Clinical Study, May 2024: Immediate Placement of Zirconia Implants in the Posterior Region

Advanced techniques for preserving bone and soft tissue stability in molar implant cases

Introduction

Maintaining peri-implant tissue stability is crucial for the long-term success of dental implants, particularly in the posterior maxilla. This clinical study presents the immediate placement of zirconia implants in four patients presenting with complex anatomical and prosthetic conditions. The primary objective was to evaluate osseointegration, marginal bone stability, and the establishment of a natural emergence profile in molar regions.

Objectives

• Preserve marginal bone to prevent soft tissue recession.
• Ensure optimal primary stability of immediately placed implants.
• Achieve harmonious integration with the adjacent dentition.
• Maintain long-term functional and esthetic outcomes in the posterior region.

Methodology

• Surgical Approach:
  • Cone-beam computed tomography (CBCT) was used to evaluate alveolar bone height and septal morphology. A minimally invasive, supracrestal, immediate implantation technique was applied. SDS zirconia implants with a tulip-shaped “balcony” design were selected to enhance primary stability.
• Augmentation and Tissue Support:
  • Advanced platelet-rich fibrin (A-PRF and i-PRF) was applied around, under, and over the implants. Collagen blocks (Condress) were used to stabilize the alveolar ridge and fill minor defects. Optional healing discs were placed to secure the PRF and collagen graft materials.
• Postoperative Support:
  • Patients received pre- and postoperative supplementation with vitamins D, K2, and C, in addition to essential minerals, to support bone metabolism and healing. Implant stability was assessed using a Periotest device.
• Follow-up:
  • Clinical and radiographic evaluations were conducted at 10 days, 2–3 months, and 12 months postoperatively to assess marginal bone level changes, peri-implant soft tissue condition, and emergence profile formation.

Clinical Relevance

• Immediate implantation combined with PRF and collagen enhances preservation of bone and soft tissues.
• The tulip-shaped implant design supports stable emergence profile development in molar regions.
• The tissue-level configuration minimizes crestal bone loss at the implant–abutment interface.
• After 12 months, all implants demonstrated survival with minimal marginal bone changes.

Conclusion

Immediate placement of zirconia implants in the posterior region, when combined with PRF and collagen augmentation, provides predictable preservation of peri-implant bone and soft tissue. Accurate implant positioning, sufficient apical primary stability, and biologically supportive augmentation techniques contribute to functionally and esthetically successful outcomes. For patients seeking metal-free alternatives, SDS zirconia implants represent a safe and effective option to titanium counterparts.

References

The full case report, "Esthetics and Functionality of Tissue-Level Zirconia Implants in the Posterior Region," is available in the May 2024 ePaper of ZMK – Zahnheilkunde Management Kultur (Spitta Verlag).

Treating dentists and co-authors of the study:

Prof. Dr. med. dent. E. Schnurr (Scientific Advisor, SDS)

Provides scientific guidance for SWISS DENTAL SOLUTIONS. She researches the oral microbiome, biofilm infections, and their impact on overall health: from clinical research and data analysis to drug development.

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Dr. Gregor Hočevar

Dr. dent. med., M.Sc. 2nd Level University Master in Oral Implantology, Specialist in Biological Dentistry and Ceramic Implants (ISMI Germany, IAOCI USA), leader in biological dentistry, founder of Center Hočevar, Swiss Dental Solutions Ambassador.

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