Zirconia Dental Implants
It is becoming increasingly common for patients to be aware of the types of materials which they are coming into contact with in addition to the safety of the materials being used. In terms of dental implants, it is ideal to use materials which are the least toxic and reactive. Additionally, it is critical to ensure the implant material is strong, has proven success in a clinical setting, is manufactured by a reputable source, and meets other implant material and design requirements.
A dental implant is a medical device which is often used to replace missing or damaged teeth. Dating back to the 1960s, titanium implants have a standard industry solution. Through the observation of clinical success and innovation over the past few decades, titanium implants are one of the most successful medical devices across medicine. Titanium implants have a 94-97% long-term success rate.
Recent trends are moving towards avoidance of using of metals in the body. Zirconia is an alternative material for titanium which can be used for dental implants. Patients often want to know if zirconia implants are better compared to titanium. Unfortunately, there is no simple answer to this question. In order to make an informed decision, patients first need to understand the potential benefits, limitations, risks, and current data regarding zirconia implants.
Zirconia implants are an alternative solution which can be used instead of titanium implants. While they were originally introduced in 1987, they have gained recent attention due the increasing awareness and interest in holistic and Biomimetic dentistry. Although they are relatively new, these implants are being actively investigated through clinical research trials and rapid manufacturing and design improvements. After receiving approval by the FDA in 2011, zirconia implants have gained momentum across the dental industry. In Europe, these implants have been used for more than a decade and have proven to have great stability and biocompatibility. While they are not suitable for all patients, zirconia implants may a better solution for some patients.
Implants made from zirconia are often presented as a non-metal alternative to a titanium implant. Zirconia is a white ceramic material. Ceramics actually contain both metal and non-metal materials.
Zirconia, which is also called Zirconium dioxide, is a ceramic which contains the elements Zirconium and Oxygen. More specifically, it contains 1 atom of Zirconium and 2 atoms of Oxygen. Zirconium has an atomic number of 40, meaning it is a transitional metal. As a result, Zirconia implants contain metallic atoms of Zirconium, but are not considered a metal because of the metal oxide structure (ZrO2). The inclusion of the oxide modifies the composition structure, name, and behavior.
Zirconia Advantages
For patients who want to pursue dental implants, but want to avoid the use of metal, their only option is zirconia. Because the material is completely inert, it can be a good solution for patients with known metal sensitivities and allergies. In addition, zirconia implants may be more aesthetically attractive as they eliminate the risk visible dark lines around the gums. In the beginning, zirconia implants were only available in a single piece. Two-piece zirconia implants were introduced which allows for the use of customized abutments and helps ensure a successful outcome. Metal-free zirconia implants may also be healthier for the gum tissue as the material has been found to retain lower amounts of plaque and calculus compared to titanium. This is especially true when using a one-piece zirconia implant. Zirconia also has good flexural strength and is superior compared to other types of ceramics in terms of resisting fractures. The material is white in color, has low modulus of elasticity, and low thermal conductivity, making it an attractive option for implants. In clinical studies, zirconia has been found to be equal to or better than titanium with its ability to osseointegrated to the bone. This is based on the high level of contact between the implant and the jaw bone, which allows the bone to fuse with the implant and form a strong base. Zirconia has also demonstrated an excellent ability in resisting corrosion.
Disadvantages of Zirconia Implants
One of the greatest disadvantage of zirconia implants is the low-temperature degradation over time. This has the potential to result reduce the material’s strength, density, and toughness. Unfortunately, there are not many clinical studies available regarding the long-term success of zirconium. In most cases, the failures identified for two-piece dental implants were from aseptic loosening. Because there is limited research regarding two-piece zirconia implants, some dental professionals prefer using one-piece implants. There are some limitations to consider when using these types of systems. There are fewer options for the angulation of the abutment, which can compromise the surgical placement of the implant. In addition, the positioning of a zirconia implant in an undesirable location can have an adverse effect on the material’s physical properties. Single-piece zirconia implants also require a load-free healing period. This can be difficult to achieve in clinical settings.
Because zirconia implants are relatively new, there are limited clinical studies available on the long-term success and viability of the solution. In comparison, titanium dental implants have been studied quite extensively for many years. These studies have resulted in reliable data confirming the long-term use of titanium in implants. Unfortunately, the studies focusing on zirconia implants have only been able to assess survival rates of a few years. The studies which have been conducted related to zirconia have resulted in positive results and demonstrated comparable survival rates to titanium implants. A common complication associated with titanium implants is excess cement. In some cases, it provoked an inflammatory reaction. This complication has not yet been reported with zirconia implants. However, this could be associated with the limited research performed.
It is difficult to answer whether zirconia implants are better than titanium as it can vary based on the patient’s priorities. Titanium has been used for decades, has more data and clinical studies which prove that it a safe and reliable biomaterial to use for dental implants. Zirconia, on the other hand is proving to be a promising alternative option with its reported superior soft-tissue response, biocompatibility, and esthetics compared to titanium implants.