Zirconia Dental Implants
Over time, patients have become more concerned with the type of materials they are coming into contact with and what is going into their bodies. In addition, patients want to know how these various materials may impact their health and safety over time. When selecting which type of dental implants should be used, it is important to use materials which are the least reactive and least toxic. To ensure the longevity of an implant, it is also important to evaluate the strength, success rates, manufacturer, and other factors related to the design.
In recent years, there has been a growing trend of working towards avoiding the use of metals in our body. For dental implants specifically, zirconia is an alternative material which can be used rather than titanium. Patients who are especially conscious of their health often ask if zirconia dental implants are superior to their titanium counterparts. Unfortunately, there is no simple answer to this question. It is important for patients to first understand the benefits, limitations, risks, and current data related to zirconia dental implants.
A dental implant is a medical device which is often used to replace missing or damaged teeth. Titanium has been an industry standard and used with dental implants dating back to the 1960s. Titanium implants have seen incredible success and innovation over time. They are one of the most successful medical devices in all of medicine. The impressive long-term success rates of implants ranges from 94-97%.
Zirconia dental implants were approved by the FDA in 2011 and have gained popularity over the past decade. While not all patients are candidates for zirconia implants, they may be an excellent choice in some situations. Zirconia implants were first introduced in 1987 as an alternative to titanium implants. In recent years, they have gained attention based on a growing demand for Biomimetic and holistic dentistry. Because of their relatively recent introduction to the industry, research and improvements are continuing to improve zirconia implants.
Zirconia dental implants are often presented as a non-metal alternative to traditional implants made from titanium. Zirconia is a ceramic material and white in color. Ceramics actually contain both metals and non-metals. Zirconia, or Zirconium dioxide, is a ceramic which contains the elements Zirconium and Oxygen. Specifically, it contains 1 atom of Zirconium and 2 atoms of Oxygen. Zirconium has an atomic number of 40, which means it is a transitional metal. While zirconia implants do contain metallic atoms of Zirconium, they are not actually considered a metal because of the metal oxide structure. This is due to the inclusion of the oxide, which changes the composition structure, behavior, and name.
Zirconia and Titanium Implants
When comparing zirconia and titanium implants, it is challenging to say which one is better. The optimal implant will vary based on the patient’s individual priorities. Because titanium has been around for quite a while, there is more data, studies, and decades of evidence which confirms that it is a successful biomaterial to be used for dental implants.
Zirconia, however, is proving to be a promising alternative. Based on data gathered, it is reported to have superior soft-tissue response, biocompatibility, and esthetics when compared to titanium implants.
In addition, studies have demonstrated that titanium and zirconia implants have a similar Osseointegration or ability to fuse to the bone. This is critical in determining the success and stability of the implant.
Zirconia Implant Benefits
When a patient wants to pursue dental implants, but is concerned with using a metal product, their only option is zirconia. For patients who have known metal allergies or sensitivities, this material is completely inert and may be a good solution. Zirconia implants are also aesthetically attractive as they do not expose any dark lines near the gum. When they were originally introduced, zirconia implants were only available as a one-piece implant. However, two-piece zirconia implants are now available and allows for a customized abutment, which helps ensure a positive outcome. Zirconia implants may also be healthier for gum tissue as it retains less plaque and calculus compared to titanium. This is especially true when using a one-piece zirconia implant. Zirconia also has a good flexural strength. It is superior compared to other ceramic solutions in its ability to withstand fractures. Zirconia is white in color, has a low modulus of elasticity, and low thermal conductivity, all making it a very attractive solution and offering natural results. In terms of osseointegration, clinical studies are suggesting that zirconia is equivalent or better compared to titanium.
Zirconia Implants Disadvantages
A major disadvantage associated with zirconia implants is a low-temperature degradation over time. This can cause the mechanical properties of the material to slowly become degraded, which reduces the strength, density, and overall toughness of the material. Because of their relatively recent introduction, there are limited clinical studies regarding the longevity and long-term success of zirconia implants. Most of the reported failures with two-piece implants were caused by aseptic loosening. Because of the limited research associated with two-piece zirconia implants, some providers prefer using one-piece dental implants. However, it is important to consider the limitations of these types of systems. Another drawback associated with zirconia implants is the limited options for abutment angulation. This can potentially compromise the surgical positioning of the implant. When a zirconia implant is positioned in an undesirable location, in can have a negative effect on the physical properties of the material. When single-piece zirconia implants are used, a load-free healing period is required. In some cases, this is difficult to achieve.
Because zirconia dental implants are still relatively new, there is limited availability of clinical studies which prove the long-term success and viability of the implants. Titanium implants in comparison, have undergone extensive studies dating back decades. Reliable data is available for titanium implants which boasts their longevity and impressive success rates. Studies associated with zirconia implants is only able to review survival rates of a few years. When the studies are conducted on zirconia, they produce optimistic results which are equivalent with titanium implants. Excess cement has been a common complication associated with titanium implants as it can cause an inflammatory reaction. There have not been reports yet of this issue with zirconia implants. It is unclear if this is associated with zirconia high biocompatibility or due to the limited research.
For patients who are considering zirconia implants, be sure to discuss this with your dentist and weigh the pros and cons of each solution. There are various factors which may impact a patient’s decision which should be considered.