A major milestone has been achieved with the publication of the first long-term study on two-piece zirconia dental implants. The independent study by the University of Düsseldorf revealed healthy soft tissues, stable bone levels, and no peri-implantitis around integrated Patent™ Implants after 9 years.[1] Dr. Wolfgang Winges, co-developer of the Patent™ Dental Implant System along with Dr. Johan Feith, shares his thoughts on this groundbreaking long-term study and the rationale for developing this implant system.
Dr. Winges, were you surprised by the results of the 9-year study?
Not at all. The scientific evidence finally backs up what I have been observing in my daily practice with Patent™ Implants for over 18 years. Our decades of hard work have paid off, as the study's findings demonstrate that biological and mechanical late-term complications can be avoided with the right implant system. I see this as the reward for over twenty years of research and development.
What prompted the development of the Patent™ Dental Implant System?
We saw the need for it. At the beginning of the new millennium, Dr. Johan Feith and I had placed several thousand implants and were familiar with many of the systems established at that time. Despite regular checks and strict patient oral hygiene, we struggled to keep many implants in good condition in the long term – that is, eight years or more. Daily challenges included unaesthetic greyish margins, screw loosening, peri-implant mucositis, and peri-implantitis. The Patent™ Dental Implant System was purposefully developed to overcome these complications.
What is your solution?
Our solution involves an implant with a soft-tissue-level design to eliminate the micro-gap at bone level. The parallel-walled implant body features a conservative thread design that, in combination with a unique surface topography, ensures a fast and safe healing cascade, as supported by studies.[2] In the transgingival area, the use of custom-made zirconia is crucial to allow the formation of a strong soft-tissue cuff. This strong attachment (soft-tissue seal) is able to prevent bacteria from penetrating the tissues, which could lead to chronic inflammatory diseases like peri-mucositis and, ultimately, peri-implantitis. The prosthetic concept is based on a tulip-shaped platform, designed to ensure optimal force transmission into the bone while avoiding micro-movements. When combined with an adhesive connection to the crown, this approach effectively maintains long-term stability of the marginal bone level. These findings were impressively demonstrated in the 9-year study. However, it should be noted that the choice of zirconia as the implant material presented a significant manufacturing challenge.
What is the challenge with zirconia?
Before the development of Patent™, zirconia implants did not have the surface roughness necessary for predictable osseointegration – there were simply no promising technologies available. With a complex manufacturing process that we developed and secured by patents in the early 2000s, we were able to overcome this challenge. This patented process gives the Patent™ Implant a high enossal roughness while eliminating all microcracks on its surface. Today, the processing of zirconia is the core competency of Zircon Medical Management, the manufacturer of the Patent™ Dental Implant System.
Is it difficult to apply this implant system?
It's like with everything in life: Once you understand how something works, it's not difficult. The same goes for the Patent™ Dental Implant System. Users have to understand the concept behind the system in order to apply it optimally and successfully. Once they have understood the Patent™ Concept, outstanding results can be achieved, as demonstrated by the 9-year study.
Is zirconia the future?
Zirconia alone is not the solution; rather, it is the combination of material, design, and the ideal prosthetic concept. The reproducible long-term successes achieved through this combination, as demonstrated in the 9-year study, represent the future for every patient.
Literature:
1. Brunello G, Rauch N, Becker K, Hakimi AR, Schwarz F, Becker J. Two-piece zirconia implants in the posterior mandible and maxilla: A cohort study with a follow-up period of 9 years. Clin Oral Implants Res. 2022 Dec;33(12):1233-1244. doi: 10.1111/clr.14005. Epub 2022 Oct 31. PMID: 36184914.
2. Glauser R, Schupbach P. Early bone formation around immediately placed two-piece tissue-level zirconia implants with a modified surface: an experimental study in the miniature pig mandible. Int J Implant Dent. 2022 Sep 14;8(1):37. doi: 10.1186/s40729-022-00437-z. PMID: 36103094; PMCID: PMC9474793.