ZERAMEX® XT Tapered Ceramic Implant placed in Narrow Ridge

Zeramex Xt

Treatment planning and surgical placement of the FDA approved ceramic dental implant ZERAMEX® XT by Dr. Alvaro Ordonez.

In this case, Dr. Alvaro Ordonez grafts a large defect utilizing cortical cancellous bone and a membrane prior to placement of the ceramic implant. He uses the Versah Osseodensification burs with a tapered design to match the implant shape. A lot of attention was paid to proper suture of the delicate soft tissue.

Case Report

This patient appeared in my office with a severely compromised tooth at #8. At the time, the patient was not ready for an implant and the decision was made to extract the tooth with the intent to place an implant at a later date. The tooth was carefully extracted using luxators to preserve the soft tissue surrounding the socket. A crestal incision was made from tooth #9 to #7 with a partial pocket flap. The defect was filled with cortical cancellous bone and covered with a PTFE membrane.

After 4 months the patient was eager to proceed with the implant. 2D and 3D scans were used for treatment planning of the case and the decision was made to select a ZERAMEX XT tapered, ceramic implant. A full flap was done to take full view of the hard tissue situation. Utmost care was taken to preserve the soft tissue. Bone density and ridge width were enhanced in this case by utilizing the osseodensification burrs by Verah.

We worked our way through the drilling sequence and finished with the final drill from the ZERAMEX XT Tapered kit to precisely match the shape and diameter of the implant. The implant was placed .6mm supracrestal and excellent primary stability was obtained. The implant with protected with the cover screw provided with the implant. Once again extreme attention was paid to the soft tissue. I enhanced the site with additional cortical cancellous particulate and covered with a resorbable collagen membrane. Final suturing was done with 4.0 PTFE with considerable attention again paid to maintaining the soft tissue.

I will soon come back and share the final outcome. We will take a fixture level impression and send a ZERAMEX zirconia abutment to the lab and a final crown will be connected to the implant using the VICARBO® screw. I am eager to share the results of this challenging case.

Dr Ordonez has been working with ceramic implants since 2005. In his practice ceramic are used as alternative titanium especially for patients requesting a natural and organic solution for missing teeth.

 – Dr. Ordonez is not affiliated with any of the products mentioned in this case –


Zeramex Xt

Dr. Alvaro Ordonez is a trained expert and professor on Temporomandibular disorders, dental occlusion and Orofacial Pain. He was trained at the Gelb Craniomandibular and Orofacial pain Center at Tufts University in Boston, Ma By Noshir Mehta, Albert Forgione and Harold Gelb. He is a recognized expert in the diagnosis, treatment and long term management of TMD that has been refractory to conventional, conservative and surgical treatment.

His field of practice is related to advanced implant dentistry and cosmetic reconstruction of dentitions that have been destroyed by parafunctional habits like clenching and grinding.

Dr. Ordonez is a well known international speaker in the fields of dental implants, TMD, dental occlusion and facial pain. His involvement in the dental community as an expert and educator has span through out his career from the moment he began as a dental student. He teaches and lectures regularly at the University of Florida and the Veterans Hospital in Miami. He teaches residents the clinical and academic aspects of TMD, Dental occlusion and facial pain. He has been an honored guest speaker at the Miami Childrens Hospital, the University of Miami, and the Jackson Memorial Hospital, as well as a professor at both Tufts University and Nova Southeasten University. As a result, he has been recognized by many educational institutions and dental societies.


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Implant Tribune

Spotlight on ZERAMEX®XT for the month of April 2020