postponed from last year because of the Covid-19 pandemic. Organised by the European Federation of Periodontology (EFP), EuroPerio10 will take place on 15–18 June in Copenhagen, Denmark. It features a top-level scientifi c programme packed with sessions covering all the latest trends and topics for oral- healthcare professionals, with 135 well-known speakers from over EAO Congress 2022 in Geneva Uniting nations through innovations FIRST ANNOUNCEMENT UNITING NATIONS THROUGH INNOVATIONS The European Association for Osseointegration is pleased to announce details of its 29th congress, which will take place in Geneva from 29 Septem- ber to 1 October with a digital programme for those who cannot attend in person. Geneva is home to many international organisations includ- ing the United Nations, the World Health Organi- sation and the Red Cross. Refl ecting their goals of global collaboration, the theme of the EAO congress will be uniting nations through innova- tions. It will focus on the role of new technology in disrupting the way we communicate, work and learn. The programme will feature renowned speakers who will share their knowledge on the application of digital technologies across all aspects of implant dentistry. Sessions will com- pare current digital techniques with conventional techniques and will provide clinically relevant take-home recommendations. As well as 29 Sept. - 1 Oct. 2022 Chair: Irena Sailer congress.eao.org the daily live programme, the digital evening event will feature additional content, available to a global online audience. Anyone attending in person will be able to participate in both parts of the programme, experiencing two educational events at the same time. The congress is being held in partnership with the Swiss Society of Oral Implantology (SGI), the Swiss Society of Periodontology (SSP), the Swiss Society for Oral Surgery and Stomatology (SSOS) and the Swiss Society of Reconstructive Dentistry (SSRD). Geneva 2022 will be a unique opportunity to learn from the best. We hope that you can join us— either in person or virtually—for what will be a ground-breaking programme focused on the evolving role of technology in implant dentistry. & ONSITE ONLINE EAO Office · eao.org · eaocongress@eao.org · +33 1 42366220 46 implants 1 2022

| news GC International participates in awards ceremony Prof. Maria Fidela de Lima Navarro honoured at University of São Paulo the ceremony in recognition of the contributions that Prof. Navarro has made to dentistry research in Brazil. “Many actions have led us to share knowledge and con- tinue to learn. We are here in this solemn moment, and it gives me immense joy and a feeling of accomplishment with the professional and personal goals that were achieved, as a group,” Prof. Navarro said in her accep- tance speech. “We reaffi rm our confi dence in being able to always share a new path, towards the highest peaks that certainly still need to be climbed. This is because, despite the paths we have taken so far, many other fi elds still need to be explored, and a journey of new discoveries is just beginning,” she continued. Prof. Navarro has contributed and continues to contribute to research related to glass ionomers and glass hybrids as well as their properties and applications in several clinical cases. Source: GC International AG GC Brazil, represented by José Geraldo Lopes Neves on the right, joined a hybrid ceremony held in honour of Prof. Maria Fidela de Lima Navarro, among other academics, during which she was awarded the title of professor emeritus by the University of São Paulo. (Image: © GC South America) The faculty of dentistry on the University of São Paulo’s Bauru campus bestowed the honour of professor emeri- tus including Prof. Maria Fidela de Lima Navarro. The honour is awarded to retired professors who have distin- guished themselves through teaching, research and other contributions to the university. The hybrid two-day awards ceremony took place on 7 and 8 March and was broadcast live on YouTube. GC Brazil, represented by José Geraldo Lopes Neves, attended Eklund Foundation Applications for odontological research and education are welcome Researchers within dentistry will soon be able to apply for grants of up to €250,000, which is the total sum allo- cated by the Eklund Foundation in 2022. The application portal will be open during May for the seventh year run- ning, welcoming applicants from all parts of the world in all fi elds of dentistry. Both experimental and clinical studies within all fi elds of dentistry are accepted, but the foun- n o i t a d n u dation will prioritise projects that can be related to peri- odontology, implantology, or cariology. Researchers may apply for funding for a project in its entirety or for part of a project. The Board will announce the successful projects in September. Information in short – Allocated sum: €250,000 – Application period: 1–31 May 2022 – Announcement of grants: September 2022 – Applications from any location or university are accepted – Read more and apply at www.eklundfoundation.org Background The Eklund family, owners of TePe Oral Hygiene Products, created the Eklund Foundation in celebration of their long-standing relationship with the professional dental community. Since 2016, the foundation has distributed €140,000–240,000 annually, supporting odontological research worldwide. More information about the grants, published studies, and interviews with previous recipients are available on the website. The Eklund Foundation was established in 2015 to support research and education in the odontological fi eld. Eklund Foundation is established to support research within odontology. Source: TePe Oral Hygiene Products AB 48 implants 1 2022

