Peri-implantitis and ceramic implants: first clinical observations

Peri-implant infections with crestal bone loss are among the main reasons for early and late titanium implant failure. The microbial colonization and subsequent plaque formation on the surface of the implant or the suprastructure are very important factors with regard to the etiology of peri-implant infections. Zirconium dioxide (zirconia) has become an alternative to titanium for the fabrication of dental implants, as experimental studies have shown an equivalent osseointegrative capacity for zirconia and titanium implants. In addition, several experimental studies have reported a reduced bacterial adhesion to zirconia compared to titanium. The reduced bacterial adhesion seems to be very relevant for the clinical daily routine, as clinical long-term studies have not reported any typical peri-implant infections with bone loss around zirconia dental implants. Thus, very little information is available with regard to incidence, progress, and therapy of zirconia peri-implantitis. The presented case reports etiology and therapy of an advanced peri-implant infection with bone loss around a zirconia dental implant. It is also shown that the compromised anatomical situation has primarily promoted the microbial infection in this case.