Immediate provisional restoration of single-piece zirconia implants: a prospective case series results after 24months of clinical function

Objective Aim of this prospective case series was to evaluate the outcome of immediately provisionalized single-piece zirconia implants. Material and methods A total of 20 zirconia implants were inserted in single-tooth gaps in the maxilla (11) and mandible (9) of 20 patients. Implants were restored with all-ceramic CAD/CAM provisionals without occlusal contacts immediately after placement. Permanent all-ceramic restoration was performed 4months after surgery. Plaque index (PI), bleeding on probing (BOP), Periotest (R) (PV), pink aesthetic score (PES), mean radiographic marginal bone levels (MBL), implant survival and success were evaluated up to 24months. Results Assessment of PI at baseline and follow-ups after 6, 12, 18 and 24months revealed 27% (+/- 5.3), 24% (+/- 6), 23% (+/- 6.1), 23% (+/- 5.3) and 22% (+/- 6.4), respectively. Evaluation of BOP revealed 25% (+/- 5.6), 21% (+/- 6), 21% (+/- 7.2), 18% (+/- 5.9) and 15% (+/- 5.5), respectively. Implants presented stable at follow-ups (PV). PES improved, but not statistically significant from 8.13 (+/- 1.5) at baseline to 10 (+/- 2) 24months after implantation. Measurements of MBL showed a significant bone loss of 1.01mm within the first year after placement (P<0.001) and 1.29mm 24months post-implant insertion, not reaching further statistically significant levels (0.05). One implant was lost 4months after placement, resulting in a survival and success rate of 95%. Conclusion Clinical and radiographic parameters demonstrated a 95% integration of immediately loaded zirconia single-piece implants. A long-term randomized-controlled clinical trial was initiated to confirm evidence of this protocol.