Clinical Outcome of Root Analog Dental Zirconia Implants: A Systematic Literature Review

Purpose: The purpose of this systematic review is to evaluate the clinical significance and outcome of custom-milled root analog zirconia implants (RAZI) for immediate replacement of an untreatable tooth.

Materials and methods:b> A PubMed search was conducted to acquire the articles which were published between 1st Jan 2000 to 31st July 2019. The topic related to the clinical outcome for root analog zirconia implants. Different combinations of the keywords “dent*, impel*, root, tooth, zirconia, shaped, analog and analogue” were searched.

Results: An initial 284 publications with abstracts were collected. Finally, seven articles meeting our inclusion and exclusion criteria and were selected for full text analysis in this review. This review was able to identify two immediate RAZI hybrid implant studies and five immediate delayed studies on full zirconia RAZIs. Single-rooted as well as two-rooted molar RAZIs were described. All successfully osseointegrated RAZIs had promising primary stability as a precondition. Radiological analysis showed no significant changes of the marginal bone. The representative overall implant survival rate was 91.30 %. Implants with only sand-blasted surface modification failed.

Conclusion:b> From the seven studies showing relative promising data that the individual custom milled RAZI is a predictable and successful method for immediate teeth replacement. In the future, more studies and long term clinical observational data need to be conducted to prove that this novel approach is feasible safe treatment for patients.

Keywords: Root analogue; Zirconia; Implant; Immediate; Clinical outcome

Abbreviations: 3D: Three dimensional visualisation; BID: Twice daily; CAD: Computer-aided design; CAM: Computer-aided manufacturing; CBCT: Cone beam computed tomography; DICOM: Digital imaging and communication in medicine file; DVT: Digital volume tomography; RAZI: Root analog zirconia implant; STL: Standardized triangulation language; TID: Three times daily