| about the publisher Congresses, courses and symposia 11th IAOCI World Congress 19–22 May 2022 Washington DC, USA https://www.iaoci.com 6th Annual Meeting of ISMI 24–25 June 2022 Berlin, Germany ismi-meeting.com Bioceramics 32 32nd Symposium and Annual Meeting of ISCM 20–23 September 2022 Venice, Italy bioceramics32.org 2nd European Congress of Ceramic Implant Dentistry 20–22 October 2022 Zurich, Switzerland www.esci-online.com CERAMIC IMPLANTS STATE OF THE ART t n e t a P © 6 TH ANNUAL MEETING OF 24./25. Juni 2022 Berlin 50 implants 1 2022 Imprint Publisher Torsten R. Oemus oemus@oemus-media.de CEO Ingolf Döbbecke doebbecke@oemus-media.de Member of the Board Lutz V. Hiller hiller@oemus-media.de Chairman Science & BD Jürgen Isbaner isbaner@oemus-media.de Editorial Council Dr Michael Gahlert (Germany) Dr Sofi a Karapataki (Greece) Dr Franz-Jochen Mellinghoff (Germany) Editorial Management Janine Conzato j.conzato@oemus-media.de Executive Producer Gernot Meyer meyer@oemus-media.de Product Manager Timo Krause t.krause@oemus-media.de Art Director Alexander Jahn a.jahn@oemus-media.de Designer Franziska Schmid f.schmid@oemus-media.de Customer Service Marius Mezger m.mezger@oemus-media.de Published by OEMUS MEDIA AG Holbeinstraße 29 04229 Leipzig, Germany Tel.: +49 341 48474-0 Fax: +49 341 48474-290 kontakt@oemus-media.de Printed by Silber Druck oHG Otto-Hahn-Straße 25 34253 Lohfelden, Germany www.oemus.com Copyright Regulations ceramic implants international magazine of ceramic implant technology is issued three times a year and is a special edition of implants international magazine of oral implantology — the fi rst issue was published in October 2017. The magazine and all articles and illustrations therein are protected by copyright. Any utilisation without the prior consent of editor and publisher is inadmi ssible and liable to prosecution. This applies in particular to duplicate copies, translations, microfi lms, and storage and processing in electronic systems. Reproductions, including extracts, may only be made with the permission of the publisher. Given no statement to the contrary, any submissions to the editorial department are understood to be in agreement with a full or partial publishing of said submission. The editorial department reserves the right to check all submitted articles for formal errors and factual authority, and to make amendments if necessary. No res- ponsibility shall be taken for unsolicited books and manuscripts. Articles bearing symbols other than that of the editorial department, or which are distinguished by the name of the author, represent the opinion of the aforementioned, and do not have to comply with the views of OEMUS MEDIA AG. Responsibility for such articles shall be borne by the author. Responsibility for advertisements and other specially labelled items shall not be borne by the editorial department. Likewise, no responsibility shall be assumed for in- formation published about associations, companies and commercial markets. All cases of consequential liability arising from inaccurate or faulty representation are excluded. General terms and conditions apply, legal venue is Leipzig, Germany.

SOME STARS SHINE BRIGHTER THAN OTHERS.* In-Kone GLOBAL D CLEANIMPLANT QUALITY EVALUATION UPDATE INDEPENDENT. THOROUGH. RELIABLE. AnyRidge MEGAGEN T6 NUCLEOSS ICX-Premium MEDENTIS MEDICAL Conelog CAMLOG Patent/BioWin! ZIRCON MEDICAL Prama SWEDEN & MARTINA NobelActive NOBEL BIOCARE UnicCa BTI SDS SWISS DENTAL SOLUTIONS BlueSky BREDENT MEDICAL Kontact S BIOTECH DENTAL BlueDiamond MEGAGEN *These implant systems were awarded the CleanImplant „Trusted Quality“ seal after an unbiased and peer-reviewed quality assessment. Receive quality information about your implant in use. Provide more safety for your patients and avoid negligence claims. Win new patients as a CleanImplant Certifi ed Dentist. Find out more. Join in and support the charitable initiative. More information: www.cleanimplant.com/dentists