Is it fair to ask for a Metal-Free Implantology ?
- Andre Chen
- Feb 8
- 3 min read
Updated: Mar 10
Of course it is; single unit esthetic cases are my favorite areas , normally the main indication , but 3 Unit bridges are making their way in !!
Are you excited about the world of metal-free implantology? 🎉 I am for sure, I admit that I may be a little biased but the clinical results I see are amazing !
This approach is a fantastic option for patients who want both beautiful and biocompatible dental solutions! Let’s dive into some key considerations, along with an interesting case that shows just how effective this technique can be!
Background story !
We had a young lady come to us with a tough situation—her previous endodontic treatment just did not work out! She had a fight with the dentist about taking the tooth out!
The dentist wants it in and the patient out ! in , out , in , out , in , out, in , out...... After some discussions, another dentist decided an extraction was necessary, and once that was done, she had a special request: a ceramic implant with no metal involved! How awesome is that? 😄
Step into my office; you are in the correct clinic !!😏
She was worried about inflammation and hypersensitivity, so we were thrilled to accommodate her wishes!
"Now I’m ready for you Doc!!! " - she spell it!
A good starting point to discuss some mistakes in ceramic-based implantology that happened to me over the years, and by reading this, hopefully you can skip it!
💡 Key Considerations for Pure One-Piece (P1P) ceramic Implants :
When you are ready to use a one-piece pure ceramic implant ( there are a lot of brands for the one piece , straumann , zbone , z systems , bredent, zinova , zeramex, …..), keep these important points in mind:
1. Interocclusal Space For the Abutment: Make sure there is enough room for the abutment and the ceramic crown. Remember: in one piece implants you cannot change the abutment or grind it !!
2. Gingival Height: Check the gingival height for a perfect supracrestal collar! Do not put the supracrestal collar below the bone !!!
3. Bucal-Palatal Position: Positioning is key for cement-retained restorations! Aim to that incisal edge!
4. Implant Diameter and Height: Choose the right dimensions for a snug fit!
5. Emergency Profile of the Crown: Design it for both function and aesthetics!
Using software to input these key points will help you create a precise surgical guide! Go always guided , Implantology is a prosthetic driven treatment , don’t underestimate the case!!!!!! 🤔
Surgical Technique and Bone Approach 🔪
Now, let us talk about the surgical approach! You have two great options:
• Mucoperiosteal Flap with Papilla-Saving Incision: This method includes two vertical release incisions—Tarnow style!
• Intrasulcular Incision: This technique can be performed from canine to canine , including a vertical incision behind the root eminence! Buser Style !
(We go for a separate blog post to illustrate advantages and disadvantages of both)🤓
Don’t forget to consider the tissue biotype! A thicker biotype might lead to more scar tissue, so the latter technique could be the better choice! 🎉
Remember also to allow enough space for the guided bone regeneration, membrane and primary wound closure ! So….. no Mickey Mouse stuff ( as George Romanos used to say) if you need space !! 🎃
Implant Placement Protocol
When placing that stunning ceramic implant, remember these tips:
• Drill Speed: Keep it at 800 RPM to avoid overheating that precious bone! 🔥
• Osteotomy Preparation: Ensure the osteotomy is not undersized for a secure fit! (If you undersize this one piece Pure will not enter, believe me !!)
• Insertion Torque: Keep it under 35 N/cm²—no “macho” moves here! Ceramic (zirconium Dioxide - zirconia )does not dissipate heat. Know your biomaterial !! Know the physical properties !!
We want to protect that bone! 🙏
• Final Checks: Verify the bite and ensure the implant remains supracrestal. Let’s keep it classy and avoid cementing crowns onto intact osseous structures! 😎
Take home message !
Metal-free implants are not just a solution; they are a fantastic advancement in dental implantology! By following these friendly guidelines, you can achieve amazing results and make your patients happy! Let’s keep pushing the boundaries of what is possible in implantology! 🌈✨
Happy implanting, everyone! 🦷🎊
Enjoy
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