Confidence in Ceramic Implants
Paul Fugazzotto, DDS
Since first utilizing implants in 1985, I have placed slightly more than 20,000 implants (not in the same patient). The leap to ceramic implants is more of a short hop for us, as we have evolved from smooth-surface titanium implants to titanium implants with what is (in my opinion) one of the best surfaces on the market (SLActive®), and then to Roxolid® implants, which are a titanium-zirconium alloy. I believe the move to a Roxolid material represents the most important evolution/revolution since the introduction of osseointegrating implants by P-I Brånemark.
For years, I have looked at the possibility of incorporating ceramic implants into our practice, both to address patient desires and expand our treatment options. However, I did not feel that adequate research and clinical data were available to provide me the level of comfort as I have with other implants. Nevertheless, I did place a few ceramic implants with mixed results. Even though I performed comprehensive care, diagnosing and addressing patient parafunctional forces, two of the ceramic implants I used in the past fractured under function.
I am much more comfortable utilizing the Straumann® PURE, a ceramic implant, for a number of reasons. Significant bench testing, animal research, and clinical research are available. While these implants have understandably not been documented in function for as long as titanium or Roxolid implants, the initial data is excellent, and the time frame of the data is enough to provide a level of comfort to conscientious clinicians.
My implant of choice, and the type of implant which is in my mouth, is Straumann. I utilize only products and materials, including implants, whose success is substantiated by significant histology and human clinical studies. In addition, I want to be confident when a product has been brought to the general market that it has undergone such testing prior to its release. I refuse to be a beta test site for my patients, who trust me. When using Straumann products, I never have this concern.
There is no doubt that the ceramic implant market will continue to expand. The multilevel impact of ceramic implants on clinical practices cannot be denied. Either because of patient concern about other materials, patient desire for more “holistic” therapy, or clinical needs (such as thin tissues) that are theoretically better met with this material, the use of ceramic implants will continue to increase. In addition, incorporating ceramic implants into everyday clinical practice has already had a marked effect on practice growth and patient referral.
Expansion of treatment options based upon appropriate data is a win-win situation for both the patient and the surgeon/restorative dentist team. Our recent clinical field study, carried out with many of our referring partners, underscores these points. Patients were excited to receive ceramic implants and to be part of such a progressive study. The interrelationship and effectiveness of our working team of restorative doctors, laboratory technicians, and ourselves as surgeons was strengthened. Patient and doctor feedback following this event has been 100% positive, and in many cases highly enthusiastic.
This is the true success story: addressing patient needs, fulfilling patient desires, strengthening interdisciplinary care, and positively impacting all of our practices. The accompanying case report demonstrates the ease and predictability of such a therapeutic approach. What should also be mentioned is the fact that treating patients in such a manner is less expensive for the treating clinician and ultimately the patient than more “conventional” care involving a provisional removable appliance and additional office visits.
Ask not whether Straumann ceramic implants should be utilized on a regular basis. Ask why anybody would hesitate to do so.
About the Author
Paul Fugazzotto, DDS
Private Practice Limited to Periodontology and Implant Therapy