Zirconia Dental Implants
Patients are becoming more and more aware of what kind of materials they are coming into contact with and the safety associated with the types of materials being used. Dentistry is no exception to this. When it comes to dental implants, materials which are non-toxic and not reactive should be used. It is also vital to ensure the material being used for the implant is strong, successful over time, has reputable manufacturing, and meets other implant material and design standards.
Dental implants are medical devices which are commonly used to replace missing or severely damaged teeth. Titanium implants have been a standard solution since the early 1960s. As a result of their clinical success and rapid innovation over time, titanium implants have proven to be one of the most successful medical devices through medicine. Titanium implants have an impressive long-term success rate of 94-97%.
Based on recent trends, there is a popular movement to avoid the use of metals in the body. Zirconia is a popular alternative to titanium for use in dental implants. A common question patients have is whether zirconia implants are better than titanium. There is unfortunately no easy way to answer this question. It is important for patients to have a good understanding of the potential benefits, limitations, risks, and current data regarding zirconia implants and how they compare to their titanium counterparts.
Zirconia implants are a popular alternative solution to titanium implants. After originally being introduced in 1987, zirconia implants have gained increased attention based on a growth in awareness and interest in Biomimetic and holistic dentistry. While this type of implant is relatively new, they are actively being pursued through clinical research and improvements to both the manufacturing and design. Following their 2011 approval by the FDA, zirconia implants have continued to gain momentum in the dental industry. However, these implants have been used in Europe for over a decade. Over time, they have proven to be a stable and biocompatible solution. Not all patients are good candidates for zirconia implants, however they may an excellent solution for some.
When implants are created from zirconia, they are presented as being a non-metal alternative to titanium implants. Zirconia is a ceramic material which is white and contains both metal and non-metal components.
Zirconia, which is also known as Zirconium dioxide, is a ceramic containing Oxygen and Zirconium. It specifically contains 1 atom of Zirconium and 2 atoms of Oxygen. Zirconium has an atomic number of 40, which makes it a transitional metal. Because of this, Zirconia implants actually contain metallic atoms from the Zirconium, however, it is not technically considered a metal due to the metal oxide structure (ZrO2). Because oxide is included, it modifies the structure, name, and behavior of the composition.
Advantages of Zirconia
When a patient is considering dental implants as a tooth replacement solution, but they want to avoid using metal in their mouth, zirconia is actually their only option. The material is completely inert. Meaning it is a good solution for patients with known allergies or sensitivities to metal. Zirconia implants may be more aesthetically pleasing as they eliminate the risk of visible dark lines which can appear around the gumline.
When they were first introduced, zirconia implants were only available to patients as a single piece unit. Two-piece zirconia implants were more recently introduced which allowed for using customized abutments. This aids in ensuring a successful outcome of the implant procedure. Zirconia implants may also be healthier for the gum tissue. The material was found to retain reduced levels of plaque and calculus when comparing it to titanium. This is particularly the case when a one-piece zirconia implant was used. Zirconia also has be found to have good flexural strength. It is far superior when compared to other types of ceramics in its ability to resist fractures. The material is also naturally white in color, has low modulus of elasticity, and low thermal conductivity. Each of these aspects make it a great option for use in implants. In the early clinical studies, zirconia was equal to or superior to titanium with its ability to osseointegrated or successfully fuse to the bone. This is based on the high level of contact between the implant and the jaw bone. Allowing the bone to fuse with the implant and ultimately form a strong and secure base for the crown. Zirconia also demonstrates the ability to resist corrosion.
Zirconia Implants Disadvantages
One of the most prevalent disadvantage associated with zirconia implants is a low-temperature degradation as it ages. This can possibly reduce the strength, density, and toughness of the material. There are unfortunately limited clinical studies regarding the long-term success of zirconium.
In most cases, the failures which were observed for two-piece zirconia implants were due to aseptic loosening. The limited research regarding two-piece zirconia implants has resulted in some dental professionals preferring the use of one-piece implants.
There are some limitations which should be considered when using single piece zirconia implants. For example, there are fewer abutment angulation options available. This can compromise the surgical placement of the implant and overall success of the procedure. When the zirconia implant is positioned in a less than undesirable location, it can have negatively impact the physical properties of the material. Single piece zirconia implants also require a load-free healing period, which can be difficult a difficult task in a clinical setting.
Due to their relatively new introduction, there are limited clinical studies available on the long-term success, life expectancy, and viability of zirconia implants. Titanium dental implants, in comparison, have been extensively studied for decades. These studies have provided reliable data which confirms the success and use of titanium implants over long periods of time. The studies which focuse on zirconia implants, have unfortunately been limited in their ability to monitor the survival rates of more than a few years.
While they are limited, the studies which have been conducted on zirconia have resulted in positive results and demonstrated similar survival rates to implants made of titanium. Excess cement is a common complication affiliated with titanium implants, which may cause an inflammatory reaction. There have been no reports of this complication with zirconia implants, however, this could be a result of the limited data.
While it is challenging to answer the question of whether zirconia implants are better than titanium, the goal of this article is to review the advantages, disadvantages and data regarding both solutions. At the end of the day, the ideal solution will vary based on the priorities and goals of each patient. Titanium has been in use for many decades. There has also been more data collected on titanium which prove it as a safe and reliable material to be used in implants. In comparison, zirconia is proving to be a promising non-metal alternative.