logo 18 • CAMLOG Partner Magazine • July 2018 12 Dr. Detlef Hildebrand, Berlin CERALOG® IMPLANTS THE SOLUTION FOR SPECIAL PATIENT NEEDS Fig. 1: The initial situation: a unilateral free-end situation in the left upper jaw: teeth 26-28 are missing. Fig. 3: To condense the soft bone over the sinus floor, the bone site was prepared using an osteotome. Patient demand for metal-free implant solutions is steadily increasing. Although titanium implants are biocompatible and well tolerated [1], studies have found titanium oxide burdens in the body after implantation [2]. It is being discussed that an inflammatory reaction of varying intensity is detectable in a few patients, depending on the genetic disposition [3]. In contrast, fewer reactions have been observed with zirconium dioxide particles. A further advantage of zirconium dioxide implants is their good tissue compatibility. In the following, a patient case is presented in which two-piece CERALOG® Hexalobe implants were inserted in the maxillofacial free-end situation and systematically documented. Ceramic implants have been on the market for many years, but the percentage share of the total dental implant market remained largely modest. One reason for this was the bad experiences in the 1980s and 1990s with many ceramic fractures – particularly with one-piece implants made of aluminium dioxide, the socalled Tübingen and Munich immediate implants – and the lack of scientifically based data at that time [4]. Intensive material research in recent years has led to the newer generation, the yttrium-tetragonal-stabilized zirconium dioxide, which defines the new industrial standard. It proves convincing, for example, in the crown and bridge technique and as an abutment material. Thus, the material strength for implants no longer proved a challenge, the focus was now primarily on the inner surface quality of the ZrO 2 material, which was identified as a possible source of error during integration, as well as a reversibly screw-retained two-piece version. Newer hightech manufacturing processes to achieve a bone-friendly surface texture on zirconium dioxide implants, such as the injection molding process, now create significantly more confidence in this technology. [5]. If we interpret the signs of the times correctly, we are on the verge of being able to treat patients with special, in part medically justified requirements, with these new materials in terms of implants and longterm stability. Findings and therapy planning A 38-year-old female patient presented in our practice with a free-end situation in the second quadrant. As the residual dentition was completely intact, she wished for a fixed, metal-free restoration to replace the two missing molars. After detailed explanation of the implant treatment as well as reference to the little documented study situation on zirconium dioxide implants, we planned the restoration on the two-piece CERALOG® Hexalobe implants. The X-ray showed a sufficiently high alveolar bone for insertion of two 10 mm long implants without elevation of the sinus floor (Figs. 1 and 2). CASE STUDY Fig. 2: The X-ray shows the sufficiently high bone in the area of the maxillary sinus to accommodate two implants.
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