Progress in Science and Education with Ceramics (PROSEC) presented its new non-profit organization and current research projects, and provided an outlook for positioning and further development in an international environment at the 2019 International Dental Show (IDS) in Cologne. With its network of experts and its scientific and education committees, PROSEC is the world’s first independent non-profit organization for new and evidence-based solutions in the field of ceramic implantology and metal-free prosthetics.

A paradigm shift towards metal-free products

An increasing number of patients, find it important to get more than functional and cosmetic treatment. The biocompatibility of the restoration materials that are used is gaining more and more attention. Scientific discussions currently focus particularly on the use of metallic substances such as titanium, for implantology, despite many years of proven clinical success. This is due to the fact that biocorrosion of titanium may play a role in incompatibility. The corrosive properties of titanium are said to be associated with altered cell metabolism. PROSEC is concentrating on this research subject, since the extent of its clinical relevance is not yet clear. Precisely because of the growing number of manufacturers and the increasing demand for ceramic implants, scientific evidence as an outcome of systematic research is necessary to reassure both the implantologists, who will employ them in practice, and the patients that there will be no issues over the long-term clinical course. PROSEC was launched to meet this demand and to develop new insights into the associated possibilities and limitations. Its objective is to implement alternative metal-free substances and their evidence-based clinical use through interdisciplinary PROSEC courses and quality-assured and multi-professional PROSEC learning events, both in the laboratory and in clinical practice.

Top-class Specialist Network

PROSEC is managed and continuously developed by a group of renowned national and international experts, of independent scientists, clinicians and practitioners. Under the auspices of PROSEC, they present exceptional scientific and clinical documentation and objective examination of the current literature and research on ceramic implants and metal-free materials for superstructures. They are the professional companions and trendsetters for a paradigm shift towards all-ceramic and metal-free implants based on scientific evidence and clinical practice. The Scientific Board led by Prof. Dr. Dr. h.c. Jörg Rudolf Strub (Freiburg, Germany) is logically divided into two interdisciplinary specialist committees for the purpose of effective acquisition of knowledge. The objective of the “Science” committee is to advance basic research. Definitive PROSEC Scientific Statements shall be developed from systematic reviews of the literature and evidence-based assessment as clinical recommendations for treatment for their users. The “Science” committee members are Prof. Dr. Christoph Hämmerle (Zurich, Switzerland), Prof. Dr. Barbara Nebe (Rostock, Germany) and Prof. Dr. Wilfried Wagner (Mainz, Germany). The members of the “Clinical Concepts” committee, the objective of which is to develop innovative clinical protocols and treatment concepts and to communicate them as PROSEC Clinical Expert Statements, include Prof. Dr. Florian Beuer (Berlin, Germany), PD Dr. Gerhard Iglhaut (Memmingen, Germany), Prof. Dr. Ronald Jung (Zurich, Switzerland) and Dr. Michael Tholey (Bad Säckingen, Germany).

Groundbreaking program at IDS 2019

Distinguished scientists and practitioners provide the latest information at the IDS Press Conference. Prof. Dr. Dr. Wilfried Wagner reported on the current developments and activities around the PROSEC network. He explained why science and research led by PROSEC are important for establishing new quality standards and forming the bridge between science and clinical practice. Prof. Dr. Florian Beuer presented the core components of research funding, studies that received financial support from the new PROSEC Research Grant and a perspective of international development at PROSEC. Dr. Michael Tholey emphasized the focus on successes and intensification of required multi-professional cooperation among the disciplines involved.

Non-profit organization structure: PROSEC gGmbH

PROSEC is the first established non-profit organization for science and application in ceramic implantology and metal-free prosthetics. Under the leadership of Prof. Dr. h.c. Jörg R. Strub, PROSEC has developed into a recognized network of competencies that has grown consistently since 2015. PROSEC started as a quality initiative of VITA Zahnfabrik, but it is now an independent non-profit organization. As a registered non-profit limited liability company (gGmbH), all funds will be used in the future for non-profit purposes. PROSEC therefore not only sets scientific and clinical standards, but also fulfills its social responsibility by performing targeted research promotion and knowledge transfer. Future activities will include granting targeted research contracts, promoting scientific studies, scientific and clinical symposia and targeted educational events, and supporting and issuing scientific publications on ceramic implantology and metal-free prosthetics.

