CASE REPORT Replacement of congenically missing maxillary permanent canine with a zirconium oxide dental implant and crown. A case report from an ongoing clinical study X. Oliva, J. Oliva & J.D. Oliva Clinica Oliva, Granollers, Barcelona, Spain Abstract This article describes a case report of an ongoing clinical investigation with zirconium oxide (ZrO2) dental implants. The patient was a young female who was missing an upper right canine. A one-piece (implant + abutment) ZrO2 implant (CeraRoot) with acid-etched surface (ICE surface ® ) was implanted. The preoperative situation was ideal in terms of soft tissue and bone preservation, and the surgery was done transmucosally without having to raise a flap. The soft tissue healed successfully around the implants within few days. The case was finally restored with a ZrO2 crown (CeraCrown) and ceramic characterisation. Key words: acid-etched, agenesia, implant, rough, zirconium oxide, zirconia Correspondence to: Dr. Xavi Oliva Clinica Oliva Josep Umbert, 126 08402 Granollers Barcelona Spain Tel.:+34 609815378 Fax: +34 938792373 email: laclinica@clinicaoliva.com Accepted: 11 August 2008 doi:10.1111/j.1752-248X.2008.00029.x Clinical relevance Today, it is accepted that zirconium oxide is a highly biocompatible material and it is being used in restor- ative dentistry for many years. The scientific evidence shows that zirconium oxide dental implants osseointe- grate well, but the relative smooth surface of this material osseointegrate with lower bone-to-implant values compared with roughened surface titanium implants. Acid-etched zirconium oxide dental implants have a novel rough surface that is being clinically studied with promising results. This article is a case report of an ongoing clinical study with zirconium oxide dental implants. Introduction The material of choice for dental implants is commer- cially pure titanium because of its well-documented biocompatibility and suitability for tooling. This bio- compatible material 1 has been used for about 30 years as implant substrate and has shown high success rates 2 .A possible alternative to titanium might be tooth-coloured materials such as ceramics 3,4 . Ceramic materials are highly biocompatible and can be used as dental devices 5 . One ceramic material that has been used in the past as dental implants is aluminium oxide (Al2O3). This was the so-called Tübingen implant made by Frialit (Dentsply-Friadent, Germany) 6–8 . This material appar- ently osseointegrated well but did not have sufficient mechanical properties for long-term loading, and the product was withdrawn from the market. Recently, another ceramic material with potential for future use as dental implant material was introduced. Zirconia as a metal substitute possesses good phy- sical properties, like a high flexural strength (900– Source of funding: This case report is part of an ongoing clinical study (Oliva et al. 2007) supported by Oral Iceberg s.l. Conflict of interest: Drs Oliva are clinical advisors of Oral Iceberg s.l. Oral Surgery ISSN 1752-2471 140 Oral Surgery 1 (2008) 140–144. © 2008 The Authors Journal compilation © 2008 Blackwell Munksgaard