“A match made in heaven” - Bone Level and Tissue Level with the tried and tested surface topography
The two-piece ceramic implant with ZLA surface is the result of almost twelve years of development. Like the monotype, it is made of 100 percent high-performance zirconia ceramic (yttrium-stabilized, tetragonal polycrystalline zirconia, Y-TZP). Zirconia implants are biocompatible and have a low rate of widespread peri-implantitis [16]. Study groups report that plaque accumulation at an early stage is lower on zirconia implants compared to titanium implants [13].
The ZLA ceramic implant surface is characterized by macro- and micro-roughness, which is similar to the topography of the proven SLA surface (sand-blasted, large-grit, acid-etched). Animal studies have shown osseointegration equivalent to Ti-SLA in terms of peri-implant bone density and BIC value (bone-to-implant contact) [2, 9]. The SLA surface is one of the best documented rough surfaces in implantology and, due to its osseointegration properties, reduces the ingrowth time of implants [3, 5]. Studies show a much-improved accumulation of fibroblasts on the ceramic surface and good soft tissue grafting is therefore expected [5, 16, 17, 19]. Given that “the biofilm on ceramic implants appears to be less harmful, ceramic implants could be an advantage especially in patients who have been treated for periodontitis, with better long-term survival rates”, Dr. Hesse continues.
“Naturally, the data available is not comparable with the data from titanium implants. Just in terms of the osseointegration and durability over the course of three years, there is no difference between titanium and ceramic” [4]; this is also the outcome of a multicenter clinical trial after an observation time of twelve months, with an implant survival and success rate of 97.6 percent [9]. The form of the two-piece PURE Ceramic Implant is based on characteristics of both the Soft Tissue Level Standard Plus and the Bone Level Implants: “I see this as an ideal combination”, explains the experienced implantologist. “With titanium, I use the tissue level, but now enjoy the stability of the bone level thread form. What is especially fascinating is that you can use the same instruments for ceramic implants as for titanium implants”, explains Dr. Hesse.