Clinical case documentation Zeramex Plus - Dr. Mario Kirste (2013)

Practical implantology and implant prosthetics | pip 4 | 2013

The following case report is intended to show the use of the Zeramex Plus implant (Switzerland Dental Point AG Zurich). This implant combines two properties demanded and recommended by science.

What is meant is the use of an industrial, high-quality zirconium dioxide manufactured according to standardized criteria as well as a microstructured and rough implant surface. After several years of experience with one-piece zirconia implants, the author was excited to see the results of a two-part system. The implant insertion does not differ in any way – apart from the mandatory thread cut for every bone quality – from the implantation process in titanium implantology. The two-part system has considerable advantages because the implants can heal unloaded. No special interim prosthetic measures are required. In the prosthetic phase, we can use healing caps as well as screwed down temporary restorations. The Zeraloc connection and abutment bonding let us forget the micro-gap discussions.

The present case describes the treatment of a 53-year-old patient with a Zeramex Plus implant in region 45, after an uncomplicated extraction in September 2012. Due to various intolerances, the patient wished for a zirconia implant. On April 2, 2013, the patient was treated with a ten millimeter implant with a 4.1 millimeter diameter under local anesthesia. The patient received a single shoot dose of penicillin 1.5 grams preoperatively.

Many thanks for the good cooperation to my colleague Dipl. Stom. Dentist Katrin Zenker and master dental technician Dirk Seiring, MSc Dental Technik.

Fig. 1: Initial situation in March 2013, condition after uncomplicated tooth extraction from 45 in September 2012.

Fig. 2: Occlusal view, completely epithelized extraction zone 45 (mirror image).

Fig. 3-4: Preoperative preparation of a DVT (January 2013) due to the proximity of the inferior alveolar nerve. The incomplete osseous healing in region 45 was also assessed

Fig. 7: Preparation with the pilot drill.

Fig. 8: Final Implant stock preparation

Fig. 9: Diagnosis: fenestration, therefore preparation for a lateral augmentation.

Fig. 10: After thread cutting Zeramex Plus implant insertion. The macro design differs significantly from all known zirconia implants, whether in one or two parts. Friction is enough for the manufacturer due to the micro design. The manufacturer's decision to pursue a tissue-level implant concept is remarkable.

Fig. 11: Placement of the Zeramex Plus implant at tissue level.

Fig. 12: Occlusal view and control of the region 45 implant position.

Fig. 13: Insertion of a medicinal cap to avoid repeated intervention

Fig. 14: Replantation of the autologous particulate bone.

Fig. 15: Placement of a biphasic KEM (BoneCeramic, company Straumann).

Fig. 16: Double-layer technology with a collagen membrane (Bio Guide, Geistlich company).

Fig. 17: Primary tension-free wound closure with Gore Tex, P5K17 CV5 RT 16 (mirror image).

Fig. 18: Postoperative x-ray control

Fig. 19-20: Situation one week postoperatively (mirror images).

Fig. 21-22: Course of healing eight weeks postoperatively (mirror images).

Fig. 23-24: Condition 12 weeks postoperatively (mirror image).

Fig. 25-27: Implant situation immediately before taking the impression

Fig. 28-29: Optimization of the individual tray, impression taking with impregum and technique implant positioning. The impression post contains three reproducible positions, the latest impression posts can be fixed with a screw.

Fig. 30, 31, 32: Model production, scanning of the ceramic abutment, zirconium dioxide coping.

Fig. 33-34: Ceramic veneering of the crown after sintering.

Fig. 35-36: Only the abutment tip has to be coated with the special adhesive ZERAGLU

Fig. 37-40: Locking with a lock key, also necessary for gluing. Gluing under rubber.

Fig. 41-42: Inserted abutment, glued and secured with the lock.

Fig. 43-44: Zirconium dioxide region 45.

Comment materials

Zirconium Ceramill Zi was used for the crown production, the material shrinks by about 22% after the sintering process. The zirconia body was colored with DD Bio Z color TS immediately before the sintering process. The material of the veneer is zirconia (Heraceram), both masses and glaze pastes are from Heraeus.

About the Doctor

Dr. Mario Kirste

1984-1989 studies of the ZHK at the dental clinic of the Humboldt University in Berlin, state examination
1989-1991 Assistant at the Frankfurt (Oder) Clinic for MKG surgery

Branch in group practice in Frankfurt (Oder) Mario Kirste Dr.Mario Kirste
1992-1993 special training in parodontology under Prof. Dr. W. Kruge
1996 Doctorate
2004 DGI curriculum implantology
2005 ITI membership
2007 Completion of the master’s degree in implantology in Krems, Austria
2008 Current member of the Bonemanagement college, supervision of the stud. Training in Chieming, 2008-2009 in Düsseldorf, 2011 in Berlin, 2012 in Bad Saarow

Scientific Research in the field of piezo technology (bone surgery) and intraosseous anesthesia
2012 Publication of the user manual (clinical guide) for Anesto (company W&H)
2009-2012 Training event / expert meeting for Degradable Solution (CH), clinical examination for bone supplement material “easy-graft CRYSTAL”
u. internal training events
[email protected]

ABOUT ZERAMEX® P6

ZERAMEX® P6 offers great flexibility with its reversible threaded connection and ceramic abutments. The lean, uncomplicated portfolio offers many options to choose from.

Monolithic crowns and bridges made of various optimised plastics or zirconium dioxide
All-ceramic crowns and bridges made of layering or pressed ceramic on a zirconium dioxide cap

Different shoulder heights and angles make it possible to find the correct abutment in every case for an aesthetically demanding, 100% metal-free individual-tooth restoration.

Learn more about this Metal-free ceramic dental implant by CLICKING HERE.

Contact

Want to know more about Zeramex?
Email us at [email protected] with your contact details and we will get in touch with you!

All, Case Presentation

Clinical case documentation Zeramex Plus – Dr. Mario Kirste (2013)