On Healthy Oral Rehabilitation

Eliminating Peri-implantitis with Zirconia Implants


Dr. Sofia Karapataki is a Greece-based implantologist, who maintains a private practice in Athens, where she focuses on healthy oral rehabilitation by means of zirconia dental implants. She holds a degree in Dentistry from the School of Dentistry of the National and Kapodistrian University of Athens and received her specialty degree in Periodontics – Implantology at the Institute for Postgraduate Dental Education of Jönköping University in Sweden. She attended a postgraduate program in periodontology which also included oral surgery, implant surgery and prosthetics, perio-prosthetics and general pathology, and received an M.Sc. at the University of Gothenburg in Sweden.

In collaboration with the University of Graz, Austria, Dr. Sofia Karapataki is currently preparing the publication of a landmark retrospective study that delivers promising results regarding the long-term performance of the Patent™ Dental Implant System. She has amassed data on over 90 inserted Patent™ implants over a functional period of five to 12 years. The patient group included medically compromised patients with a wide spectrum of health profiles. The study group reflected the “average patient” in the current Greek/Austrian population that initially selected tooth replacement as a therapy to resolve tooth loss due to periodontal disease. Despite the challenging intra-oral conditions, the Patent™ Implants maintained stable marginal bone and soft tissue levels throughout the study period. Also, even after 12 years in function and less than ideal oral hygiene, none of the documented implants showed signs of peri-implantitis – this is proof that Patent™ is the perfect solution when it comes to offering patients long-term healthy oral rehabilitation with dental implants.

Dr. Karapataki, you are an active proponent of long-term healthy oral rehabilitation by means of metal-free implants, and we see that your practice is specialized in this regard. Do most of the patients in your region gravitate towards this kind of dental treatment? 

Typically, new patients who visit my practice are not specifically looking for metal-free solutions but rather for a dental treatment to solve their oral health issues. This is changing, however, with all the information that exists on the internet and the steadily increasing number of people who are interested in their health and consciously looking for alternative treatment solutions. Unfortunately, according to the website of the European Commission on Public Health, the adult Greek population has one of the highest smoking rates in Europe and one of the highest rates of obesity too. These two significant health conditions pose grave challenges when it comes to resolving an oral disease like periodontitis and subsequent tooth loss. It is mainly for this reason that I am eager to reduce each patient’s toxicity profile the best I can and to promote a healthy oral rehabilitation of his or her condition.

Speaking of healthy oral rehabilitation: What does it mean to rehabilitate patients in a healthy way? Aren’t dental treatments always healthy?

Naturally, traditional dentistry intends to heal and improve oral health. However, now that we have significant evidence regarding the long-term effect of certain metals and materials used in dentistry, we have to be aware that long-term exposure to some materials has undesired negative impacts on the immune and systemic health of some our patients. This view is backed, for instance, by a 2013 study by Dr Elisabeth Jacobi-Gresser et al., in which the authors report that microparticles released by titanium implants affect the immunological mechanism of the body and can possibly initiate peri-implantitis. With regard to our average patients who come to see us and who have lifestyle-related risk factors, we have to find ways to lower their toxicity profile or even eliminate their toxin exposure and to bolster their overall systemic health to overcome such long-term complications.
Dr. Sofia Karapataki received the 2021 GHP Award “Most Influential Female in Dentistry in Greece”. When treating her patients, she uses only the best of the best materials. No wonder that she relies on the Patent™ Dental Implant System. Science proves her right: In a retrospective long-term study at the University of Graz, she observed over 90 inserted Patent™ Implants over a functional period of up to 12 years. With impressive results: Even after 12 years, none of these showed signs of peri-implantitis.
Implantologist Dr. Sofia Karapataki: Healthy Oral Rehabilitation and eliminating peri-implantitis with Zirconia implants

You specialize in periodontics and implantology. What’s your treatment approach to replacing missing teeth?

I have been placing dental implants for the last 27 years. I learned about zirconia implants ten years ago, and I’ve been placing only zirconia implants for the last eight years. During and after my implantological training in Sweden, I replaced missing teeth primarily with titanium implants. In spite of all my efforts to follow up and maintain my dental implant patients, unfortunately I was faced with the occurrence of peri-implant inflammation and—in the worst cases—peri-implantitis on a regular basis. No matter how thorough my follow-up and post-treatment maintenance was, it seemed inevitable that, with a growing patient pool, the frequency of these problems would increase too over time. This, combined with my personal interest in understanding the immunological behavior of patients in response to various dental materials, has led to me using zirconia implants only, and the Patent™ Dental Implant System in particular.

What makes a zirconia implant healthy in your eyes? 

Zirconia is a ceramic material devoid of any metal properties. It is electrochemically inert, causing no galvanizing nor electrical current negative effects at an inter- or intracellular level. It is a fully bio-inert material and the most biocompatible implant material that is currently available on the market, and no allergies to or intolerances of it have been reported. The material as such exhibits lower surface free energy, which leads to reduced biofilm accumulation, which is the basis for plaque formation. The lower levels of bacterial accumulation result in better soft- and hard-tissue adaptation, not only making the surrounding tissue look healthier and more aesthetic, but also allowing for long-term healing stability and predictability.
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Your upcoming publication will present long-term results regarding the peri-implant health around zirconia implants. What can you tell us about that? 

For roughly the last eight years, I have been treating my patients exclusively with the Patent™ Dental Implant System. This implant possesses some special features in terms of its design and production, which have been really helpful in the treatment of my patients. Beyond the implants that I place myself in my private practice, I have been following over 90 Patent™ implants for five to 12 years of function in collaboration with Dr Harald Fahrenholz from Vienna, and I’ve been meticulously tracking the soft-tissue performance around them. In addition to their highly reliable osseointegration, I discovered significant soft-tissue benefits and stability over this period. I am excited about my collaboration with the University of Graz, which has reviewed my data and concluded that there is compelling evidence that zirconia offers long-term health benefits for all types of patients who are looking for tooth replacement solutions. The results will be published this year under the title “Results of zirconia implants after 5 years and up to 12 years of clinical performance—a retrospective study”.

What advice would you give young dentists who are just starting their journey in implantology? 

I would advise young implantologists to pay attention to the integrity of the research that supports the clinical choices that they are making. They should scrutinize the material that product manufacturers provide to them and take an in-depth look at peer-reviewed long-term clinical evidence to give them an indicator of what they can expect when their patient base starts to grow. I think it’s important to challenge the claims that are being made and to make sure that one can offer the highest standards of quality and safety to one’s patients. Also, implantologists should always follow the manufacturer’s surgical protocols for the implant systems that they are using.

Ultimately, one has to help patients to become healthier, and one can only do this with products that are not only scientifically proven but also safe for the whole of the human body. As dental professionals it is our responsibility to always think about what our decisions mean for the long-term health of our patients. I therefore urge my colleagues to start using implant materials that are as healthy for our patients in the long run as they can possibly be.

How to successfully prevent Peri-implantitis