Comprehensive literature search: zirconium dioxide versus titanium

For example, PROSEC has already commissioned an independent literature review at a DEKRA-certified Contract Research Organization (CRO) to offer practitioners and researchers current scientific core content on oral implantology using ceramic implants. The scientific findings regarding titanium and zirconia implants were systematically compared to one another. The summarized results are available from PROSEC as a complimentary “Documentation Summary“ and offer a brief and basic scientific introduction to the subject.

PROSEC Research Funding

The key objectives of the PROSEC specialist network are to support scientific studies on ceramic and metal-free restorations in implantology by preparing evidence-based scientific literature and through research projects. The PROSEC Research Grant (PRG) was created to provide non-bureaucratic and targeted funding. PROSEC gGmbH awards this grant after an annual call for applications for scientific studies that are in line with the objectives of the PROSEC network of experts. A maximum of EUR 100,000 per application may be granted as a stimulus or as co-financing to scientific projects and clinical research that will run for two years. The financial support enables independent research. The following key subjects can be funded as part of preclinical or clinical studies, or basic research:

  • Ceramic restorations on implants and natural dentition
  • Indications and application strategies for ceramic implants
  • Various biological reactions, particularly those involving other metal-free materials compared to ceramics
  • Biological, mechanical, and dental basic research into metal-free materials
  • Patient-centric comparative outcome studies

The first research proposals have been approved by PROSEC

Various projects applications were submitted for the 2019/2020 funding period. These included basic research projects, preclinical studies and a randomized clinical study. Four projects have already been approved after minor amendments. Noteworthy examples include the randomized, multicenter split-mouth comparative study of titanium and ceramic implants and the elaborate, comparative clinical study of the immunological inflammatory soft tissue reactions using the very latest laboratory analyses. The first major results are expected at the end of the two-year study period, which shall then be continued as a long-term study.

Multi-professional Organizational Structure

The interdisciplinary cooperation between scientists and users initiated and funded by PROSEC shall contribute to highlighting the clinical benefits of ceramic and metal-free materials and creating reliable standards and recommendations for use in dental practices and laboratories. Therefore, the PROSEC network integrates experts from the fields of basic research and dental technology, along with specialists from the field of prophylaxis (dental hygienists and qualified dental assistants) as part of the overall multi-professional concept to ensure that all detailed aspects of treatment and follow-up care are included in the scientific findings, recommendations and research projects. PROSEC research is conducted by three working groups where PROSEC

Partners who focus on various aspects cooperate:

  • Working Group 1: “Hard and soft tissue stability”
  • Working Group 2: “Restorative dentistry and dental technology with ceramic and metal-free materials“
  • Working Group 3: Advanced development of ceramic hardware

The active members in the working group will meet again at the PROSEC Expert Partner Workshop that takes place in the fall to discuss and agree on their new research questions and projects. The next PROSEC Symposium for those focused on continuing education will take place on January 17, 2020. The latest scientific outcomes on ceramic implantology and metal-free prosthetic treatment will be presented during this event.

PROSEC goes international

PROSEC has been active in German-speaking countries for three years. The subject of ceramic implantology and metal-free prosthetics is also of interest to international researchers, clinicians, practitioners and patients. This has been become apparent by the great worldwide interest in PROSEC, which has spread among experts and patients. World-renowned experts and scientists want to be involved in future PROSEC activities. As such, the next logical step would be to expand our commitment at the international level. In addition to the integration of other European countries, PROSEC will also generate new partnerships in Asia, and immediately followed by the USA. Additional regions will follow gradually, to cooperatively assemble and consolidate global knowledge and future international research under the auspices of PROSEC. From a long-term view, PROSEC will position itself on the international stage to advance the paradigm shift to ceramic implantology and metal-free prosthetics with concentrated skills and power.