The use of zirconium oxide implants associated with all-ceramic prosthetic rehabilitations can allow excellent esthetic results to be achieved, ensuring stable osseointegration.
The devices used for the rehabilitation of single edentulism are single-component implants (White-SKY, Bredent, Senden Germany) made of sintered and stabilized zirconium oxide with yttrium.
The aim was to evaluate survival rate and radiographic marginal bone loss (MBL) of zirconia implants placed in the esthetic and posterior areas of the jaws and of the maxillary bone in association with multiple or single implant restorations with a follow-up period of 10 years.
At the Department of Implantology, Dental Clinic, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, 10 patients were treated from 2007 to 2009. 25 one-piece zirconium implants were utilized for single or partially edentulous ridges rehabilitation.
The follow-up protocol included the radiographic control examination. The radiographs were taken using the customized silicon bite record. Measurements were made using the Image-J analysis software in order to calculate MBL. Bone level changes were calculated at the distal and mesial surfaces of all implants by applying the distortion coefficient.
At the end, survival rate was formulated.
During the follow-up, no implant failure was reported, with no pain or paresthesia, and, at the radiographic evaluation, peri-implant radiolucency was not detected. Thus, the cumulative survival rate was 100%.
The total average resorption at 10 years is 0.81 mm.
A statistically significant difference emerges between the resorption of single implants and those with multiple anchors, with a lower resorption of the multiple anchorage implants (p<0.05). Instead, there is no significant difference in the comparisons between implants placed in the jaw and maxillary bone and between anterior and posterior implants (p <0.05).
Zirconia showed a good marginal bone preservation that could be correlated with one-piece morphology and characteristics of zirconia implants. The radiographic measurements of MBL showed values between 0,01-3,21 mm during the ten years and not exceeding 0.2 mm 1 year up to 10 years after surgery in accordance with Albrektsson implant success criteria.
Finally, a better behavior, in terms of bone resorption, of multiples anchor implants compared to single implants has been noted.

Edentulous rehabilitation with zirconia dental implants- 10 years follow-up