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. 2025 Apr;36(4):460-470.
doi: 10.1111/clr.14396. Epub 2024 Dec 23.

One-Piece Monolithic Zirconia Single Tooth Implant-Supported Restorations in the Posterior Region: A 1-Year Prospective Case Series Study

Vincent J J Donker  1 , Henny J A Meijer  1   2 , Wim Slot  2 , Arjan Vissink  1 , Gerry M Raghoebar  1
Affiliations

One-Piece Monolithic Zirconia Single Tooth Implant-Supported Restorations in the Posterior Region: A 1-Year Prospective Case Series Study

Vincent J J Donker et al. Clin Oral Implants Res. 2025 Apr.

Abstract

Objective: To assess the clinical, radiographic and patient-reported outcome measures, and the success of screw-retained one-piece monolithic zirconia implant-supported restorations in the posterior region during a 1-year follow-up.

Methods: In a prospective case series, 50 single molar sites in the posterior region of 41 patients with a minimum age of 18 years and sufficient bone volume for placing an implant (≥ 8 mm) and space for an anatomical restoration were included. Following prosthetic-driven digital three-dimensional treatment planning, a tissue-level implant with an internal connection was inserted during a one-stage surgical procedure. Three months later, the implant was restored with a screw-retained one-piece monolithic zirconia restoration. Clinical, radiographic and patient-reported outcome measures, and restoration survival and success according to the modified USPHS criteria were assessed at baseline prior to and immediately after implant placement, and 1-month and 1-year after definitive restoration placement.

Results: At the 1-year follow-up, 1 implant had been lost (implant survival rate 98%) hence, 49 restorations were evaluated. The restoration survival and success rates were 100% and 98%, respectively. Plaque, calculus, bleeding and suppuration on probing and peri-implant inflammation were absent in most cases. The mean (SD) marginal bone level change between implant placement and the 1-year follow-up was -0.14 mm (0.27) on the mesial and -0.25 mm (0.31) on the distal side. The mean (SD) patient satisfaction (0-10) was 9.2 (0.8) at the 1-year evaluation.

Conclusion: One-piece monolithic zirconia implant-supported restorations exhibited favourable outcomes over 1 year in situ.

Trial registration: Registered in the National Trial Register (NL9059).

Keywords: digital workflow; implant‐supported; monolithic; restoration; zirconia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Surgical guide with a pilot‐drill metal sleeve inserted.
FIGURE 2
FIGURE 2
CAD/CAM zirconia healing collar.
FIGURE 3
FIGURE 3
(a) Tissue‐level implant with a tapered body, sandblasted, large grit, acid‐etched medium‐rough surface, and 2.0 mm pink anodised implant neck. (b) Close‐up of the implant's 20° internal conical connection.
FIGURE 4
FIGURE 4
Intraoral photograph of a screw‐retained one‐piece monolithic zirconia restoration at the left mandibular first molar after 1 year in function.
FIGURE 5
FIGURE 5
Intraoral radiograph of a tissue‐level implant with a screw‐retained one‐piece monolithic zirconia restoration with an individualised emergence profile at the mandibular left first molar after 1 year in function.
FIGURE 6
FIGURE 6
Line graph illustrating the marginal bone levels (mm) with standard deviation on the mesial and distal side of the implant at the baseline immediately after implant placement (T1) and 1 month (T2) and 1 year (T3) after definitive restoration placement. A negative value indicates bone loss.
See this image and copyright information in PMC

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